Head and neck cancer risk factors and causes

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science

This page was updated on May 19, 2022.

This overview will cover the basic facts about head and neck cancer risks factors and causes, including:

Common head and neck cancer causes

When it comes to head and neck cancer, some risk factors can’t be changed, such as age, race, genetic makeup and medical history. But other risk factors people do have control over, including a history of certain lifestyle behaviors.

In fact, according to the American Society of Clinical Oncology, 70 to 80 percent of head and neck diagnoses are linked to tobacco use, and a considerable number of cancers are caused by the combined use of tobacco and alcohol.

Common head and neck cancer risk factors

Here's a list of risk factors for head and neck cancers and, in some cases, the specific type of cancer they are associated with.


This is the single largest risk factor for head and neck cancer. Smoking presents the greatest risk of developing this type of cancer, but secondhand smoke may also increase the risk. Chewing tobacco has been linked to oral cavity cancer.


Excessive drinking is the second largest risk factor for cancers of the mouth, pharynx, larynx and esophagus. Those who use both alcohol and tobacco increase their risk even more. Tobacco and alcohol use are linked to squamous cell carcinomas of the mouth and voice box.


Men are two to three times more likely than women to develop head and neck cancer. However, more women have been diagnosed with head and neck cancers in the past several decades. Oropharyngeal cancer related to the human papillomavirus (HPV) is more common in men.


Head and neck cancer is more common in people over the age of 40. Oral cancers develop slowly, which is why they’re not found as frequently in younger people.


Head and neck cancers are more common in certain ethnic groups. In particular, those of Asian ancestry may be at higher risk for nasopharyngeal cancer.

Certain illnesses

Epstein-Barr virus (EBV) and two inherited genetic syndromes—Fanconi anemia and dyskeratosis congenita—have been linked to head and neck cancer. EBV, the virus that causes mononucleosis, is a risk factor for nasopharyngeal cancer and cancer of the salivary glands. Fanconi anemia may increase the risk of developing precancerous lesions and certain cancers at a younger age.

Human papillomavirus (HPV)

People infected with HPV are at higher risk for some throat and mouth cancers. HPV has been on the rise in recent years, especially among people in their 40s and 50s. HPV type 16 is most often linked to cancer of the oropharynx, especially those found in the tonsil and at the tongue’s base.

Sun exposure

Prolonged sun exposure may increase the risk of lip and oral cancer. The risk is particularly high for the lip area and skin cancers of the head and neck area. People who work outdoors and are exposed daily to the sun’s ultraviolet rays for a long time are particularly at risk.

Radiation therapy

High doses of radiation to the head and neck, such as may be given during radiation therapy, may increase the risk of developing this type of cancer. Radiation exposure is a risk factor for cancer of the salivary glands. Children have an increased risk of nasal cavity cancer if a hereditary form of retinoblastoma (eye cancer) has been treated with radiation.

Other head and neck cancer risk factors

In addition to the risk factors discussed above, there are several other factors that may play a role in the development of head and neck cancers.

Poor nutrition

Poor nutrition and vitamin deficiencies may raise a patient’s risk of developing head and neck cancers. For example, those whose diets don’t include fruits and vegetables may be at an increased risk for cancers of the oral cavity and oropharynx.

Vaping and marijuana use

Most physicians discourage vaping, although more studies are needed. Studies also have linked marijuana use to a higher risk for head and neck cancer. Marijuana may be taken orally, but it’s usually smoked, exposing the upper respiratory tract and lungs to irritants and cancer-causing substances.

Poor oral health and dental hygiene

Not taking proper care of the mouth, teeth and gums may increase the risk of developing head and neck cancer. The risk may be linked to normal bacteria found in the mouth that are allowed to thrive when people don’t brush and floss. Poorly fitting dentures also may trap particles from cancer-causing elements such as tobacco and alcohol.

Unhealthy work environment

Environmental factors may increase risk. For example, people who inhale asbestos, wood dust, paint fumes and other chemicals at work may be at increased risk of developing head and neck cancer.

Gastroesophageal reflux disease (GERD)

GERD causes stomach acid to move into the upper airway and throat. That acid may increase the risk for head and neck cancer. The National Cancer Institute reported that the increased risk is two-fold for squamous cell cancers of the esophagus and larynx. GERD may also raise the risk of hypopharyngeal cancer, but more research is needed.

Weakened immune system

People whose immune systems are compromised may be at higher risk of developing head and neck cancer. When the immune system is less efficient at stopping invaders, the risk of cancer and other diseases increases.

History of head and neck cancer

People who have previously been treated for head or neck cancer are at a higher risk of developing another cancer. Head and neck cancers that aren’t related to HPV infection are more likely to recur after they have been treated.

Paan (betel quid)

A common custom in Southeast Asia is the chewing of paan (betel quid). This habit is strongly connected to an increased risk of mouth cancers. People who chew a mix of betel quid and tobacco are also at increased risk.

Next topic: What are the symptoms of head and neck cancer?

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