Risk Factors

There are significant risk factors that contribute to head and neck cancers. A few are genetic, which predisposes one to developing a cancer later in life. Others are environmental or behavioral based, such as the use of tobacco products, second hand smoke and alcohol.

Typically, oral cancer occurs in older individuals between the ages of 65 and 75 and increases with age. It can also occur in younger individuals. However, those persons between the defined ages are thought to have longer exposure to the following risk factors:

Environmental

Exposure to known carcinogens such as industrial toxins (for example, asbestos, benzenes). Causative agents are identified when individuals have a specific type of cancer and are found to have a history of high exposure to particular agents. It is repeated exposure to such agents (i.e. chemicals in tobacco and tobacco smoke) which can cause cellular alterations leading to cancer. Carcinogens are believed to play a part in damaging or destroying genes that control cell proliferation. Unrestrained proliferation of rapidly dividing cells results in a mass of abnormal cells known as a tumor. Carcinogens may selectively enhance the growth of tumor cells.

Behavioral

Socioeconomic factors (particularly with regards to ethnicity) have a defined role in the acquisition of oral cancer. In cases where individuals have an underprivileged lifestyle, nutrition may be deficient and social habits may include frequent and regular indulgence in the use of alcohol and tobacco products. Individuals who use tobacco products such as cigarettes, cigars, pipes and chewing tobacco are at a greater risk of acquiring the disease. The combined use of both alcohol and tobacco increases this risk more than using either substance alone.

• Tobacco
  Tobacco smoke is the single most lethal carcinogen in the United States. Tobacco contains multiple chemicals; at least 60 are cancer-causing agents and are contributing factors in one-third of all annual cancer deaths. Whether an individual acquires a tobacco related malignancy, or benefits from the preventive effects of smoking cessation, is dependent upon their total lifetime exposure. This includes the frequency, quantity of cigarettes smoked and duration of the habit. The risk is significantly greater for individuals who began smoking at a young age.
  
  
• Secondhand smoke
  Health risks posed by environmental tobacco smoke are not limited to smokers. Secondhand or passive smoking contributes annually to a few thousand cancer diagnoses; and, in some cases deaths from lung cancer can be attributed to secondhand smoke. Frequent inhalation of secondhand smoke has the same effect as breathing environmental pollutants. In the past decade, the Environmental Protection Agency has classified passive cigarette smoke as a Group "A" carcinogen, thereby categorizing it as a known human carcinogen.
  
  
• Alcohol
  Frequent and heavy use of alcohol has an impact on many health disorders and diseases. However, when it is combined with tobacco, the two substances are believed to have a synergistic effect whereby one substance significantly amplifies the hazardous effects of the other.

Genetics

Genetics influence the development of some cancers, as it predisposes one to the possibility of acquiring the disease. Through genetics, it is possible to inherit gene mutations that promote growth of cancer cells. However, genetics are responsible for less than five percent of the development of fatal cancers. Genetic variables are higher within races than between.

Mortality

The cure rates for cancer of the oral cavity varies depending on the stage and site. Early stage cancers are thought to have a cure rate as high as 90 percent. Moderate or advanced cancers may be controlled by combined modality therapies such as surgery or radiation or both. In the case of the latter, the survival rate differs and is dependent upon the site and the extent of spread of the disease.