What's Behind the Rise in Mouth and Throat Cancer?

The habits that may be putting you at risk for oral cancer

An esti­mat­ed 53,000 peo­ple are diag­nosed with mouth or throat can­cers each year in the Unit­ed States. These can­cers can be found on your gums, lips, sali­vary glands, tongue, ton­sils and oth­er parts of your mouth and throat. Tra­di­tion­al­ly, these can­cers are more like­ly to occur in men, typ­i­cal­ly over the age of 55, and have been pri­mar­i­ly linked to tobac­co and alco­hol use. While the over­all rate of mouth and throat can­cer cas­es is declin­ing, the rate of throat can­cer cas­es diag­nosed in younger adults and linked to HPV infec­tion are on the rise.

As with any type of can­cer, it is impor­tant to be aware of com­mon symp­toms and to under­stand your indi­vid­ual risk. You may be at an increased risk of devel­op­ing mouth or throat can­cer if one (or more) of the fol­low­ing apply to you.

Com­mon Caus­es of Mouth and Throat Cancers

Tobac­co use

The major­i­ty of peo­ple with mouth or throat can­cers use, or have used, tobac­co. Your risk increas­es the longer and more fre­quent­ly you use tobac­co. In addi­tion to cig­a­rettes, oth­er tobac­co prod­ucts can cause can­cer. If you use a pipe, your risk is very high to devel­op can­cer of the lips, par­tic­u­lar­ly in areas that come into con­tact with the pipe. Oral tobac­co prod­ucts, like chews or dips, are linked to can­cers of the cheeks, gums and lips.

Alco­hol consumption

Fre­quent or exces­sive alco­hol con­sump­tion increas­es your risk of devel­op­ing mouth or throat can­cer. In fact, an esti­mat­ed 70 per­cent of patients diag­nosed with oral can­cers are heavy drinkers.

If you smoke and drink, your risk is even high­er. If you use tobac­co prod­ucts, take steps to quit. Alco­hol con­sump­tion should be lim­it­ed to one drink per day for women and no more than two drinks per day for men.

Age

Oral can­cers can occur at any age, but until recent­ly, they were uncom­mon before the age of 55 because they often take sev­er­al years to devel­op. This is chang­ing as HPV-relat­ed can­cers con­tin­ue to become more com­mon and tobac­co use declines.

Gen­der

Men are almost twice as like­ly as women to devel­op mouth and throat can­cers. This gen­der gap may begin to shrink if HPV-relat­ed cas­es con­tin­ue to increase.

HPV infec­tion

HPV is a group of more than 150 dif­fer­ent virus­es, each assigned a unique num­ber. Cer­tain strands of HPV have been linked to oral and repro­duc­tive can­cers, how­ev­er HPV16 is the virus sub­type most often asso­ci­at­ed with mouth and throat can­cers. The num­ber of throat can­cers linked to HPV16 has increased sig­nif­i­cant­ly over the last sev­er­al years, espe­cial­ly in young adults. The exact rea­son for this increase is still being researched, but it is thought to be relat­ed to cul­tur­al shifts in sex­u­al behav­iors, includ­ing more sex­u­al part­ners, unpro­tect­ed sex and increased fre­quen­cy of oral sex. Vac­ci­na­tions against HPV infec­tions are avail­able and your pri­ma­ry care provider can help you deter­mine if an HPV vac­cine is right for you. You can also reduce your risk by prac­tic­ing safe sex.

Oral health

The health of your mouth, teeth and gums may also play a role in your over­all risk. Poor oral hygiene can dis­rupt the bal­ance of healthy bac­te­ria found in your mouth and may cause a vari­ety of issues includ­ing tooth loss, gum dis­ease and cancer.

Ultra­vi­o­let light exposure

Ultra­vi­o­let (UV) light expo­sure, includ­ing sun­light, can increase your risk of devel­op­ing can­cers of the lips. If you spend a lot of time out­doors, it is impor­tant that you take pre­cau­tions to lim­it your UV expo­sure. Prop­er pre­cau­tions include avoid­ing time out­side dur­ing the mid­dle of the day when the sun’s UV rays are the strongest, wear­ing a wide-brimmed hat and fre­quent­ly apply­ing sun­screen and lip balms that con­tain a sun pro­tec­tion fac­tor (SPF) of 30 or higher.

Symp­toms of Mouth and Throat Cancer

It is pos­si­ble to devel­op mouth or throat can­cer with­out expo­sure to any of these risk fac­tors. If you expe­ri­ence any of the fol­low­ing symp­toms for more than two weeks, you should make an appoint­ment with your pri­ma­ry care physi­cian to deter­mine the cause:

  • Mouth pain or a sore that does­n’t heal
  • A red or white patch or lump that forms on your cheeks, gums, tongue or tonsils
  • A per­sis­tent sore throat or cough
  • An irri­ta­tion in your throat or sen­sa­tion that some­thing is caught in your throat
  • Dif­fi­cul­ty swal­low­ing or chewing
  • Vocal changes
  • Bad breath

In many cas­es, the first symp­tom is not in your mouth or throat, but in your neck. If you dis­cov­er a lump in your neck when you are not feel­ing sick, or if the lump does not go away after a few weeks, you should see your pri­ma­ry care physician.

Your doc­tor will review your symp­toms, along with your med­ical and fam­i­ly his­to­ry, and com­plete a phys­i­cal exam to check for abnor­mal­i­ties on your face, head, neck and mouth. If fur­ther exams or test­ing is need­ed, your doc­tor may refer you to an ear, nose and throat spe­cial­ist, or oto­laryn­gol­o­gist.

If can­cer is sus­pect­ed, a small tis­sue sam­ple called a biop­sy will be tak­en to con­firm the diag­no­sis and test for HPV infec­tion. Biop­sies pro­vide your doc­tor with impor­tant infor­ma­tion about how far the can­cer has pro­gressed and help guide treat­ment decisions.

There are cur­rent­ly no rou­tine screen­ing tests avail­able for mouth and throat can­cers. You can use a mir­ror to check the inside of your mouth for any lumps, patch­es or sores that may have formed. Oral can­cers may also be found dur­ing rou­tine den­tal exams, so it is impor­tant to get reg­u­lar clean­ings and main­tain good oral hygiene.

Sched­ule an appoint­ment with a pri­ma­ry care provider to dis­cuss your risk fac­tors and pre­ven­tive steps you can take to reduce your risk for mouth and throat cancer. 

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