The International Agency for Research on Cancer (IARC) constituted a "working group" comprising 17 experts drawn from India, China/Taiwan, UK, USA, Germany, Netherlands and South Africa, to study the possible carcinogenic risk posed by areca nut and betel quid to humans. After a detailed study, the working group prepared a monograph having 300 pages, detailing the mode of the assessment and evaluation, the research papers considered for assessing each criterion, the type of research papers considered for the assessment etc. and was published in 2004 in Lyon, France.
The working
group concluded the following in their monograph.
· There is sufficient evidence in humans for the
carcinogenicity of betel quid with tobacco. Betel quid with tobacco causes oral
cancer and cancer of the pharynx and esophagus.
· There is sufficient evidence in humans for the
carcinogenicity of betel quid without tobacco. Betel quid without tobacco
causes oral cancer.
· There is sufficient evidence in experimental animals
for the carcinogenicity of betel quid with and without tobacco.
·
There is sufficient evidence in experimental animals
for the carcinogenicity of areca nut.
· There is evidence suggesting lack of carcinogenicity
in experimental animals for betel leaf and slaked lime.
·
There is limited evidence in experimental animals for
the carcinogenicity of arecoline.
·
There is inadequate evidence in experimental animals
for the carcinogenicity of arecaidine.
The working
group concluded that areca nut causes oral submucous fibrosis, a precancerous
condition in humans. Further it claims to have found sufficient evidence of
carcinogenicity in experimental animals.
The overall
conclusion was,
·
Betel quid with tobacco is carcinogenic to humans
(Group 1).
·
Betel quid without tobacco is carcinogenic to humans
(Group 1).
·
Areca nut is carcinogenic to humans (Group 1).
This
monograph created a huge uproar against areca nut and its products among the
cancer biologists, research community dealing with human health, doctors,
policy makers and Government of several developed countries. This created a
renewed interest in the research groups throughout the world to take up studies
dealing with areca nut consumption and subsequent effect on human health.
