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Cancer Epidemiol. 2017 Oct;50(Pt B):241-246. doi: 10.1016/j.canep.2017.08.006.

Epidemiology of areca (betel) nut use in the mariana islands: Findings from the University of Guam/University of Hawai`i cancer center partnership program.

Author information

1
University of Guam, School of Nursing and Health Sciences, Room 103, Mangilao, GU 96923, United States. Electronic address: paulinoy@triton.uog.edu.
2
University of Hawai`i at Mānoa, Office of Public Health Studies, Biomed D-201, Honolulu, HI 96822, United States. Electronic address: ehurwitz@hawaii.edu.
3
Commonwealth Health Care Corporation, Division of Public Health, Non-Communicable Disease Bureau, P.O. Box 500409, Saipan, MP 96950, United States. Electronic address: joanne.ogo@gmail.com.
4
University of Guam, Tropical Agriculture Undergraduate Program, Mangilao, GU 96923, United States. Electronic address: tristan.vpaulino@gmail.com.
5
University of Hawai`i at Mānoa, Office of Public Health Studies, Biomed D-201, Honolulu, HI 96822, United States. Electronic address: aby@hawaii.edu.
6
University of Hawai`i at Mānoa, College of Tropical Agriculture and Human Resources, Honolulu, HI 96822, United States. Electronic address: novotny@hawaii.edu.
7
University of Hawai`i Cancer Center, 701 Ilalo St., Honolulu, HI 96817, United States. Electronic address: lynne@cc.hawaii.edu.
8
University of Guam, School of Education, 208 K, Mangilao, GU 96923, United States. Electronic address: mjmiller@triton.uog.edu.
9
University of Hawai`i Cancer Center, 701 Ilalo St., Honolulu, HI 96817, United States. Electronic address: npalafox@hawaii.edu.

Abstract

BACKGROUND:

Areca (betel) nut is considered a Group 1 human carcinogen shown to be associated with other chronic diseases in addition to cancer. This paper describes the areca (betel) nut chewing trend in Guam, and health behaviors of chewers in Guam and Saipan.

METHODS:

The areca (betel) nut module in the Guam Behavioral Risk Factor Surveillance Survey was used to calculate the 5-year (2011-2015) chewing trend. To assess the association between areca (betel) nut chewing and health risks in the Mariana Islands, a cross-section of 300 chewers, ≥18years old, were recruited from households in Guam and Saipan. Self-reported socio-demographics, oral health behaviors, chronic disease status, diet, and physical activity were collected. Anthropometry was measured. Only areca (betel) nut-specific and demographic information were collected from youth chewers in the household.

RESULTS:

The 5-year areca (betel) nut chewing prevalence in Guam was 11% and increased among Non-Chamorros, primarily other Micronesians, from 2011 (7%) to 2015 (13%). In the household survey, most adult chewers (46%) preferred areca nut with betel leaf, slaked lime, and tobacco. Most youth chewers (48%) preferred areca nut only. Common adult chronic conditions included diabetes (14%), hypertension (26%), and obesity (58%).

CONCLUSION:

The 5-year areca (betel) nut chewing prevalence in Guam is comparable to the world estimate (10-20%), though rising among Non-Chamorros. Adult and youth chewers may be at an increased risk for oral cancer. Adult chewers have an increased risk of other chronic health conditions. Cancer prevention and intervention strategies should incorporate all aspects of health.

KEYWORDS:

Alcohol; Areca; BRFSS; Betel; Chronic disease; Commonwealth of the Northern Mariana Islands; Guam; Micronesia; Obesity; Oral cancer; Surveillance; Tobacco

PMID:
29120831
PMCID:
PMC5747254
DOI:
10.1016/j.canep.2017.08.006
[Indexed for MEDLINE]
Free PMC Article

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