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Betel nut use raises risk of oral cancer six-fold: study

A dentist inspects a woman’s mouth last year at a Phnom Penh dental clinic.
A dentist inspects a woman’s mouth last year at a Phnom Penh dental clinic. Charlotte Pert

Betel nut use raises risk of oral cancer six-fold: study

Cambodian betel nut chewers are six times more at risk of contracting potentially malignant oral cancers, according to a new report.

The study surveyed 1,634 people in Phnom Penh, Kampot, Kampong Cham, Pursat and Stung Treng and found that 54 percent had oral lesions – white or red swellings, ulcers or abnormalities in the mouth.

Though most were benign, the research revealed that 5.6 percent of those surveyed had oral cancers or lesions that could potentially become cancerous.

While the study found consuming alcohol did not carry a significant risk of developing a potentially malignant mouth lesion, those who drank alcohol in tandem with a smoking or chewing betel quid – which usually contains tobacco – increased their risk five-fold.

The study, Prevalence of oral cancer, oral potentially malignant disorders and other oral mucosal lesions in Cambodia, was published in the peer-reviewed medical journal Ethnicity and Health early last week.

Callum Durward, one of the report’s several authors and head of the dentistry department at Puthisastra University, said the study was also an opportunity to train dentists to identify a cancer risk early and thus increase their patients’ chances of survival.

“Most of the time, the oral cancer presents very late, so it’s already a huge ulcerated swelling by the time they see [a medical professional],” Durward said. “People should look in their own mouths . . . if they see a swelling, or a white patch, it’s a very good idea to have a biopsy.

“Even if they are benign – not cancer – they can become cancer later, especially if the risk factors continue.”

Durward added that oral cancers are one of the top five cancer killers in the Kingdom.

Dentist Heng Someth, who runs the private clinic Standard Dental Surgery, said despite the prevalence of mouth cancers, oral health was not high on the Health Ministry’s agenda.

“Most people think anything related to teeth or oral health is aesthetic, that it’s not a major problem,” he said. “The Ministry of Health also [puts] oral health in the bottom line . . . we should not be bottom of the list.”

He added public education was of “prime importance” and that practical, post-graduate training for young dentists could save lives.

Tepirou Chher, head of the Health Ministry’s Oral Health Bureau, also co-authored the report but could not be reached for comment. Other ministry officials did not respond to requests for comment.

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