Role of paan chewing and dietary habits in cervical carcinoma in Chennai, India

• Published in: British journal of cancer Vol. 88; no. 9; pp. 1388 - 1393
• Main Authors: RAJKUMAR, T, FRANCESCHI, S, VACCARELLA, S, GAJALAKSHMI, V, SHARMILA, A, SNIJDERS, P. J. F, MUNOZ, N, MEIJER, C. J. L. M, HERRERO, R
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 06.05.2003
• Subjects: Adult; Areca - toxicity; Biological and medical sciences; Body Height; Body Weight; DNA, Viral - isolation & purification; Epidemiology; Feeding Behavior; Female; Female genital diseases; Gynecology. Andrology. Obstetrics; Humans; India - epidemiology; Medical sciences; Middle Aged; Nicotiana; Papillomaviridae - isolation & purification; Papillomavirus Infections - epidemiology; Sexual Behavior; Smoking - epidemiology; Socioeconomic Factors; Surveys and Questionnaires; Tropical medicine; Tumor Virus Infections - epidemiology; Tumors; Uterine Cervical Neoplasms - epidemiology; Asia; India; Human; paan chewing; Carcinoma; Vegetables; Fruit; Food habit; Betel; Malignant tumor; Uterine cervix; Case control study; Chewing; Carcinogenesis; Epidemiology; cervical cancer; Female genital diseases; Body mass index; Uterine cervix diseases; Public health
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/sj.bjc.6600902

Non-viral factors contribute to human papillomavirus (HPV)-related cervical carcinogenesis. We investigated the role of paan chewing and dietary habits among 205 women with invasive cervical cancer (ICC) and 213 age-matched control women in Chennai, India. Odds ratios (OR) and 95% confidence intervals (CI) were computed by means of unconditional multiple regression, taking into account major correlates of ICC risk. Paan chewing showed a dose-dependent direct association with ICC (OR for >/=5 paan day(-1)=4.0; 95% CI 1.2-13.3). Among dietary habits, the highest vs lowest intake tertile for vegetables and fruit was associated with an OR of 0.5 (95% CI 0.2-1.0). Low education level and low body weight were also risk factors for ICC, but they did not account for the associations of paan chewing and low vegetable and fruit intake. In the analyses restricted to HPV-positive cases and controls, the inverse association with vegetable and fruit intake was confirmed. Conversely, the adverse influence of paan chewing on ICC risk seemed to be attributable to a higher prevalence of cervical HPV infection in women who chewed.