Meta-Analysis
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 6, 2022; 10(10): 3131-3142
Published online Apr 6, 2022. doi: 10.12998/wjcc.v10.i10.3131
Betel quid chewing and oral potential malignant disorders and the impact of smoking and drinking: A meta-analysis
Hui-Jun Lin, Xiao-Lei Wang, Meng-Yuan Tian, Xing-Li Li, Hong-Zhuan Tan
Hui-Jun Lin, Xiao-Lei Wang, Meng-Yuan Tian, Xing-Li Li, Hong-Zhuan Tan, Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410008, Hunan Province, China
Author contributions: Lin HJ contributed to the literature search, data extraction, analysis and interpretation and manuscript drafting; Wang XL and Tian MY contributed to the literature search, data extraction and analysis; Li XL contributed to data interpretation and manuscript revision; Tan HZ contributed to data interpretation, manuscript drafting and revision; all authors read and approved the final manuscript.
Conflict-of-interest statement: The authors declare having no potential conflicts of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hong-Zhuan Tan, MD, Full Professor, Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, No. 110 Xiangya Road, Changsha 410008, Hunan Province, China. tanhz99@qq.com
Received: July 12, 2021
Peer-review started: July 12, 2021
First decision: October 22, 2021
Revised: October 26, 2021
Accepted: February 23, 2022
Article in press: February 23, 2022
Published online: April 6, 2022
Processing time: 260 Days and 6.7 Hours
ARTICLE HIGHLIGHTS
Research background

Studies have found that betel quid chewing, smoking and alcohol drinking might be the risk factors of oral potential malignant disorders (OPMDs). But the relationships of them, especially the interaction are still inconclusive.

Research motivation

This meta-analysis was to determine the damage of betel quid on OPMDs and to explore the potential interaction between smoking, alcohol drinking and betel quid. It could provide new ideas for the prevention of OPMDs.

Research objectives

To evaluate the relationship between betel quid chewing and OPMDs and to explore the interaction of smoking and drinking on the relationship.

Research methods

We searched four database and finally selected 9 from 987 studies. The research data were extracted according to the inclusion criteria. The pooled odds ratios (ORs) and 95% confidence intervals (CIs) were used to evaluate the effect size and relative excess risk of interaction (RERI) was used to estimate the size of interaction.

Research results

The results showed that betel quid chewing (pooled OR: 8.70, 95%CI: 5.18-14.61) could significantly increase the risk of OPMDs. And smoking and drinking synergistically increased the association between betel quid chewing and OPMDs (pooled OR(BQ+SM):14.38, 95%CI: 7.14-28.95, RERI(BQ+SM): 2.33; pooled OR(BQ+DK): 11.12, 95%CI: 8.00-15.45, RERI(BQ+DK): 1.47, respectively).

Research conclusions

Betel quid chewing is associated with an increased risk of oral potential malignant disorders. There was a synergistic effect between smoking or drinking and betel quid chewing.

Research perspectives

Governments should focus on individuals with multiple exposure.