Oral Cancer Prevention (PDQ®)

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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:

  • Changing lifestyle or eating habits.
  • Avoiding things known to cause cancer.
  • Taking medicines to treat a precancerous condition or to keep cancer from starting.

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

  • Oral Cancer Screening
  • Lip and Oral Cavity Cancer Treatment
  • Oropharyngeal Cancer Treatment
  • Cigarette Smoking: Health Risks and How to Quit
Oral cancer is a disease in which malignant (cancer) cells form in the lips, mouth, or throat.

Oral cancer may form in any of three main areas:

  • Lips.
  • Oral cavity, which includes:
    • The front two thirds of the tongue.
    • The gingiva (gums).
    • The buccal mucosa (the lining of the inside of the cheeks).
    • The floor (bottom) of the mouth under the tongue.
    • The hard palate (the front, bony part of the roof of the mouth).
    • The retromolar trigone (the small area behind the wisdom teeth).

  • Oropharynx, which includes:
    • 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.

Most oral cancers start in squamous cells (thin, flat cells) that line the lips, 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.

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.

The following are risk factors for oral cancer:
Tobacco use

Using tobacco is the leading cause of oral cancer.

All forms of tobacco, including cigarettes, pipes, cigars, and chewing (smokeless) tobacco, can cause oral cancer. 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.

The risk of oral cancer is greater in people who use both tobacco and alcohol than it is in people who use only tobacco or only alcohol.

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.

The risk of oral cancer is higher in people who use both alcohol and tobacco than it is in people who use only alcohol or only tobacco.

HPV infection

Being infected with a certain type of HPV virus, especially HPV type 16, increases the risk of oral cancer. HPV infection is spread mainly through sexual contact. People who have many oral sex partners have a higher risk of HPV infection. The number of cases of oral cancer caused by HPV infection is small but increasing.

Sun exposure

Being exposed to sunlight may increase the risk of lip cancer. Lip cancer occurs most often on the lower lip.

The following is a protective factor for oral cancer:
Quitting smoking

Studies have shown that when people stop smoking cigarettes, their risk of oral cancer decreases by one-half (50%) within 5 years. Within 10 years of quitting, their risk of oral 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 cancer.

Certain risk factors, such as drinking alcohol, HPV infection, and sun exposure, increase the risk of oral cancer. It may seem that by avoiding these risk factors, the chance of having oral cancer would decrease, but that has not been proven.

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 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 oral 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 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 Web site. 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.

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Changes were made to this summary to match those made to the health professional version.

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.

This PDQ cancer information summary has current information about oral 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.

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 Web site. 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).

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 Cancer Prevention. Bethesda, MD: National Cancer Institute. Date last modified <MM/DD/YYYY>. Available at: http://cancer.gov/cancertopics/pdq/prevention/oral/Patient. Accessed <MM/DD/YYYY>.

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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 Coping with Cancer: Financial, Insurance, and Legal Information page.

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2008-08-272013-01-09