2. IARC report on the carcinogenicity of chewable tobacco & Betel quid (Tambula / Pan) in 1985

 

The International Agency for Research on Cancer (IARC), an intergovernmental agency affiliated to World Health Organization (WHO) of the United Nations (UN) published its first report on areca nut in 1985 in the for of a monograph (Vol. 37). This monograph was an outcome of a one-year effort involving 19 experts drawn from 10 countries (working group), 5 observers from 5 countries and 22 secretaries affiliated to IARC. After reviewing and analyzing numerous research papers published in reputed research journals, a week-long workshop at Lyon, France, the experts came out with a comprehensive report in the form of a monograph in 1985.

The working group looked into the carcinogenicity chewable tobacco, betel quid & areca nut in the consumers. The experts looked into the reports published on the evidence of carcinogenicity in experimental animals, DNA damage studies, Cell-line studies, case reports involving human subjects & epidemiological studies.

Based on these studies and a systematic evaluation, IARC came out with the following conclusions with respect to chewable tobacco, betel quid and areca nut as follows.

Chewable tobacco

1. There is sufficient evidence that oral use of chewable tobacco is carcinogenic to humans. 
2. There is sufficient evidence that oral use of tobacco mixed with lime (khaini) is carcinogenic to humans.

Betel quid (Pan / Tambula) comprising areca nut, betel leaf, slacked lime, catechu.

1. There is sufficient evidence that the habit of chewing betel quid containing tobacco is carcinogenic to humans.
2. There is inadequate evidence that the habit of chewing betel quid without tobacco is carcinogenic to humans.
3. The Working Group also concluded that, while there is sufficient evidence that the combined habits of smoking tobacco and chewing betel quid without tobacco cause oral and pharyngeal(throat) cancer.
4. There is limited evidence that areca nut with and without tobacco is carcinogenic to experimental animals.
5. The data are inadequate to allow an evaluation of the carcinogenicity of betel leaf or arecoline to experimental animals.

As per this monograph, neither areca nut nor the other constituents of betel quid / Tambula/ Pan (areca nut, betel leaf, Catechu and slacked lime) were implicated for carcinogenicity.  

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