Safrole in betel quid may be a risk factor for hepatocellular carcinoma: case report.

© 2000 Canadian Medical Association or its licensors Chewing betel quid or the combination of chewing betel quid and smoking cigarettes is associated with an increased risk of oral squamous cell carcinoma. The composition of betel quid varies with geographic location. In Taiwan betel quid is composed of areca nut (Areca catechu, an Asian tropical palm), slaked lime, and the inflorescence or leaf of Piper betle (an Asian climbing plant). The inflorescence of Piper betle contains high concentrations (15 mg/g fresh weight) of safrole, an essential oil used in cosmetics and as a food flavouring. Safrole is classified as a rodent hepatocarcinogen, and chewing betel quid may contribute to human exposure to this compound. The saliva of a person chewing betel quid contains on average 420 μmol/L of safrole. We describe a case of hepatocellular carcinoma in a Taiwanese man who had chewed betel quid for over 32 years; safrole-DNA adducts, a likely cause of liver carcinogenesis, were found in liver biopsy specimens.