Nik Sisodia discusses the risk factors for the big C.
Diagnoses for all types of cancer have declined dramatically since the start of the Covid-19 pandemic. Having been forced to close earlier in the year as part of a nationwide lockdown, dental practices are only just returning to a sense of normality, meaning that many cases of mouth cancer may be going undetected. This is particularly alarming considering incidents of newly diagnosed mouth cancers were on the rise before the pandemic. Sadly, an estimated 2,722 people in the UK now lose their life to mouth cancer each year, emphasising the importance of early detection, which can boost the chances of survival from 50 to 90 per cent.
Having a comprehensive understanding of the various risk factors for mouth cancer is key to improving disease awareness among patients. Mouth Cancer Action Month provides the ideal opportunity for dental professionals to engage with patients and the wider community about the prevention and early detection of mouth cancer, which is vital given that there is a concerning lack of disease knowledge within the general population. In fact, three quarters of British adults admit that they cannot identify the major signs and symptoms of the condition.
There are several factors that are likely to increase an individual’s risk of mouth cancer. Indeed, up to 90 per cent of all mouth cancers are linked to lifestyle influences, which means that with a few small changes, many people can help minimise their chances of developing the disease. Let’s consider some of the most common risk factors for mouth cancer.
Smoking and tobacco use
Tobacco exposes the mouth to carcinogenic chemicals, either during inhalation when smoked or through direct contact when chewed. It is thought that these chemicals then cause genetic changes in the cells of the oral cavity, which can lead to the development of mouth cancer. It is suggested that more than 60 per cent of mouth and oropharyngeal cancers in Britain are caused by smoking. The risk of a smoker being diagnosed with mouth cancer is almost double that of someone who has never smoked, while in regular, long-term users of smokeless tobacco, this risk is more than 11 times that of non-users.
Alcohol
Drinking alcohol to excess is another major risk factor for mouth cancer, with a third of all mouth cancers being linked to heavy alcohol consumption. Not only can alcohol irritate the mouth and throat but once consumed, it can also be converted into acetaldehyde, which is known to cause genetic changes inside the body’s cells that can lead to cancer. People who have four or more alcoholic drinks a day are five times more at risk of mouth and pharynx cancers, compared to those who never drink or drink alcohol only occasionally. Moreover, smoking whilst drinking increases the chances of developing mouth cancer by approximately 30 times, as tobacco and alcohol together can overwhelm the body’s defence mechanisms.
Human papilloma virus (HPV)
An increasing proportion of cancer is caused by HPV infection in the mouth. Primarily transmitted through sexual contact, HPV refers to a very common group of viruses that can affect the skin and cells lining the inside of the body. Around one in four mouth cancers and most throat cancers in younger patients are HPV-related. Although HPV does not directly cause cancer, it can impact the cells it infects – including those in the mouth and throat – making them more likely to become cancerous. HPV type-16 and 18 are linked to 73 per cent of oropharyngeal cancers and 12 per cent of oral cavity and hypopharynx cancers, with risk being higher in those with more sexual partners.
Age and gender
As we age, the cells in the body can become damaged and build up over time, which is why mouth cancer risk also increases as individuals get older. More than two in three cases of mouth cancer develop in adults over the age of 55, while one in eight occur in people younger than 50, but this may change as HPV-related cancers become more common. Furthermore, men are more than twice as likely as women to develop mouth cancer, with the condition more often diagnosed in men at a younger age compared to other cancers. The difference in cases may be related to excess tobacco and alcohol use, which is observed more commonly in men than in women.
The role of the dental team
Dental professionals are uniquely positioned to support the prevention and early diagnosis of mouth cancer, as well as provide suitable treatment to those whose oral health has been compromised by the disease and its associated therapies. If you suspect a possible mouth cancer case, or have a patient recovering from cancer treatment, you can always refer to a trusted clinic, like Ten Dental+Facial,
for a second opinion.
Many deaths caused by mouth cancer can be prevented if it is identified early and treated quickly enough. That’s why it’s essential that patients are encouraged to visit the dentist regularly to be checked for any signs or symptoms of the disease. Educating patients about the risk factors for mouth cancer is ultimately a step in the right direction towards potentially saving many more lives.
References available on request.