Elsevier

Oral Oncology

Volume 38, Issue 7, October 2002, Pages 646-649
Oral Oncology

Review
Maté: a risk factor for oral and oropharyngeal cancer

https://doi.org/10.1016/S1368-8375(01)00127-0Get rights and content

Abstract

Maté is a tea-like beverage consumed mainly in Argentina, Uruguay, Paraguay, southern Brazil and to a lesser degree in other areas of the world such as Germany, Syria, Lebanon and Northern Israel. It is brewed from the dried leaves and stemlets of the perennial tree Ilex paraguarensis (“yerba mate”) a species that belongs to the Aquifoliaceae family. Maté consumption has been associated with an increased rate of oral and oropharyngeal cancers. The purpose of this study is to review the literature and discuss the role of Maté consumption in the development of oral and oropharyngeal cancer and the potential carcinogenic mechanisms. A review of the relevant literature linking Maté consumption with oral and oropharyngeal cancer and the carcinogenicity of Maté was performed. The search was performed using Medline, library catalogues, OCLC first search and ISI web of science databases. Case control studies on Maté drinking populations and, in vivo and in vitro studies on the carcinogenicity of Maté were reviewed. The populations reviewed in many of these studies also used alcohol and tobacco products confounding the influence of Maté as an independent risk factor. There is evidence in the literature that Maté consumption is in itself carcinogenic and plays a role in the development of cancers of the oral cavity and oropharynx. Although the exact mechanism of carcinogenesis is still unknown, available information suggests that Maté drinking should be considered one of the risk factors 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

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