Muttagi Sidramesh Shivanand, Chaturvedi Pankaj, Gaikwad Rohith, Singh Bikramjit, Pawar Prashant
Department of Surgical Oncology, Head Neck Services, Tata Memorial Hospital, Dr. Ernst Borges Marg, Parel, Mumbai, Maharastra, India.
Indian J Med Paediatr Oncol. 2012 Jan;33(1):32-5. doi: 10.4103/0971-5851.96966.
Head and neck squamous cell carcinoma (HNSCC) is an important public health problem in India. Several risk factors such as tobacco, human papilloma virus, alcohol, areca nut usage have been extensively studied as causative agents. Though Areca nut chewing is known cause of oral cancer, its association with hypopharynx cancer has not been previously reported. Since areca nut is mostly consumed along with tobacco, it is uncommon to find patients who consume the areca nut alone.
This is a prospective case series of ten women who presented to us with HNSCC with history of chewing of areca nut alone for several years. We have excluded all those cases where areca nut was consumed along with tobacco in any form. The data were prospectively collected with regard to clinical parameters, duration and frequency of areca nut usage, the socio-economic status and education level.
All ten females had varying degree of submucous fibrosis and coexisting squamous cell carcinoma either in the oral cavity or hypopharynx. Submucous fibrosis was characterized by burning mouth, unhealthy oral mucosa, buried third molars, trismus, poor oral hygiene, etc. The disease presented in an advanced stage in majority of the cases. All patients were unaware of areca nut's deleterious effects.
Areca nut chewing is an important risk factor for HNSCC in females. Despite plethora of information, little importance is given to areca nut control in cancer prevention campaigns in India.
头颈部鳞状细胞癌（HNSCC）是印度一个重要的公共卫生问题。烟草、人乳头瘤病毒、酒精、槟榔使用等多种风险因素作为致病因素已得到广泛研究。尽管嚼槟榔是口腔癌的已知病因，但其与下咽癌的关联此前尚未见报道。由于槟榔大多与烟草一起食用，单独食用槟榔的患者并不常见。
这是一个前瞻性病例系列，共纳入10名女性患者，她们均因HNSCC前来就诊，且有多年单独嚼槟榔的病史。我们排除了所有以任何形式同时食用槟榔和烟草的病例。前瞻性收集了关于临床参数、槟榔使用的持续时间和频率、社会经济地位及教育水平的数据。
所有10名女性均有不同程度的黏膜下纤维化，且在口腔或下咽存在并存的鳞状细胞癌。黏膜下纤维化的特征包括口腔烧灼感、不健康的口腔黏膜、阻生第三磨牙、牙关紧闭、口腔卫生差等。大多数病例中疾病处于晚期。所有患者均未意识到槟榔的有害影响。
嚼槟榔是女性发生HNSCC的一个重要风险因素。尽管有大量信息，但在印度的癌症预防活动中，槟榔控制方面却很少受到重视。
