Pdq (physician Data Query) Summary

This PDQ (physician data query) cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about oral cavity and oropharyngeal cancer prevention. National Cancer Institute (USA.gov) Oral cavity cancer and oropharyngeal cancer are two distinct diseases, although they have some risk factors in common. People who use tobacco in any of the commonly available forms (cigarettes, cigars, pipes, and smokeless tobacco) or a have high alcohol intake are at elevated risk of both cancers; they are at particularly high risk if they use both tobacco and alcohol. People who have a personal history of cancer in the head and neck region also are at elevated risk of a future primary cancer of the oral cavity or oropharynx.

Factors with Adequate Evidence of an Increased Risk of Oral Cavity and Oropharyngeal Cancer

Tobacco use: Based on solid evidence from numerous observational studies, tobacco use increases the risk of cancers of the oral cavity and oropharynx.

Magnitude of Effect: Large. Risk for current smokers is about tenfold that of never-smokers, and is dose related. Most cancers of the oral cavity are attributable to the use of tobacco products.

Alcohol use: Based on solid evidence, alcohol use is a risk factor for the development of oral cavity and oropharyngeal cancer. Its effects are independent of those of tobacco use.

Magnitude of Effect: Lower than the risk associated with tobacco use, but the risk is approximately doubled for people who drink three to four alcoholic beverages per day compared with nondrinkers, and is dose related.

Tobacco and alcohol use: Oral cavity and oropharyngeal cancer risk is highest in people who consume large amounts of both alcohol and tobacco. When both risk factors are present, the risk of oral cavity and oropharyngeal cancer is greater than a simple multiplicative effect of the two individual risks.

Magnitude of Effect: About two to three times greater than the simple multiplicative effect, with risks for persons who both smoke and drink heavily approximately 35-fold that of persons who both never smoke and never drink.

Interventions with Adequate Evidence of a Decreased Risk of Oral Cavity and Oropharyngeal Cancer

Tobacco cessation: Based on solid evidence, cessation of exposure to tobacco (e.g., cigarettes, pipes, cigars, and smokeless tobacco) leads to a decrease in the risk of cancer of the oral cavity and oropharynx.

Magnitude of Effect: Decreased risk, moderate to large magnitude.

Interventions with Inadequate Evidence of a Reduced Risk of Oral Cavity and Oropharyngeal

Cancer Cessation of alcohol consumption: Based on fair evidence, cessation of alcohol consumption leads to a decrease in oral cavity cancer, but not until approximately 10 years after cessation. For cancer of the oropharynx, reduction in risk does not occur until approximately 20 years after cessation

Magnitude of Effect: Decreased risk, small to moderate magnitude.