Oral and Oropharyngeal Cancer: Risk Factors and Prevention

Approved by the Cancer.Net Editorial Board, 10/2022

ON THIS PAGE: You will find out more about the factors that increase the chance of developing oral and oropharyngeal cancers. Use the menu to see other pages.

A risk factor is anything that increases a person’s chance of developing cancer. Although risk factors often influence the development of cancer, most do not directly cause cancer. Some people with several risk factors never develop cancer, while others with no known risk factors do. Knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choices.

The risk of oral and oropharyngeal cancers is greatly increased by 2 factors:

  • Tobacco use. Using tobacco, including cigarettes, cigars, pipes, chewing tobacco, and snuff, is the single largest risk factor for head and neck cancer. Eighty-five percent (85%) of head and neck cancer is linked to tobacco use. Pipe smoking in particular has been linked to cancer in the part of the lips that touch the pipe stem. Chewing tobacco or snuff is associated with a 50% increase in the risk of developing cancer in the cheeks, gums, and inner surface of the lips, where the tobacco has the most contact. Secondhand smoke may also increase a person’s risk of head and neck cancer.

  • Alcohol. Frequent and heavy consumption of alcohol increases the risk of head and neck cancer. Using alcohol and tobacco together increases this risk even more.

Other factors that can raise a person’s risk of developing oral or oropharyngeal cancer include:

  • Prolonged sun exposure. High exposure to the sun, without sun protection measures, is linked with cancer in the lip area.

  • Human papillomavirus (HPV). Research shows that infection with the HPV virus is a risk factor for oropharyngeal cancer. In recent years, HPV-related oropharyngeal cancer in the tonsils and the base of the tongue has become more common. Sexual activity, including oral sex, with someone who has HPV is the most common way someone gets HPV. There are different types of HPV, called strains. Research links some HPV strains more strongly with certain types of cancers.

    It is likely that receiving an HPV vaccination before exposure to HPV can reduce the risk of oropharynx cancer (see below).

  • Gender. Men are more likely to develop oral and oropharyngeal cancers than women.

  • Fair skin. Fair skin is linked to a higher risk of lip cancer.

  • Age. People older than 45 have an increased risk for oral cancer, although this type of cancer can develop in people of any age.

  • Poor oral hygiene. Lack of dental care and not following regular oral hygiene practices may cause an increased risk of oral cavity cancer. Poor dental health or ongoing irritation from poorly fitting dentures, especially in people who use alcohol and tobacco products, may contribute to an increased risk of oral and oropharyngeal cancers. Regular examinations by a dentist or dental hygienist can help detect oral cavity cancer and some oropharyngeal cancers at an early stage.

  • Poor diet/nutrition. A diet low in fruits and vegetables and a vitamin A deficiency may increase the risk of oral and oropharyngeal cancer. Chewing betel nuts, a nut containing a mild stimulant that is popular in Asia, also raises a person’s risk of developing oral and oropharyngeal cancers.

  • Weakened immune system. People with a weakened immune system may have a higher risk of developing oral or oropharyngeal cancer.

  • Marijuana use. Recent studies have suggested that people who have used marijuana may be at higher-than-average risk for head and neck cancer.

Prevention

Different factors cause different types of cancer. Researchers continue to look into what factors cause oral and oropharyngeal cancers, including ways to prevent it. Although there is no proven way to completely prevent this disease, you may be able to lower your risk. Several of the risk factors for oral and oropharyngeal cancers can be avoided by making healthy lifestyle choices.

Stopping the use of all tobacco products is the most important thing a person can do to reduce the risk of oral and oropharyngeal cancers, even for people who have been using tobacco for many years.

Another way to reduce your risk of developing oropharynx cancer is to reduce your risk of contracting HPV. It is likely that receiving an HPV vaccination before exposure to HPV can reduce the risk of oropharynx cancer. The Gardasil 9 vaccine helps prevent infection from HPV-16, HPV-18, and 5 other types of HPV linked to cancer.

In the United States, the vaccine is approved for anyone between the ages of 9 and 45. The U.S. Centers for Disease Control (CDC) recommends HPV vaccination for everyone through the age of 26 if not already vaccinated. Some adults between the ages of 27 and 45 who have not already been vaccinated may decide to get it after reviewing their risks for infection and the benefits of the vaccine with their doctor. Even if you already have 1 type of HPV, the vaccine may protect you from types of HPV you do not have.

Another way to reduce your risk of HPV infection is to limit your number of sexual partners. Having many partners increases the risk of HPV infection. Using a condom does not fully protect you from HPV during sex.

Also, to reduce your risk of lip cancer, reduce your exposure to sunlight and other sources of ultraviolet (UV) radiation. Read more about protecting your skin from the sun.

Talk with your health care team if you have concerns about your personal risk of developing these types of cancer.

The next section in this guide is Screening. It explains how tests may find these types of cancer before signs or symptoms appear. Use the menu to choose a different section to read in this guide.