Oral cancer

Oral cancer is any abnormal growth and spreading of cells that occurs in the mouth. Learn about the types of oral cancer, risk factors, prevention and more.

On this page

• Types of oral cancer
• Signs and symptoms of oral cancer
• Risk factors
• Prevention
• Early detection
• Oral cancer self-assessment quiz
• Common myths about oral cancer

Types of oral cancer

Oral cancer can affect many areas of the mouth. These include the:

• lips
• gums
• tonsils
• tongue
• salivary glands
• back of the throat
• roof and floor of the mouth
• inside of the lips and cheeks
• oropharynx (made up of the tongue, soft palate, tonsils, middle part of the pharynx)

Signs and symptoms of oral cancer

Risk factors

There are many risk factors linked to developing oral cancer.

Age

Oral cancer can occur at any age, but people over the age of 45 are at higher risk. People who are over the age of 60 have the highest incidence of oral cancer.

Smoking

Smoking or using tobacco products increases the risk of oral cancer. Tobacco use combined with high alcohol consumption can increase the risk even further. Tobacco products include:

• cigarettes
• e-cigarettes
• pipes
• snuff
• chewing tobacco
• smokeless tobacco
• paan
• areca nut
• betel quid

Alcohol

Chronic or heavy use of alcohol also increases the risk of oral cancer. The increase in risk is in proportion to the amount of alcohol consumed and the length of time it is used.

HPV

According to the U.S. Centers for Disease Control and Prevention (CDC), human papillomavirus (HPV) is thought to cause 60% to 70% of oropharyngeal cancers in the United States. In Canada, the prevalence of HPV-positive oropharyngeal cancer rose from 47% in 2000 to 74% in 2012, with more men than women showing a greater rate of increase.

HPV is spread mainly through skin-to-skin or skin-to-mucosa contact. It may infect the mouth and throat and can increase the risk of developing oropharyngeal cancer.

Getting the HPV vaccine can protect you against HPV infections and reduce your risk of developing oropharyngeal cancer.

People who already have HPV may still benefit from receiving the HPV vaccine. This is because there are more than 200 types of HPV. Getting the vaccine can help protect from types of HPV to which you have not been exposed previously. However, the vaccine will not help protect against types of HPV to which you have been exposed.

Gender

Men are more susceptible than women to developing oral cancer. In the past, the ratio of incidence of oral cancer was 6 to 1 for men compared to women. However, this ratio is narrowing and is now closer to 2 to 1.

Diet

A diet low in fruits and vegetables puts you at greater risk of oral cancer. Micronutrients commonly found in fruits and vegetables, such as polyphenols, carotenoids and vitamins, have antioxidant and anti-inflammatory properties. These help to protect against the development of cancers, including oral cancer.

Poor oral health

Studies show that people with poor oral health have an increased risk of developing oral cancer.

Sun exposure

People who are in the sun a lot, especially those who do not have protection, are at an increased risk of developing lip cancer.

Family history or previous history of oral cancer

People who have had oral cancer or who have a family history of oral cancer are at higher risk of developing oral cancer, especially when combined with other risk factors such as heavy use of tobacco and alcohol.

Oral lichen planus

Oral lichen planus (OLP) is a chronic inflammatory condition that affects the mucous membranes of the mouth. OLP should be monitored regularly, as people who develop certain types of OLP may be at higher risk of developing oral cancer.

Chronic candidiasis

Candidiasis is an infection with the yeast Candida. Deep, chronic candidiasis inside the mouth may increase the risk of developing oral cancer, especially when combined with other risk factors such as tobacco and alcohol use.

Ill-fitting dentures

Dentures that don't fit properly may increase the risk of developing oral cancer. A possible explanation for this is that poor-fitting dentures may irritate the gums, cause sores and trap carcinogens such as alcohol and tobacco against the gums.

Prevention

Prevention is key. To help prevent oral cancer, you should:

• brush and floss your teeth daily
• see an oral health professional regularly for dental appointments
• minimize prolonged exposure under the sun
  • Wear a hat and UV protective clothing, apply UV-AB-blocking sunscreen on the face and use lip balm with UV protection when you are outside and exposed to the sun.
• get vaccinated against HPV infections
  • Even if you are already sexually active or had an HPV infection previously, you should still get vaccinated.
• use a condom if you are sexually active to help reduce your risk of HPV infection
• follow Canada's food guide and eat a variety of healthy foods each day, including plenty of vegetables and fruits
• quit or reduce alcohol consumption
• quit smoking and using tobacco products
• see an oral health professional for adjustment and repair if your dentures do not fit properly

Early detection

Oral cancer can often be treated successfully if caught early. If it isn't treated early, the cancer can spread to other parts of the body and may be more difficult to treat.

Understanding your risk for oral cancer is an important part of prevention. Have a regular oral cancer screening done by an oral health professional or other health professional to catch oral cancer early.

You can also help detect oral cancer early by performing self-examination regularly. Speak to an oral health professional or other health care provider right away if you notice anything unusual or changes that you have not seen before:

• feel your neck and underneath the lower jaw for lumps
• look at and feel your lips, gums and roof of the mouth for any unusual changes
• stick out your tongue and look at the top and bottom of the tongue
  • Have your tongue touch both corners of your mouth, so you can view both sides of your tongue. Lift your tongue up toward the roof of the mouth, so you can see the floor of the mouth for any unusual changes.
• pull your cheeks outward to view the inside of your cheeks, the back gums and the back of your throat
• lift your lips to view the inner side of your lips and front gums

Oral cancer self-assessment quiz

The self-assessment quiz can help you assess your personal risk for developing oral cancer. If you know you are at increased risk, you can develop a plan to make healthier choices.

Indicate 'yes' or 'no' to each of these questions.

1. Are you over the age of 45?
2. Are you male?
3. Do you have oral HPV?
4. Are you sexually active and not regularly tested for sexually transmitted infections?
5. Do you use tobacco products?
6. Do you drink a lot of alcohol and have you done so consistently for a long period of time?
7. Are your lips exposed to the sun on a regular basis, without protection?
8. Is your diet low in fruits and vegetables?

The more risk factors you have replied "yes" to in the questionnaire, the higher your risk of developing oral cancer.

You should take a few moments to check your mouth for the signs and symptoms of oral cancer. If you notice any of these signs or symptoms, speak to an oral health provider or other health care provider right away. Be sure to ask for an oral cancer screening at a dental or medical clinic.

Common myths about oral cancer

There are still many myths about oral cancer. Some of the most common are:

• only people who smoke or who drink a lot of alcohol or both are at risk of developing oral cancer
  • There is a higher risk for people who smoke or drink a lot of alcohol. This risk is even higher if you do both. However, about 25% of oral cancers occur in people who don't smoke or drink alcohol.
• only older adults should get screened for oral cancer
  • Oral cancer can develop at any age. Incidence of oral cancer rises steeply at age 45 and peaks at 60 years of age.
• the incidence of oral cancer is lower than certain other cancers
  • The number of new oral cancer cases and related deaths is relatively low compared to prostate, breast and colorectal cancer. Yet, it is almost 3 times higher than for cervical cancer and almost double that of liver cancer.

For quick facts and more information on oral cancer, visit the Canadian Cancer Society website.