Behind the betel nut smile: the quiet epidemic of oral cancer in Papua New Guinea
Chewing betel ‘quid’ is culturally ingrained in PNG. But it is also linked to high oral cancer rates. A new project aims to improve early detection and reporting.
Papua New Guinea (PNG) is grappling with an often-overlooked health crisis: oral cancer. This issue is linked to a cultural practice known as betel quid chewing, a mixture of unripe areca nut, mustard stick, and slaked lime. The act is deeply ingrained in PNG's Indigenous communities and has become widespread, even in urban centers like the capital city of Port Moresby, where betel quid components are readily available on street corners.
The primary alkaloid in areca nut, arecoline, delivers a pleasant sensation while stimulating dopamine release, which can be addictive. However, arecoline is also classified as "probably carcinogenic to humans" by the International Agency for Research on Cancer's World Health Organization (WHO). Other ingredients in betel quid can also impact arecoline concentration.
An estimated 185 countries have oral cancer incidence rates, with Papua New Guinea and India leading the pack, closely followed by Bangladesh and Pakistan. While tobacco use also plays a role, betel quid is the primary culprit.
To address this growing epidemic, the dentistry department at the University of Papua New Guinea is spearheading a nationwide research project on oral submucous fibrosis, a chronic condition that increases the risk of oral cancer. The country lacks a national cancer registry, making it difficult to determine the true prevalence of oral cancer. However, the widespread practice of betel quid chewing is well-known.
Dentists in PNG often fail to recognize early signs of oral cancer due to a lack of knowledge and skills. A 2024 survey revealed this knowledge gap, and to address it, a program was initiated to train dentists in identifying "oral potentially malignant disorders" (OPMDs). Annual workshops have been held across the country, with the goal of equipping dentists with the ability to perform visual oral examinations and identify OPMDs. These findings can then be reported at provincial dental clinics.
While there is no global policy to control areca nut consumption, there is a pressing need for more research on the detrimental effects of betel quid chewing in Pacific and Southeast Asian countries to inform global control policies. In the meantime, the oral cancer screening and early detection project is gaining momentum. So far, 12 provinces have sent dentists to participate in the workshops, and their teams are expected to return to their hospitals and clinics, spreading the knowledge and skills they've acquired.
Written by urgent.news from The Conversation AU's reporting — not their text. Machine-written — may contain errors; check the original before relying on it.
