Head and Neck Cancer: Important Risk Factors to Know
The good news: You may have control over many of these risk factors.
While many people express fear at developing cancer, many people do not realize that their everyday lifestyle choices may help lower the chances of that happening. Knowing the habits that can increase your risk of cancer can empower you to take care of yourself for years to come. This is especially true for head and neck cancers.
Head and neck cancer is a category of cancers that can affect the mouth, nose, throat, and face. (Learn more about types of head and neck cancers here.) Many of the primary risk factors for head and neck cancer are lifestyle-related, meaning most individuals have a real opportunity to manage their risk.
Alcohol and Tobacco Use
The primary risk factors for head and neck cancer are alcohol consumption and tobacco use (including traditional cigarettes, chewing tobacco, hookah pipes, and e-cigarettes). In fact, at least 75 percent of these cancers are linked to alcohol and tobacco use, according to the National Cancer Institute.
“Abuse of alcohol and tobacco certainly increases the risk for developing the cancer,” says Mark Persky, MD, otolaryngologist and surgeon at NYU Langone Health in New York City. “If you do one or the other, either could potentially cause cancer, but if the smoking and drinking are combined, then indeed the chances of developing cancer is much increased.”
HPV Infection
An infection of the human papillomavirus (HPV) can increase your risk of several types of cancer, including head and neck cancer. HPV comes in many strains, and HPV type 16 is linked to a higher risk of head and neck cancer—especially oropharyngeal cancers of the tonsils or base of the tongue. This has become more common in the past decade, according to Dr. Persky.
“Now we have younger patients being involved with no history of smoking or drinking developing significant lymph node involvement in the neck from these HPV-associated tumors,” says Dr. Persky.
You can lower your risk of an HPV infection by getting the HPV vaccine (if you’re eligible), using condoms during sex, and getting regular pap tests and HPV tests to stay informed about your health.
Other Risk Factors
A number of other less common risk factors may influence the development of head and neck cancer, such as:
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A diet high in preserved or salted foods may increase the risk of nasopharyngeal cancer.
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Poor oral hygiene may slightly increase the risk of oral cavity cancer.
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Infection with the Epstein-Barr virus (the virus that causes “mono”) increases the risk of nasopharyngeal cancer and salivary gland cancer.
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Certain occupational exposures may increase someone’s risk, such as exposure to wood dust, asbestos, synthetic fibers, nickel dust, or formaldehyde. People working in construction, metal, ceramic, logging, food, or textile industries have been found to have a higher rate of laryngeal cancer.
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Radiation exposure to the head and neck may increase the risk of salivary gland cancer.
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Chewing paan, or betel quid, significantly increases the risk of oral cancer. Betel quid is a leaf used as a wrapping for the areca nut or tobacco that is chewed for ceremonial purposes in parts of Southeast Asia.
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Chinese ancestry is associated with nasopharyngeal cancer, partially due to the popular consumption of salted fish and preserved eggs, veggies, and roots in traditional Chinese cuisine. Furthermore, the Epstein-Barr virus is also common among this population.
Since many of these risk factors can be prevented or controlled, it’s important to talk to a doctor if you have any of these risk factors. Your doctor may be able to help you manage your risk of head and neck cancer, which will likely have an effect on your overall health as well.
Dr. Persky is an otolaryngologist and surgeon at NYU Langone Health in New York City.
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Abuse of alcohol and
tobacco certainly increases the risk for
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developing a cancer.
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If you do one or the other,
either could potentially cause cancer.
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But if the smoking and
drinking are combined,
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then indeed the chances of
developing cancer is much increased.
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[MUSIC]
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Well, traditionally, the most common risk
factors are tobacco and alcohol abuse.
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That certainly is a major risk factor
in causing the oral cavity carcinomas.
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In the past decade or so, there's been
a remarkable increase in the oral pharynx
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tumors, where HPV, or
human papillomavirus,
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has been much more commonly involved
in the development of these tumors.
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Much more so
than those associated with the tobacco and
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alcohol exposure for the oral pharynx.
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We have younger patients being involved,
with no history of smoking or
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drinking, developing significant
lymph node involvement in the neck,
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from these HPV-associated tumors.
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The other factors are very difficult
to define as far as how they develop
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predisposed to head and neck cancer.
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Certainly, there's a cancer of
the nasopharynx that the Asian population,
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especially, is predisposed to developing.
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It's directly associated with what's
called EBV, or Epstein-Barr virus,
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which in a great majority of the
nasopharynx cancers that Asians develop,
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have high titers of that virus within the
tumor itself and within the blood stream.
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And certainly there are some patients, for
whatever reason, are more predisposed to
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developing cancer even with less
exposure to those cancer agents.
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So sometimes it's difficult to define, but
the more you drink, the more you smoke,
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the more of a chance that you would
develop one of these cancers.
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Cheng H. Nasopharyngeal cancer and the Southeast Asian patient. Am Fam Physician. 2001 May 1;63(9):1776-83.
Epidemiology and risk factors for head and neck cancer. Waltham, MA: UpToDate, 2019. (Accessed on March 21, 2019 at https://www.uptodate.com/contents/epidemiology-and-risk-factors-for-head-and-neck-cancer.)
Epstein-Barr virus and infectious mononucleosis. Atlanta, GA: Centers for Disease Control and Prevention. (Accessed on March 21, 2019 at https://www.cdc.gov/epstein-barr/about-ebv.html.)
Head and neck cancers. Bethesda, MD: National Cancer Institute, 2017. (Accessed on March 21, 2019 at https://www.cancer.gov/types/head-and-neck/head-neck-fact-sheet#q2.)
How can I make sure I don’t get or spread HPV? Washington, DC: Planned Parenthood. (Accessed on March 21, 2019 at https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/hpv/how-can-i-make-sure-i-dont-get-or-spread-hpv.)
If you have head and neck cancer. Atlanta, GA: American Cancer Society, 2018. (Accessed on March 21, 2019 at https://www.cancer.org/cancer/oral-cavity-and-oropharyngeal-cancer/if-you-have-head-or-neck-cancer.html.)