Betel Leaves & Areca Nuts and Cancer Risk

The betel plant is a vine that grows in parts of Asia and Africa. Betel quid is made up of slices of areca nuts, wrapped in the leaf of the betel plant. Other ingredients are often added to it such as slaked lime and spices for flavor. In many countries, tobacco is also added. Betel quid may also be called pan, gutka, ghutka, or gutkha. The use of betel quid is very common throughout the Asia-Pacific region. Use extends to migrant communities in the US, Africa, Europe, and the Middle East.

The way betel plant, areca nut, and betel quid are prepared varies by country and region. A person's risk for developing cancer is increased with betel quid use, but the risk is based on the way it is prepared and made. Cancer risk is higher when cigarettes or chewing tobacco is also used. Quids are often held in the mouth for about 20 to 25 minutes. Some users will hold the quid in the space between the teeth and cheek (mandibular groove) for many hours during sleep.

What does the use of betel plant, areca nut, and betel quid cause?

• Increased risk of white or reddened lesions in the mouth that can turn into oral and esophagus cancers.
  • Types of cancer include lip, mouth, tongue, and pharynx (throat).
• A condition called oral submucous fibrosis (OSF). This is when there is swelling and scarring (fibrosis) in the lining of the mouth, that can affect the esophagus (swallowing tube).
  • This condition can make the jaw stiff and make it hard to open the mouth.

Betel leaves and areca nuts can cause cancer in some cases. Talk to your provider about your cancer risk if you are using these products.

Learn more about smokeless tobacco and quitting.