ReviewMaté: a risk factor for oral and oropharyngeal cancer
Introduction
Maté, a tea-like infusion of Ilex paraguayensis which is commonly drunk in many parts of South America, has been associated with increased risks of upper digestive tract cancers.
The name Maté is derived from the quechua word “mate” meaning a cup or vessel used for drinking. It is also known as Yerbe-Maté, Jesuit's tea and Paraguayan tea. In Brazil it is known as “Chimarrão”. The scientific name Ilex paraguarensis was given by the French naturalist and botanist Auguste de Saint Hilaire in 1822 [1]. Maté has long been used by the indigenous peoples of South America, especially the Guarani Indians. In the nineteenth century South American gauchos (cowboys) relied on Maté not only as a stimulant but also as a vital part of their diet. Maté contains minerals including phosphorous, iron, and calcium, as well as vitamins C, B1, and B2. Maté is also used in local folk medicine and is employed in commercial herbal preparations as a central nervous system stimulant, diuretic, and anti-rheumatic [2]. The drinking of Maté is a social habit amongst the gauchos of the South American prairies and South Americans throughout the world. It is also consumed socially in the Middle East by the Druze of Lebanon, Syria and the Golan Heights in northern Israel. An average of 300,000 t of Maté are produced each year in South America. Consumption of Maté in Argentina was 5.14 kg per head caput in 1987. Uruguay had an average annual consumption of 6–8 kg per person and these figures are on the rise [3]. It is estimated that 70% of adult males and 50% of females in southern Brazil are daily Maté drinkers [4].
Section snippets
Methods
A review of the relevant literature linking Maté consumption with oral and oropharyngeal cancer and the carcinogenicity of Maté was performed. The literature search was done via Medline using the mesh words Mate, Ilex paraguariensis Chimarrao, yerba-mate, cancer and carcinoma. Other databases searched included: library catalogues, OCLC first search and ISI web of science databases. Reports on the connection between Maté and unrelated forms of cancer were excluded as were those related to Maté
Discussion
Clinical and epidemiological studies have found a moderate [4], [5], [6] to high [7], [8], [9], [10] risk of malignant neoplasms of the upper aerodigestive tract amongst Maté drinkers. It should also be noted that the incidence of oral and oropharyngeal cancer in Argentina, southern Brazil, and Uruguay is very high and on the rise, particularly in the southern parts of South America. Specific risk factors which have been identified are tobacco smoking, alcohol drinking, high intake of charcoal
Oral and oropharyngeal cancer
The effect of Maté as a risk factor for oral and oropharyngeal cancer has been studied in a number of case-control studies. Pintos et al. analyzed the data from a case-control study of upper aerodigestive tract cancers conducted in southern Brazil. They confronted the problem of separating the carcionogenic risk of Maté attributable to confounding factors such as smoking and alcohol by estimating the effect of Mate consumption by conditional logistic regression with adjustment for smoking,
Carcinogenic mechanism of Maté
Thermal injury has been suggested as one of the carcinogenic effects of Maté, particularly on the esophagus. A working group of the International Agency for Research Cancer concluded that “hot Maté drinking is probably carcinogenic to humans” [5]. Most of these studies pertain to esophageal cancer and no study to date has been performed specifically on the thermal effects of hot Maté on the oral cavity or oropharynx.
Although thermal injury has been suggested as a mechanism of action, a chemical
Conclusion
Although the exact mechanism of carcinogenesis is still uncertain there is evidence in the literature that Maté consumption plays a significant and independent role in the development of oral and oropharyngeal cancers. Available evidence shows that Maté drinking should be considered one of the risk factors in these types of cancer. This is especially important in parts of the globe where the habit is prevalent. Future studies on animal models without confounding risk factors would be helpful in
References (17)
- et al.
Studies on mate drinking
J. Ethnopharmacol.
(1986) - et al.
The burden of mouth cancer in Latin America and the Caribbean: epidemiologic issues
Semin. Oncol.
(2001) - Omar Stradella Description of the Yerba Mate 1997. Available:...
- et al.
A new saponin from mate, Ilex paraguarensis
J. Nat. Prod.
(1989) - et al.
Patterns of mate drinking in a Brazilian city
Cancer Res.
(1990) - International Agency for Research on Cancer. Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to...
- et al.
Risk factors for oral cancer in Brazil: a case control study
Int. J. Cancer
(1989) - et al.
Esophageal cancer in Uruguay: a case-control study
J. Natl. Cancer Inst.
(1985)
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