TY - JOUR ID - 89031 TI - Evaluation of Khat (Catha edulis) Use as a Risk Factor of Cancer: A Systematic Review JO - Asian Pacific Journal of Cancer Prevention JA - APJCP LA - en SN - 1513-7368 AU - Chong, Zhi Xiong AU - Ho, Wan Yong AU - Yan, Pan AU - Alshagga, Mustafa Ahmed AD - Division of Biomedical Sciences, School of Pharmacy, University of Nottingham Malaysia. Y1 - 2020 PY - 2020 VL - 21 IS - 4 SP - 881 EP - 895 KW - Risk of Bias (RoB) KW - Khat KW - premalignant condition KW - cancer DO - 10.31557/APJCP.2020.21.4.881 N2 - Background: Conducting systematic review to evaluate plant use as a risk factor to cancer could be challenging. A systematic and well-balanced method should be applied to accommodate in vivo and in vitro studies to make a final decision. In this article, khat, a recreational plant used in some Arabic and African regions, was employed as an example to systematically determine its relationships to the premalignant and cancerous conditions. Methods: Systematic database search was performed to recruit original human, animal or in vitro studies on khat and cancer. Sixteen studies fulfilled the inclusion criteria and subjected to assessment using Risk of Bias (RoB). Office of Health and Translation (OHAT) approach was used to rate the confidence level in the body of evidence. The evidence was integrated to establish the relationships between khat, premalignant conditions and cancer. Results: Seven out of eight studies showed that khat causes premalignant oral lesions with moderate evidence level. Four studies showed that khat causes cancer with low evidence level and another three studies showed that khat has anti-cancer effect with moderate to high evidence level. Only one study suggested that khat is unrelated to cancer. Conclusion: RoB and OHAT approach are reliable systematic tools to evaluate plant risk to cancer and provide objective and uniform summary regardless of the study type. In conclusion, our pooled analysis did not find a direct relationship between khat and cancer but anti-cancer effect would require to be proofed on human studies. UR - https://journal.waocp.org/article_89031.html L1 - https://journal.waocp.org/article_89031_c9a8dcc9c2d9a89d59ae01de43a4085d.pdf ER -