Betel Quid Chewing in the Mid-Atlantic United States: Any Consequence?

Abstract

According to the NYU Center for the Study of Asian American Health, the New York City Metropolitan area is home to the largest concentration of South Asians in the United States [1]. The chewing of betel quid related products is common to these immigrants from countries including India, Pakistan, Bangladesh, Sri Lanka, Nepal, Bhutan, and the Maldives among others [1]. Betel quid and its constituent areca nut are known risk factors for many oral and esophageal cancers [2]. However, the lack of awareness regarding adverse effects of the areca nut among its users, limited understanding of its cultural role among healthcare providers, and lack of global policy for control of the substance has resulted in what has been termed a global public health emergency [2]. Within a six-month period from October 2017 to March 2018, three cases of oral squamous cell carcinoma were diagnosed at St. Joseph s University Medical Center in Paterson, NJ and treated using wide local excision and reconstructive flap surgery. All three patients were South Asian immigrants, and in each case, the patient admitted to a history of ten or more years of betel quid chewing. Considering these cases, the purpose of this presentation is to report on the incidence of oral squamous cell carcinoma in the greater New York and New Jersey area associated with betel quid use the purpose of this paper is to report on the rising incidence of squamous cell carcinoma.