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Addressing a silent killer - The International Conference on Betel Quid and Areca Nut

, by Hedieh Mehrtash

After nearly a year of effort, The Center for Global Health, National Cancer Institute, in coordination with the National Institute of Dental and Craniofacial Research , The University of Texas at MD Anderson Cancer Center, Oral Cancer Research Coordinating Center, University of Malaya, Taiwan Health Promotion Administration, Ministry of Health and Welfare, and with the generous support of the Malaysia Ministry of Health, hosted the International Conference on Betel Quid and Areca Nut in Kuala Lumpur Malaysia on April 27-28, 2016.

The conference welcomed more than 130 participants from 21 countries. Our meeting aimed to address the major issue surrounding betel quid and areca nut use, and its associated cancers. More than 600 million, approximately 10% of the world’s population, use betel quid and areca nut. Widely unregulated, with its use steeped in culture and tradition, the use of betel quid and areca nut poses a significant and understudied health threat to the Asia-Pacific region where prevalence is high. Betel quid and areca nut use is a risk factor for oral, esophageal, and other associated cancers. Unlike many forms of smoked tobacco, is the two are widely used by women in regions where common. Betel quid and areca use extends beyond the Asia-Pacific region to diaspora and migrant communities in US, South Africa, and parts of Europe and the Middle East.

We developed the meeting with a special focus on the following topic areas: 1) Basic Biology: Patterns of Use and Epidemiology of Betel Quid/Areca Nut related cancers; 2) Biology of Addiction and Use; 3) Behavioral Factors in Addiction and Dependence; 4) Prevention and Control (including cessation); 5) Screening and Early Detection for Areca Nut and Betel Quid- Related Cancers; and 6) Policy and Economic Impact.

Dr. Saman Warnakulasuriya, World Health Organization Collaborating Centre for Oral Cancer and Pre-cancer, King’s College London, United Kingdom, opened the meeting with a history of areca nut use, closing his keynote speech with a call to action. Following Dr. Warnakulasuriya’s inspirational keynote, conference participants attended interactive plenary and breakout sessions.

During the sessions, research that pertained to the focus areas were prepared via action planning sessions, and presented to conference participants. Included in the recommendations for future research directions were: improved understanding of the biology of associated diseases; increased efficacy of early detection and cessation programs; and additional research studies to understand carcinogenesis, social norms and cultural beliefs related to use, and how evidence can best inform policy, translating the actions necessary to address the region’s oral cancer disease burden associated with betel quid and areca nut use.

The outcomes of our meeting will be published in the coming months. It is our hope that this publication will identify and facilitate new research collaborations and projects among investigators from high income and low- and middle-income countries.

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