World Oral Health Day: Chewing betel nuts, smoking... these high-risk behaviors that cause oral cancer should be stopped!

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"Betel nut with cigarettes makes you as happy as a god", "Betel nut with wine, the more you drink, the better" - you must have heard a lot of such sayings.

In southern my country, betel nut is a popular food. According to statistics, the number of consumers of finished betel nut in my country exceeds 60 million. However, this small betel nut is a "time bomb" that causes oral cancer.

In 2022, 36-year-old male singer Fu Song released a video of himself developing oral cancer due to chewing betel nuts, and showed his left face ulcerated due to oral cancer, which was shocking.

(Photo source: Sina Weibo @Sina Entertainment)

According to the data of the National Cancer Center based on tumor registration and follow-up monitoring, there were 65,100 new cases of oral cancer and 35,200 deaths in my country in 2022. It can be seen that oral cancer is not far away from us. Oral cancer patients not only have to endure the pain of cancer, but also have to endure the difficulties in eating, speaking, and facial ulcers, which seriously affect their quality of life. So, what can we do to prevent oral cancer?

A study was published in Science magazine, which conducted a comprehensive analysis of the incidence and related factors of 32 types of cancer based on massive data collected from 69 countries covering 4.8 billion people. It was found that 70.8% of oral cancer was caused by external factors.

So, what are the external factors that can cause oral cancer?

Based on the tumor incidence data of 22 provinces, four municipalities and five autonomous regions in China, the National Cancer Center conducted an attribution analysis on 23 common potentially controllable risk factors in the population and found that the behavioral factors related to oral cancer are smoking and drinking, and the dietary factors related to oral cancer are low intake of fruits and vegetables.

At the beginning, we mentioned that chewing betel nut can also cause oral cancer. Betel nut is recognized as a Class I carcinogen by the International Agency for Research on Cancer. The arecoline contained in betel nut can itself cause mucosal cancer. Chewing betel nut can also cause a precancerous lesion in the oral cavity, namely oral submucosal fibrosis, which may transform into cancer.

In clinical work, we often see cases where residual roots, residual crowns and inappropriate dentures cause long-term stimulation to the oral mucosa, leading to traumatic ulcers and eventually cancer. We also see some cases of potential malignant diseases of the oral mucosa becoming cancerous.

The key to preventing oral cancer is to control risk factors. Currently recognized risk factors for oral cancer are: smoking, drinking, chewing betel nut and local trauma to the oral cavity. Lip cancer is related to long-term exposure to sunlight. Therefore, to reduce the risk of oral cancer, the following points should be achieved:

1. Don’t smoke, drink less, and don’t chew betel nuts.

2. Treat the affected teeth promptly, remove residual roots and crowns, and adjust ill-fitting dentures in a timely manner to reduce local irritation factors.

3. Avoid prolonged exposure to sunlight and pay attention to sun protection when engaging in outdoor activities.

4. Timely diagnosis and treatment of potential malignant diseases of the oral mucosa. Patients with oral erythema, oral leukoplakia, oral lichen planus and oral submucosal fibrosis must go to the oral mucosal department for treatment.

5. Have regular oral examinations, preferably every six months, and at least once a year.

In addition to the above points, you should also pay attention to oral hygiene, eat a balanced diet, and especially increase the intake of vegetables, fruits and whole grains, which are rich in fiber, vitamins and minerals, and help maintain oral health. In short, by taking active preventive measures, you can reduce the risk of oral cancer, maintain oral health, and ensure that you can chew food effectively, speak clearly and have a bright smile.

Author: Sun Zheng, consultant of the Chinese Stomatological Association and chief physician of Beijing Stomatological Hospital affiliated to Capital Medical University

Review | Si Yan, a researcher at the Chinese Stomatological Association and chief physician at Peking University School of Stomatology