Preventing Oral Cancer: What do we really KNOW?

Dr. Ziad Jalbout

The story always go something like this: stop smoking, stop drinking coffee and alcohol, don’t eat chocolate, eat vegetable and fruits, exercise and drink a lot of water and you prevent this or that type of cancer. Really! It is like a dogma, where anything that makes us happy is bad for us…

This is the naked science about Oral Cancer:

Tobacco use

The bad news: the most common cause of oral cancer is tobacco use (risk factor for tobacco use is 5 to 10 times higher for smokers than for people who have never smoked). This applies to all types of tobacco such as cigarettes, cigars, pipes and smokeless snuff and chewing tobacco. The risk of oral cancer increases with the number of cigarettes smoked per day.

The good news: quitting smoking will reduce your risk by 50% in 5 years. In 20 years your risk will be equal to someone who never smoked.

Alcohol use

The bad news: alcohol is a risk factor for oral cancer and the risk increases with the number of alcoholic drinks per day. The risk is about twice as high in people who have 3-4 drinks per day and 5 times as high in people who have 5 or more alcoholic drinks per day compared to people who don’t drink alcohol.

The good news: It has not been proven that stopping alcohol use will decrease the risk of oral cavity cancer or oropharyngeal cancer. So just make sure you are below the 3 per day alcoholic drinks on average per week.

Tobacco and alcohol use

Here there is only bad news: alcohol + tobacco = risk factor for oral cancer 2 to 3 times more than in people who only use tobacco or only alcohol. The really bad news: 2 or more packs of cigarettes + 4 alcoholic drinks per day = risk factor of 35 times higher compared to people who never smoked cigarettes or drank alcohol.

Betel quid or gutka chewing

Chewing betel quid or gutka (betel quid mixed with tobacco) increases the risk for oral cancer because betel quid contains a cancer causing substance which is areca nut. The risk is related to how long and how often chewing has occurred.  Best advice: don’t do it.

Personal history of head and neck cancer

If you have already had cancer in the head and neck areas, then the risk for oral cancer also increases.

Bottom line:

Quitting smoking is the ONLY proven way to reduce your risk.

It would strongly help to:

  • limit alcoholic beverages to about 2 per day on average per week
  • If you must pick your poison: try and limit yourself to only one, either smoking or drinking, but avoid doing both
  • Don’t use betel quid