Risks for oral cancer

Some things can affect your risk, or chance, of developing cancer. Certain behaviours, substances or conditions can increase or decrease the risk. Most cancers are the result of many risks. But sometimes cancer develops in people who don't have any risks.

Tobacco and alcohol are the main risks for oral cancer.

Oral cancer is rare in children and young adults. The risk of developing oral cancer increases with age and is greatest after 50 years of age. More men than women develop oral cancer and it occurs more often in white men. Some studies show that low socioeconomic status may increase the risk for oral cancer.

Some of the things that increase the risk for oral cancer may also cause a precancerous condition called oral epithelial dysplasia ( leukoplakia and erythroplakia) . Oral epithelial dysplasia is not cancer, but it can sometimes become oral cancer if it isn't treated. Find out more about precancerous conditions of the mouth.

If you have a genetic condition that increases your risk for oral cancer, you may need to visit your doctor more often. Talk to your doctor about your risk and if you need to have certain tests to check for oral cancer.

There are several things that could increase your risk for cancer. Some of these risks can't be changed. But in most cases, there are things you can do to lower your risk.

The following can increase your risk for oral cancer:

• tobacco

• alcohol

• betel quid (areca nut)

• human papillomavirus (HPV)
• excess weight
• sun and indoor tanning
• weak immune system
• graft-versus-host disease (GVHD)
• lichen planus
• genetic conditions

Smoking tobacco increases your risk for oral cancer.

All forms of tobacco, including cigarettes, cigars, pipes, bidis and smokeless tobacco (including chewing tobacco and snuff), increase your risk.

The more you smoke and the longer you smoke, the greater your risk. The risk of developing oral cancer decreases with time after you quit smoking.

The risk for oral cancer greatly increases when smoking is combined with using smokeless tobacco or drinking alcohol, or both. Continuing to smoke after treatment for oral cancer increases the risk of developing a second oral cancer.

Tobacco products such as cigarettes, cigars or pipes are often linked with cancer of the lip if they sit on the lips. Using smokeless tobacco products is linked with cancer of the gums and inner lining of the cheeks and lips because the tobacco regularly touches these areas.

Some studies show that second-hand smoke may also increase the risk for oral cancer.

Learn more about how to live smoke-free.

Drinking alcohol increases your risk for oral cancer. The more you drink, the greater your risk. Using alcohol and tobacco together increases the risk of oral cancer more than using either one alone.

Learn more about how to limit alcohol.

Chewing betel quid is common in South Asia and among some South Asian immigrants in Canada. Betel quid is areca nut (the seed from the fruit of the areca palm) and slaked lime (or calcium hydroxide) wrapped in a betel leaf. Some people chew areca nut by itself. Betel quid and tobacco are often chewed together, which is called gutka.

People who chew betel quid or gutka have a higher risk of oral cancer, especially in the inner lining of the cheeks and lips.

Human papillomavirus (HPV) is a virus that can cause warts (called papillomas) on different parts of the body, including the genitals and the mouth. HPV infections are very common because the virus is easily passed by skin-to-skin contact with any HPV-infected area of the body. It's mainly spread through sexual contact, including oral sex. HPV increases the risk for oral cancer.

The different types of HPV are usually given a number to identify them. Infection with HPV16 increases the risk of oral cancer. Infection with HPV18 may increase the risk. HPV is likely the cause of oral cancer that isn't linked with tobacco or alcohol use.

Learn more about human papillomavirus (HPV).

Sun and indoor tanning equipment, such as tanning beds and sun lamps, increase your risk for lip cancer. This is especially true for people who work in the sun for long periods of time, such as farmers. Most lip cancers occur on the bottom lip, likely because it’s more exposed to the sun.

Learn more about how to be sun safe.

Overweight or obesity increases the risk for oral cancer.

Learn more about how to have a healthy body weight.

Having a weak immune system (immunosuppression) increases your risk for oral cancer. You may have a weak immune system for different reasons, including if you have HIV (the virus that causes AIDS) or if you have had an organ transplant and must take medicines to suppress your immune system. People with weakened immune systems are also more likely to get an HPV infection, which increases the risk for oral cancer.

Graft-versus-host disease (GVHD) can happen after an allogeneic stem cell transplant. An allogeneic transplant uses stem cells from someone else (a donor) instead of your own stem cells. The stem cells from the donor develop into a new immune system that will identify and destroy cancer cells. But it can also attack your healthy cells and cause damage to tissues and organs. Damage to cells in the mouth from GVHD increases the risk of oral cancer.

Find out more about graft-versus-host disease (GVHD).

Lichen planus is an inflammatory condition that can affect the tongue, gums, mouth and skin. Sometimes it can cause painful sores (ulcers) in the mouth. Having lichen planus with ulcers for a long time increases the risk of oral cancer.

A genetic condition is a disease caused by a change (mutation) in one or more genes. Having certain genetic conditions increases the risk of developing oral cancer.

Fanconi anemia is an inherited condition that affects the bone marrow so it cannot make red blood cells, white blood cells or platelets. Fanconi anemia increases the risk of oral and oropharyngeal cancers, myelodysplastic syndromes( MDS) and acute myelogenous leukemia( AML).

Congenital dyskeratosis is an inherited condition that causes abnormally shaped fingernails and toenails, a lacy rash on the face and chest, white patches in the mouth and often bone marrow failure. Congenital dyskeratosis increases the risk of oral cancer and other head and neck cancers, myelodysplastic syndromes (MDS) and acute myelogenous leukemia (AML).

The following have been linked with an increased risk of oral cancer, but more research is needed to know for sure that they are risks:

• dentures that don't fit properly
• poor oral health
• family history of squamous cell carcinoma
• previous cancer
• a diet low in vegetables and fruit

To make the decisions that are right for you, ask your doctor questions about risks. Learn how cancer can be prevented and what you can do to reduce your risk.