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Gil GF, Anderson JA, Aravkin A, Bhangdia K, Carr S, Dai X, Flor LS, Hay SI, Malloy MJ, McLaughlin SA, Mullany EC, Murray CJL, O'Connell EM, Okereke C, Sorensen RJD, Whisnant J, Zheng P, Gakidou E. Health effects associated with chewing tobacco: a Burden of Proof study. Nat Commun 2024; 15:1082. [PMID: 38316758 PMCID: PMC10844244 DOI: 10.1038/s41467-024-45074-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 01/15/2024] [Indexed: 02/07/2024] Open
Abstract
Chewing tobacco use poses serious health risks; yet it has not received as much attention as other tobacco-related products. This study synthesizes existing evidence regarding the health impacts of chewing tobacco while accounting for various sources of uncertainty. We conducted a systematic review and meta-analysis of chewing tobacco and seven health outcomes, drawing on 103 studies published from 1970 to 2023. We use a Burden of Proof meta-analysis to generate conservative risk estimates and find weak-to-moderate evidence that tobacco chewers have an increased risk of stroke, lip and oral cavity cancer, esophageal cancer, nasopharynx cancer, other pharynx cancer, and laryngeal cancer. We additionally find insufficient evidence of an association between chewing tobacco and ischemic heart disease. Our findings highlight a need for policy makers, researchers, and communities at risk to devote greater attention to chewing tobacco by both advancing tobacco control efforts and investing in strengthening the existing evidence base.
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Affiliation(s)
- Gabriela F Gil
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Jason A Anderson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Aleksandr Aravkin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
- Department of Applied Mathematics, University of Washington, Seattle, WA, USA
| | - Kayleigh Bhangdia
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Sinclair Carr
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Xiaochen Dai
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Luisa S Flor
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Matthew J Malloy
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Susan A McLaughlin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Erin C Mullany
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Christopher J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Erin M O'Connell
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Chukwuma Okereke
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Reed J D Sorensen
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Joanna Whisnant
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Peng Zheng
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Emmanuela Gakidou
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA.
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Shieu M, Ho H, Lin S, Lo Y, Lin C, Chuang Y, Hsieh M, Chen M. Association of KMT2C Genetic Variants with the Clinicopathologic Development of Oral Cancer. IJERPH 2022; 19:3974. [PMID: 35409657 PMCID: PMC8997509 DOI: 10.3390/ijerph19073974] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 11/17/2022]
Abstract
Lysine methyltransferase 2C (KMT2C) is a tumor-suppressor gene in several myeloid cells and epithelia and is linked with blood and solid tumor cancers. KMT2C single-nucleotide polymorphisms (SNPs) are also connected with several cancer types. Our study aimed to explore the potential genetic polymorphisms of KMT2C in oral cancer. Five KMT2C SNPs, including rs201834857, rs4725443, rs6464221, rs74483926, and rs6943984, were evaluated in 284 cancer-free controls and 284 oral squamous cell carcinoma (OSCC) cases. We found that individuals with the TC genotype or TC + CC genotype of rs4725443 had a higher risk of oral cancer incidence than those with the TT genotype. Further analysis of KMT2C SNP rs4725443 revealed that the TC + CC genotype of rs4725443 was associated with a significantly advanced tumor stage in the non-alcohol-drinking population. Moreover, the TC + CC genotype of rs4725443 was connected with poor cell differentiation in the alcohol-drinking population. Through analyzing a dataset from The Cancer Genome Atlas (TCGA), we found that reduced KMT2C levels were associated with advanced tumor stage, lymph node invasion, and poor cell differentiation in head and neck squamous cell carcinomas. Our data suggest that KMT2C SNP rs4725443 is a potential genetic marker for oral cancer patients in both non-alcohol-drinking and alcohol-drinking populations.
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Mohammadi H, Roochi MM, Sadeghi M, Garajei A, Heidar H, Ghaderi B, Tadakamadla J, Meybodi AA, Dallband M, Mostafavi S, Mostafavi M, Salehi M, Sadeghi-Bahmani D, Brand S. Association of N-acetyltransferases 1 and 2 Polymorphisms with Susceptibility to Head and Neck Cancers-A Meta-Analysis, Meta-Regression, and Trial Sequential Analysis. Medicina (Kaunas) 2021; 57:medicina57101095. [PMID: 34684132 PMCID: PMC8541135 DOI: 10.3390/medicina57101095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/01/2021] [Accepted: 10/09/2021] [Indexed: 11/23/2022]
Abstract
Background and objective:N-acetyltransferases 1 and 2 (NAT1 and NAT2) genes have polymorphisms in accordance with slow and rapid acetylator phenotypes with a role in the development of head and neck cancers (HNCs). Herein, we aimed to evaluate the association of NAT1 and NAT2 polymorphisms with susceptibility to HNCs in an updated meta-analysis. Materials and methods: A search was comprehensively performed in four databases (Web of Science, Scopus, PubMed/Medline, and Cochrane Library until 8 July 2021). The effect sizes, odds ratio (OR) along with 95% confidence interval (CI) were computed. Trial sequential analysis (TSA), publication bias and sensitivity analysis were conducted. Results: Twenty-eight articles including eight studies reporting NAT1 polymorphism and twenty-five studies reporting NAT2 polymorphism were involved in the meta-analysis. The results showed that individuals with slow acetylators of NAT2 polymorphism are at higher risk for HNC OR: 1.22 (95% CI: 1.02, 1.46; p = 0.03). On subgroup analysis, ethnicity, control source, and genotyping methods were found to be significant factors in the association of NAT2 polymorphism with the HNC risk. TSA identified that the amount of information was not large enough and that more studies are needed to establish associations. Conclusions: Slow acetylators in NAT2 polymorphism were related to a high risk of HNC. However, there was no relationship between NAT1 polymorphism and the risk of HNC.
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Affiliation(s)
- Hady Mohammadi
- Department of Oral and Maxillofacial Surgery, Fellowship in Maxillofacial Trauma, Health Services, Kurdistan University of Medical Sciences, Sanandaj 6617713446, Iran;
| | - Mehrnoush Momeni Roochi
- Department of Oral and Maxillofacial Surgery, Fellowship in Maxillofacial Trauma, School of Dentistry, Tehran University of Medical Sciences, Tehran 1439955991, Iran; (M.M.R.); (A.G.); (H.H.); (M.S.)
| | - Masoud Sadeghi
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran 1477893855, Iran;
| | - Ata Garajei
- Department of Oral and Maxillofacial Surgery, Fellowship in Maxillofacial Trauma, School of Dentistry, Tehran University of Medical Sciences, Tehran 1439955991, Iran; (M.M.R.); (A.G.); (H.H.); (M.S.)
- Department of Head and Neck Surgical Oncology and Reconstructive Surgery, The Cancer Institute, School of Medicine, Tehran University of Medical Sciences, Tehran 1439955991, Iran;
| | - Hosein Heidar
- Department of Oral and Maxillofacial Surgery, Fellowship in Maxillofacial Trauma, School of Dentistry, Tehran University of Medical Sciences, Tehran 1439955991, Iran; (M.M.R.); (A.G.); (H.H.); (M.S.)
| | - Bayazid Ghaderi
- Cancer and Immunology Research Center, Department of Internal Medicine, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj 6617913446, Iran;
| | - Jyothi Tadakamadla
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD 4222, Australia;
| | - Ali Aghaie Meybodi
- Department of Head and Neck Surgical Oncology and Reconstructive Surgery, The Cancer Institute, School of Medicine, Tehran University of Medical Sciences, Tehran 1439955991, Iran;
| | - Mohsen Dallband
- Department of Oral and Maxillofacial Surgery, Dental School, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran 1983963113, Iran;
| | - Sarton Mostafavi
- English Department, Baneh Branch, Islamic Azad University, Baneh 6691133845, Iran;
| | - Melina Mostafavi
- Tehran Medical Branch, Islamic Azad University, Tehran 1419733171, Iran;
| | - Mojtaba Salehi
- Department of Oral and Maxillofacial Surgery, Fellowship in Maxillofacial Trauma, School of Dentistry, Tehran University of Medical Sciences, Tehran 1439955991, Iran; (M.M.R.); (A.G.); (H.H.); (M.S.)
| | - Dena Sadeghi-Bahmani
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran;
- Center for Affective, Stress and Sleep Disorders, University of Basel, Psychiatric Clinics, 4001 Basel, Switzerland
- Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
- Department of Psychology, Stanford University, Stanford, CA 94305, USA
| | - Serge Brand
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran;
- Center for Affective, Stress and Sleep Disorders, University of Basel, Psychiatric Clinics, 4001 Basel, Switzerland
- Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
- Division of Sport Science and Psychosocial Health, Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
- School of Medicine, Tehran University of Medical Sciences, Tehran 1416753955, Iran
- Correspondence:
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