Prevention

The major risk factors for oral cancers are tobacco and alcohol use. Tobacco contains carcinogenic substances as well as substances that act as initiators or promoters of carcinogenesis. The most harmful carcinogens are found in the tars of tobacco smoke, but many forms of smokeless or "spit" tobacco have been associated with the development of oral cancer.

The role of alcohol in oral cancer appears to be related to its damaging effect on the liver. Major metabolites of alcohol, such as acetaldehyde 'a known carcinogen in animals' may also be important. Alcohol is also thought to act as a solvent that facilitates the entry of tobacco carcinogens into oral tissues.

This may partly explain why the combined use of tobacco and alcohol produces a greater risk for oral cancer than use of either substance alone. Indeed, tobacco and alcohol, working in tandem, are thought to account for 75 to 90 percent of all oral and pharyngeal cancers in the United States . For information on how to counsel patients about tobacco cessation, please refer to Tobacco cessation.