Oral Cancer Risk Factors
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What Are the Risk Factors for Oral Cancer?
Anyone can get oral cancer, however some factors may increase your likelihood of developing the disease. Several proven oral cancer risk factors include:
- Gender: Oral cancer and oropharyngeal cancer are twice as common in men as in women. This difference may be related to the use of alcohol and tobacco, a major oral cancer risk factor that is seen more commonly in men than women. According to the American Cancer Society, the gender difference is decreasing among oral cancer patients as more women are using tobacco and drinking.
- Age: The average age at diagnosis for oral cancer is 62, and two-thirds of individuals with this disease are over age 55.
- Tobacco use: About 80% of people with oral cavity and oropharyngeal cancers use tobacco in the form of cigarettes, chewing tobacco or snuff. The risk of developing oral cancer depends on the duration and frequency of tobacco use. Smoking can lead to cancer in the mouth or throat, and oral tobacco products are associated with cancer in the cheeks, gums, and inner surface of the lips.
- Alcohol: About 70% of people diagnosed with oral cancer are heavy drinkers. This risk is higher for people who use both alcohol and tobacco. For people who smoke and drink heavily, the risk of oral cancer may be as high as 100% more than the risk for people who do not smoke or drink.
- Betel quid: Many people in Southeast Asia, South Asia, and others parts of the world chew betel quid, a leaf from the betel plant wrapped around areca nut and lime. Chewing gutka, a combination of betel quid and tobacco, is also common. Both of these substances are associated with an increased oral cancer risks.
- Ultraviolet light: Cancers of the lip are more common among people who work outdoors or others with prolonged exposure to sunlight.
- Poor nutrition: Studies have found a link between diets low in fruits and vegetables and an increased oropharynx and oral cancer risk.
- Human papillomavirus (HPV) infection: Human papilloma viruses, or HPV, include about 100 similar viruses. Many HPVs cause warts, but some are involved in cancer. Most noteworthy, HPV is tied to the development of cervical cancer. HPV is also a risk factor for oral and oropharyngeal cancers. About 25% of patients with these cancers are infected with the same HPVs as are seen in with cervical cancer. In particular, there is a strong link between HPV-16 and oropharyngeal cancer. HPV appears to be a more serious risk factor for oropharyngeal cancer than for oral cavity cancers. People with oral cancers linked to HPV tend to not be smokers or drinkers, and usually have a good prognosis. Typically, HPV infections in the mouth and throat do not produce any symptoms, and only a small percentage of these infections develop into cancer.
- Immune system suppression: Taking drugs that suppress the immune system, such as those used to prevent rejection of a transplant organ or to treat certain immune diseases, may increase the risk of oral cancer.
- Lichen planus: People with a severe case of this illness, which usually causes an itchy rash but sometimes appears as white lines or spots in the mouth and throat, may have a higher risk of oral cancer. Lichen planus usually affects middle-aged people.
- Graft-versus-host disease (GVHD): This condition can occur after a stem-cell transplant, in which bone marrow is replaced following cancer occurrence or treatment. The new stem cells may have an immune response against the patient’s own cells, and tissues in the body may be destroyed as a result. GVHD increases the likelihood of oral cancer, which can develop as soon as 2 years later.
- Genetic syndromes: Some inherited genetic mutations, which cause different syndromes in the body, carry a high risk of oral and oropharyngeal cancer. These include:
- Fanconi anemia: This blood condition is caused by inherited abnormalities in several genes. Problems can begin at an early age and often lead to leukemia or aplastic anemia. The risk of oral cancer among people with Fanconi anemia is up to 500 times higher than among the general population.
- Dyskeratosis congenita: This genetically linked syndrome can also cause aplastic anemia, and carries a very high risk of mouth and throat cancer occurring at an early age.
Unproven Risk Factors
In recent years, concern has been raised about some products heightening the risk of oral cancer. These concerns are controversial and have not yet been proven in scientific studies. The products some believe to increase cancer risk factors include:
- Mouthwash: Some studies have shown a link between mouthwash that is high in alcohol content and the risk of oral and oropharyngeal cancer. However, other research has raised doubts about this concern. The frequent use of mouthwash by people who smoke and drink—two confirmed risk factors for oral cancer—makes it difficult to establish a clear link between mouthwash and oral cancer.
- Irritation from dentures: Poorly fitting dentures that cause long-term irritation of the mouth lining have also been a point of concern regarding oral cancer risk. This link has not been confirmed in several studies. However, loose dentures may trap substances that are known to cause oral cancer, such as alcohol and tobacco. Individuals who wear dentures should be sure to have their fit checked by a dentist regularly, remove them at night, and clean and rinse them thoroughly each day.
NOTE: Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer. Not having risk factors doesn’t mean that you will not get cancer. If you think you may be at risk, you should discuss it with your doctor.
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