The DOI matches its Crossref record; 70 of the 71 references it cites were found in a registry or an index.
Defining a global research and policy agenda for betel quid and areca nut
Abstract
Betel quid and areca nut are known risk factors for many oral and oesophageal cancers, and their use is highly prevalent in the Asia-Pacific region. Additionally, betel quid and areca nut are associated with health effects on the cardiovascular, nervous, gastrointestinal, metabolic, respiratory, and reproductive systems. Unlike tobacco, for which the WHO Framework Convention on Tobacco Control provides evidence-based policies for reducing tobacco use, no global policy exists for the control of betel quid and areca nut use. Multidisciplinary research is needed to address this neglected global public health emergency and to mobilise efforts to control betel quid and areca nut use. In addition, future research is needed to advance our understanding of the basic biology, mechanisms, and epidemiology of betel quid and areca nut use, to advance possible prevention and cessation programmes for betel quid and areca nut users, and to design evidence-based screening and early diagnosis programmes to address the growing burden of cancers that are associated with use.
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“The major risk factors for oral cancers are tobacco, alcohol and areca nut (betel quid).[25][26][27]”
From Oral diseases: a global public health challenge (2019) · cites this paper as [27]
Citations
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Rajendra, S., Ravvada, K., Vengamamba, L., & Burru, A. Y. (2025) · International Journal of Community Medicine and Public Health · doi:10.18203/2394-6040.ijcmph20254431
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Immunotherapy and betel nut-associated oral cavity carcinoma: challenges and opportunities
Moss, W. J., West, J. D., Brett, P., & Kwon, D. (2026) · Oral Oncology · doi:10.1016/j.oraloncology.2026.107873
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Yerrolla, S. C. (2024) · Journal of Precision Oncology · doi:10.4103/jpo.jpo_4_26
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Areca nut policy developments in the Asia-Pacific: Warning labels
Moss, W. J., Torres, R., Sablan, J. P., Tenorio, L., West, J. D., Sabino, A. A. S. S., Kwon, D., Brett, P., Paulino, Y. C., & Warnakulasuriya, S. (2026) · Journal of Cancer Policy · doi:10.1016/j.jcpo.2026.100735
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“The World Health Organization (WHO) recommends integrating BN nut cessation into tobacco dependence treatment, with strategies like clinic-based programs and mobile health technologies (mHealth) like SMS support, for rural areas (Mehrtash et al., 2017).”
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“The development of OSF is strongly associated with betel quid chewing, which is considered the primary etiological factor (Mehrtash et al., 2017).”
Joshi, K., R., A. P., Raju, D., D., S. H., Belle, V. S., Kumar, N. A. N., & Kamal, M. V. (2026) · Frontiers in Oncology · doi:10.3389/fonc.2026.1906691
The areca (betel) nut: clinical implications for dental practice in the United States
Desai, T., Tungare, S., Young, S., Vigneswaran, N., Quock, R. L., & Myers, A. L. (2026) · Oral Surgery Oral Medicine Oral Pathology and Oral Radiology · doi:10.1016/j.oooo.2026.08.011
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“Major risk factors include tobacco use, excessive alcohol consumption, and betel quid chewing, with a subset of cases associated with human papillomavirus infection [1].”
Metadata
- Authors
- Mehrtash, H., Duncan, K., Parascandola, M., David, A., Gritz, E. R., Gupta, P. C., Mehrotra, R., Amer Nordin, A. S., Pearlman, P. C., Warnakulasuriya, S., Wen, C.-P., Zain, R. B., & Trimble, E. L.
- Affiliations
- National Institutes of Health (US)
- The University of Texas MD Anderson Cancer Center (US)
- Healis Sekhsaria Institute For Public Health (IN)
- National Institute of Cancer Prevention and Research (IN)
- King's College London (GB)
- National Health Research Institutes (TW)
- University of Malaya (MY)
- Corresponding author
- Mehrtash, Hedieh
- ORCID
- Venue
- The Lancet Oncology
- Publisher
- Elsevier BV
- Published
- 2017-12
- Volume
- 18
- Issue
- 12
- Pages
- e767-e775
- ISSN
- 1470-2045 (ISSN-L)
- OpenAlex
- W2773997905
- Cited by
- 221
- References
- 71
- Citations by year
- 2026: 20 · 2025: 27 · 2024: 22 · 2023: 27 · 2022: 43 · 2021: 22 · 2020: 39 · 2019: 13 · 2018: 7
- FWCI
- 2.26
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet Oncology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Dentistry › General Dentistry › Oral Health Pathology and Treatment
- Health Sciences › Medicine › Otorhinolaryngology › Head and Neck Cancer Studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Public Health Policies and Epidemiology
- Keywords
- betel quid, areca nut, oral cancer, esophageal cancer, oral submucous fibrosis, oral leukoplakia, oral cancer screening, early diagnosis, prevention programmes, health policy, Asia-Pacific region, tobacco control
- MeSH terms
- Areca, Asia, Esophageal Neoplasms, Female, Humans, Male, Mouth Neoplasms, Policy Making, Research Design, Smoking, Global Health, Practice Guidelines as Topic, Early Detection of Cancer
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