Betel quid (BQ) and areca nut use are at risk of cancer. This review includes the latest evidence of carcinogenesis caused by BQ exposure, suggests possible prevention strategies. We conducted a systematic literature search in the PubMed and Web of Science databases to identify relevant articles published in the past 10 years according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Arecoline N-oxide, a metabolite of areca nut, is likely an initiator in carcinogenesis and is detoxified by N-acetylcysteine. Oral potentially malignant disorder and reactive oxygen species involved in carcinogenesis pathways may be treatable using antioxidants. Screening programs conducted by trained physicians are useful for identifying patients with early stages of oral cancer in high-risk groups. Anti-inflammatory medications may be used as chemopreventive agents in the disease-free stage after surgery. The association between survival and tumor somatic mutations in patients who chew BQ should be addressed in cancer studies. Current evidence on the natural course from BQ exposure to cancer occurrence and development provides information for developing primary, secondary, and tertiary prevention strategies against BQ-associated cancer at clinical or translational levels.

中文翻译：

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槟榔相关的癌症：预防策略和针对性治疗。

使用槟榔（BQ）和槟榔有患癌症的风险。该评价包括由BQ暴露引起的致癌作用的最新证据，并提出了可能的预防策略。我们在PubMed和Web of Science数据库中进行了系统的文献搜索，以根据“系统评价和荟萃分析的首选报告项目”确定过去10年中发表的相关文章。槟榔碱的代谢产物槟榔碱N-氧化物可能是致癌作用的引发剂，并被N-乙酰半胱氨酸排毒。可以使用抗氧化剂治疗口腔潜在的恶性疾病和致癌途径中涉及的活性氧。由训练有素的医生进行的筛查程序可用于识别高危人群中口腔癌的早期患者。在手术后的无病阶段，抗炎药可用作化学预防剂。咀嚼BQ患者的生存与肿瘤体细胞突变之间的关联应在癌症研究中解决。从BQ暴露到癌症发生和发展的自然过程的最新证据为在临床或转化水平上开发针对BQ相关癌症的一级，二级和三级预防策略提供了信息。