Objective This study was conducted to investigate the effect of chewing fresh or dried betel nut on the inci-dence and canceration of oral mucosa disease in Haikou City in Hainan Province.Methods Through a survey questionnaire, clinical examination, and regular follow-up, we collected clinical data from 1 722 cases and divided them into two groups, among which 704 of the afflicted people chew dried betel nut, whereas the other 1 018 chew fresh betel nut. The data were statistically analyzed using different variables which included age, number, time of onset of the disease, and the cancerous condition associated with common oral mucosa disease, including oral submucous fibrosis (OSF), oral leukoplakia (OLK), and oral Lichen planus (OLP).Results 1) The study found no significant difference in the prevalence of oral mucosa diseases between the dried betel nut group (n=704) and fresh betel nut group (n=1 018) among the 1 722 cases (P>0.05), but the peak age of oral mucosal disease was more advanced in the dried betel nut group (P<0.01). 2) The incidence within 5 years of OSF, OLK, OLP, and oral mucosa diseases in the dried betel nut group was significantly higher than that in the fresh betel nut group (P<0.01). 3) The incidence of cancer for oral mucosa disease in patients included in the dried betel nut group was significantly higher than that in the fresh betel nut group (P<0.01).Conclusion Chewing dried betel nut is more pathogenic and carcinogenic than chewing fresh betel nut. The extremely harmful components of the dried betel nut synergistically play a vital role in the occurrence and carcinogenesis of oral mucosal diseases.%目的：研究海南省海口地区嚼食干鲜槟榔嗜好的不同对口腔黏膜疾病发病和癌变的影响。方法将1722例有咀嚼槟榔嗜好的人员按嚼食槟榔嗜好不同，分为嚼食鲜槟榔和嚼食干槟榔两组。采用问卷调查、临床检查和定期复诊的方法，收集临床资料，确定罹患口腔黏膜下纤维性变（OSF）、口腔白斑（OLK）、口腔扁平苔藓（OLP）3种口腔黏膜疾病的年龄、人数、发病时间以及是否癌变等，并对数据进行统计学分析。结果1）在1722例咀嚼槟榔人群中，嚼食干槟榔组（704例）与嚼食鲜槟榔组（1018例）黏膜病的患病率无明显差异（P>0.05），但患病高峰年龄提前（ P<0.01）。2）咀嚼干槟榔组5年内所致OSF、OLK和OLP的发病率及口腔黏膜疾病的总发病率均明显高于咀嚼新鲜槟榔组（P<0.01）。3）嚼食干槟榔组口腔黏膜疾病癌变率高于嚼食鲜槟榔组（P<0.01）。结论嚼食干槟榔比嚼食鲜槟榔的致病性和致癌性更强，干槟榔中过多的有害成分在口腔黏膜疾病的发生和癌变过程中起着重要的协同促进作用。
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