Narayanan AM, et al. - Because betel nut consumption contributes to higher rates of oral cavity cancer across Micronesia, researchers reviewed local surveys and cancer data to further characterize these problems in the Northern Mariana Islands (CNMI). They extracted data pertaining to betel nut, tobacco and alcohol use. Relevant data on cancer from the Commonwealth Healthcare Corporation of Saipan and the Surveillance, Epidemiology, and End Results databases were evaluated. According to findings, 43% of Asian Pacific Islander (API) adults reported betel nut chewing, with 88% adding tobacco to chewing. These findings show trends in the use of alcohol, tobacco and betel nut in the CNMI. The use of betel nut is common among APIs of almost all ages, with the majority adding tobacco to their chewing. The available data suggest that the CNMI has a drastic burden of oral cavity cancer. Efforts should be made to evaluate primary and secondary prevention in API regions for effective means.