What are the risk factors?

Smoking

Around a fifth of the UK’s population smoke and the habit is still considered the leading cause of mouth cancer. According to the World Health Organisation, up to half of current smokers will eventually die of a tobacco-related disease, including mouth cancer. Smoking helps to transforms saliva into a deadly cocktail that damages cells in the mouth and can turn them cancerous. Around two thirds of smokers want to quit - Mouth Cancer Action Month is another opportunity for healthcare professionals to encourage smokers to give up smoking.

Alcohol

Drinking to excess can increase mouth cancer risks by four times. As alcohol aids the absorption of tobacco into the mouth, those who smoke and drink to excess are up to 30 times more likely to develop the disease.

Poor diet

Around a third of cases are thought to be linked to an unhealthy diet. It is recommended that people eat a healthy, balanced diet including five portions of fruit and vegetables each day. Increasing evidence also suggests that Omega 3, found in foods such as eggs and fish can help lower risks, as can foods high in fibre such as nuts, seeds, whole-wheat pasta and brown rice.

Chewing or Smokeless tobacco

Smokeless tobacco is normally defined as any tobacco product that is placed in the mouth or nose and not burned. Although some people believe this type of tobacco is safer than smoking, the reality is that it is much more dangerous. The types of smokeless tobacco products most used in the UK often contain a mix of ingredients including slaked lime, areca nut and spices, flavourings and sweeteners. The terminology for smokeless tobacco varies, but the main types used in the UK include:

• Gutka, Khaini, Pan Masala (betel quid), Shammah and Maras powder (these are sucked or chewed);
• Zarda, Qiwam, or Mawa (chewed);
  
• Lal dantmanjan, Gadakhu, Gul, Mishri, or Creamy Snuff (dental products which are used as toothpaste or rubbed on gums);
• Nass (can be used nasally, sucked or chewed).

Smokeless tobacco is used particularly by South Asian Communities, especially women. The incidence of mouth cancer is significantly greater among South Asian women. Other parts of South Asian communities are also more at risk from the effects of smokeless tobacco including: people of Bangladeshi origin; those in older age groups; and people from lower socioeconomic groups. 

Human Papilloma Virus (HPV)

The Human Papilloma Virus, transmitted via oral sex, is increasingly being linked to mouth cancer. Younger people are particularly at risk. A recent study in the USA has connected over 20,000 mouth cancer cases to HPV in the last five years. Experts suggest it may rival tobacco and alcohol as a key risk factor within 10 years, although some research indicates that people with mouth cancer caused by HPV may have a greater chance of survival. People with multiple sexual partners are more at risk.