National Cancer Institute


Posted Date: Jan 26, 2016

Expert-reviewed information summary about factors that may influence the risk of developing cancer of the lip or mouth and about approaches that may help in the prevention of this disease.

This PDQ cancer information summary has current information about oral cavity and oropharyngeal cancer prevention. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.

Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Screening and Prevention Editorial Board.

Oral Cavity and Oropharyngeal Cancer Prevention

What is prevention?

Cancer prevention is action taken to lower the chance of getting cancer. By preventing cancer, the number of new cases of cancer in a group or population is lowered. Hopefully, this will lower the number of deaths caused by cancer.

To prevent new cancers from starting, scientists look at risk factors and protective factors. Anything that increases your chance of developing cancer is called a cancer risk factor; anything that decreases your chance of developing cancer is called a cancer protective factor.

Some risk factors for cancer can be avoided, but many cannot. For example, both smoking and inheriting certain genes are risk factors for some types of cancer, but only smoking can be avoided. Regular exercise and a healthy diet may be protective factors for some types of cancer. Avoiding risk factors and increasing protective factors may lower your risk but it does not mean that you will not get cancer.

Different ways to prevent cancer are being studied, including:

See the following PDQ summaries for information about screening, diagnosis, and treatment of oral cancer:

General Information About Oral Cavity and Oropharyngeal Cancer

Key Points for this Section

  • Oral cavity cancer and oropharyngeal cancer are diseases in which malignant (cancer) cells form in the mouth or throat.
  • Oral cancer is more common in men than in women.

Oral cavity cancer and oropharyngeal cancer are diseases in which malignant (cancer) cells form in the mouth or throat.

The term oral cancer is used to describe cancer that forms in the tissues of the oral cavity or the oropharynx.

Oral cavity cancer forms in any of these tissues of the oral cavity:

Anatomy of the oral cavity; drawing shows the lip, hard palate, soft palate, retromolar trigone, front two-thirds of the tongue, gingiva, buccal mucosa, and floor of mouth. Also shown are the teeth, uvula, and tonsil.
Anatomy of the oral cavity. The oral cavity includes the lips, hard palate (the bony front portion of the roof of the mouth), soft palate (the muscular back portion of the roof of the mouth), retromolar trigone (the area behind the wisdom teeth), front two-thirds of the tongue, gingiva (gums), buccal mucosa (the inner lining of the lips and cheeks), and floor of the mouth under the tongue.

Oropharyngeal cancer forms in tissues of the oropharynx:

  • The middle part of the pharynx (throat) behind the mouth.
  • The back third of the tongue.
  • The soft palate (the back, soft part of the roof of the mouth).
  • The side and back walls of the throat.
  • The tonsils.

Anatomy of the pharynx; drawing shows the nasopharynx, oropharynx, and hypopharynx. Also shown are the nasal cavity, oral cavity, esophagus, trachea, and larynx.
Anatomy of the pharynx (throat). The three parts of the pharynx are the nasopharynx, oropharynx, and hypopharynx.

Most oral cavity and oropharyngeal cancers start in squamous cells (thin, flat cells) that line the oral cavity and oropharynx. Cancer that forms in squamous cells is called squamous cell carcinoma. Squamous cell carcinoma can form from lesions on the mucous membranes (the lining of the mouth and throat). These lesions include leukoplakia (an abnormal white patch of cells) and erythroplakia (an abnormal red patch of cells).

In Western countries, such as the United States, the most common areas for oral cancer are the tongue and the floor of the mouth.

Oral cancer is more common in men than in women.

Men are more than twice as likely as women to have oral cancer and die from it.

Oral Cavity and Oropharyngeal Cancer Prevention

Key Points for this Section

  • Avoiding risk factors and increasing protective factors may help prevent cancer.
  • The following are factors for oral cavity cancer and oropharyngeal cancer:
    • Tobacco use
    • Alcohol use
    • Tobacco and alcohol use
    • Family history of oral cancer
  • The following is a risk factor for oropharyngeal cancer:
    • HPV infection
  • The following is a factor for oral cavity cancer and oropharyngeal cancer:
    • Quitting smoking
  • It is not clear whether avoiding certain risk factors will decrease the risk of oral cavity cancer or oropharyngeal cancer.
  • Cancer prevention clinical trials are used to study ways to prevent cancer.
  • New ways to prevent oral cancer and oropharyngeal cancer are being studied in clinical trials.
    • Chemoprevention

Avoiding risk factors and increasing protective factors may help prevent cancer.

Avoiding cancer risk factors may help prevent certain cancers. Risk factors include smoking, being overweight, and not getting enough exercise. Increasing protective factors such as quitting smoking, eating a healthy diet, and exercising may also help prevent some cancers. Talk to your doctor or other health care professional about how you might lower your risk of cancer.

Oral cavity cancer and oropharyngeal cancer are two different diseases, but they have some risk factors in common.

The following are factors for oral cavity cancer and oropharyngeal cancer:

Tobacco use

Using tobacco is the leading cause of oral cavity cancer and oropharyngeal cancer. The risk of these cancers is about 10 times higher for current smokers than for people who have never smoked.

All forms of tobacco, including cigarettes, pipes, cigars, and chewing ( smokeless) tobacco, can cause cancer of the oral cavity and oropharynx. For cigarette smokers, the risk of oral cancer increases with the number of cigarettes smoked per day. Tobacco use is most likely to cause oral cancer in the floor of the mouth, but also causes cancer in other parts of mouth and throat.

Betel quid chewinghas also been shown to increase the risk of oral cavity and oropharyngeal cancer.

Tobacco users who have had oral cancer may develop second cancers in the oral cavity or nearby areas. These areas include the nose, throat, vocal cords, esophagus, and trachea (windpipe). This is because the oral cavity and nearby areas have been exposed to the harmful substances in tobacco, and new cancers may form over time.

Alcohol use

Using alcohol is a major risk factor for oral cancer.

The risk of oral cancer increases with the number of alcoholic drinks consumed per day. The risk of oral cancer is about twice as high in people who have 3 to 4 alcoholic drinks per day compared to those who don't drink alcohol.

Tobacco and alcohol use

The risk of oral cavity cancer and oropharyngeal cancer is 2 to 3 times higher in people who use both tobacco and alcohol than it is in people who use only tobacco or only alcohol.

Family history of oral cancer

People with a family history of oral cancer have an increased risk of oral cancer.

The following is a risk factor for oropharyngeal cancer:

HPV infection

Being infected with certain types of HPV, especially HPV type 16, increases the risk of oropharyngeal cancer. HPV infection is spread mainly through sexual contact.

The risk of oropharyngeal cancer is about 15 times higher in people with oral HPV 16 infection, compared to people without oral HPV 16 infection. Tobacco and alcohol use do not appear to further increase the risk in people with oral HPV infection.

The following is a factor for oral cavity cancer and oropharyngeal cancer:

Quitting smoking

Studies have shown that when people stop smoking cigarettes, their risk of oral cavity cancer and oropharyngeal cancer decreases by one-half (50%) within 5 years. Within 10 years of quitting, their risk of oral cavity cancer and oropharyngeal cancer is the same as for a person who never smoked cigarettes.

It is not clear whether avoiding certain risk factors will decrease the risk of oral cavity cancer or oropharyngeal cancer.

It has not been proven that the following will decrease the risk of oral cavity cancer or oropharyngeal cancer:

Cancer prevention clinical trials are used to study ways to prevent cancer.

Cancer prevention clinical trials are used to study ways to lower the risk of certain types of cancer. Some cancer prevention trials are done with healthy people who have not had cancer but who have an increased risk for cancer. Other prevention trials are done with people who have had cancer and are trying to prevent another cancer of the same type or to lower their chance of developing a new type of cancer. Other trials are done with healthy volunteers who are not known to have any risk factors for cancer.

The purpose of some cancer prevention clinical trials is to find out whether actions people take can prevent cancer. These may include eating fruits and vegetables, exercising, quitting smoking, or taking certain medicines, vitamins, minerals, or food supplements.

New ways to prevent oral cancer and oropharyngeal cancer are being studied in clinical trials.

Chemoprevention

Chemoprevention is the use of drugs, vitamins, or other agents to prevent or delay the growth of cancer. One study found no decrease in the risk of oropharyngeal cancer in male smokers who took vitamin E and beta carotene supplements (pills).

Other studies of chemoprevention are being done in patients at high risk of oral cavity and oropharyngeal cancer. This includes patients with lesions on the mucous membranes, which may become cancer, and patients with a history of oral cancer.

Clinical trials are taking place in many parts of the country. Information about clinical trials can be found in the Clinical Trials section of the NCI website. Check NCI's list of cancer clinical trials for lip and oral cavity cancer prevention trials and oropharyngeal cancer prevention trials that are now accepting patients.

About This PDQ Summary

About PDQ

Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.

PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.

Purpose of This Summary

This PDQ cancer information summary has current information about oral cavity and oropharyngeal cancer prevention. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.

Reviewers and Updates

Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change.

The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Screening and Prevention Editorial Board.

Clinical Trial Information

A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

Clinical trials are listed in PDQ and can be found online at NCI's website. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).

Permission to Use This Summary

PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”

The best way to cite this PDQ summary is:

National Cancer Institute: PDQ® Oral Cavity and Oropharyngeal Cancer Prevention. Bethesda, MD: National Cancer Institute. Date last modified <MM/DD/YYYY>. Available at: http://www.cancer.gov/types/head-and-neck/patient/oral-prevention-pdq. Accessed <MM/DD/YYYY>.

Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 2,000 scientific images.

Disclaimer

The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the Managing Cancer Care page.

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