2802 - Awareness of Carcinogenic Effects of Betel Nut in Oral Cavity Cancer among South Asians in the United States

Purpose/Objective(s): Studies show that the prevalence of buccal mucosa cancer is greater in South Asians compared to other ethnicities, likely due to the use of chewing tobacco and/or betel nut. Betel nut or areca nut is classified as a group 1 oral carcinogen by the International Agency for Research on Cancer. Despite this, the awareness of the carcinogenic effects of betel nut remains limited. The objective of the present study is to investigate and identify the percentage of South Asians who are aware that tobacco products versus betel nut cause oral cancer. We hypothesized that more than 50% of South Asians are aware that tobacco products cause oral cancer, but less than 50% of this population know that betel nut products also cause oral cancer.

Materials/Methods: A cross-sectional study was conducted between October 1, 2024, and December 31, 2024, with eligibility criteria including South Asians older than 18 years of age. To target this population, surveys were conducted at places of worship, such as temples and mosques, which are regularly frequented by South Asians. A questionnaire assessed the use and awareness of chewing tobacco and betel nut causing cancer. Data was analyzed using frequencies and percentages for categorical variables and medians and ranges for continuous variables.

Results: A total of 216 participants completed the survey, with 68% of the surveys conducted in temples and 32% in mosques. 62% of the population was in the age group between 31 to 60 years, 24% in the 18-30 years age group, and 13% greater than 60 years of age. Regarding cancer awareness, 81% (95% CI, 0.76-0.86) and 87.5% (95% CI, 0.83-0.91) of participants know that smoking and chewing tobacco cause cancer, respectively. However, awareness of the effects of betel nut was limited, and as hypothesized, only 42% (95% CI, 0.35-0.48) recognized that its usage was carcinogenic. Additionally, only 43.5% are aware that adding betel nut to chewing tobacco increases the risk of mouth cancer over chewing tobacco alone and only 55% are aware that use of betel nut causes scar tissue in the mouth.

Conclusion: This study reveals that while there is a strong understanding that tobacco products cause oral cavity cancer, a knowledge gap exists regarding the carcinogenic risk of betel nut use. Directing attention and providing culturally appropriate education regarding the risks that betel nut poses may improve and ultimately reduce the incidence of oral cavity cancer in the South Asian population.