Smoking and drinking greatly increase your risk for head and neck cancer. Find out about the patterns of alcohol and tobacco use that cause head and neck cancer.
Head and neck cancers account for about 3 percent of all cancers in the United States. It has long been known that about 75 percent of head and neck cancers are caused by a combination of alcohol and tobacco use. Recently, two large studies have reviewed patterns of alcohol and tobacco use in people with cancer of the mouth, throat, and larynx, the head and neck cancers most likely to be caused by smoking and drinking.
Patterns of Alcohol and Tobacco Use in Head and Neck Cancer
One study was published in the American Journal of Epidemiology, and another study was published in the Journal of the National Cancer Institute. Both studies pooled data from previous case-controlled studies and included thousands of cases of laryngeal, pharyngeal, and oral cancers matched against normal controls. Their findings shed some light on just how alcohol and tobacco — alone or in combination — influence the development of these head and neck cancers. Here are some of the key findings:
- Smoking lightly for many years increases the risk of head and neck cancer more than smoking heavily for only a few years.
- Drinking heavily for a few years increases the risk of head and neck cancer more than drinking moderately for many years.
- Smoking is most strongly associated with laryngeal cancer.
- Just smoking increases the risk of head and neck cancer substantially and the risk goes up with the frequency and duration of smoking.
- Just drinking only increases the risk of head and neck cancer if you have three or more drinks a day.
“These studies are interesting but the most important thing for people to know is that smoking and drinking each increase your risk of head and neck cancer and smoking and drinking together multiply your risk. That means that the cumulative effect is worse than just adding the two risk factors together,” warns Tamer Ghanem, MD, PhD, an ear, nose, and throat specialist at Henry Ford Hospital in Detroit.
How Do Alcohol and Tobacco Increase the Risk of Head and Neck Cancer?
Both alcohol and tobacco are known to be carcinogenic. Cancer is caused when the DNA inside your cells becomes altered. Substances that can lead to these changes are called carcinogens. Here is how alcohol and tobacco use may cause head and neck cancer:
- Of the hundreds of chemicals found in tobacco and tobacco smoke, more than 60 are carcinogenic.
- Alcohol alone has been shown to cause changes in the cells of the oral mucosa and may damage head and neck cell DNA.
- Alcohol may act as a solvent, making it easier for carcinogens in tobacco to enter head and neck cells.
The Role of Human Papillomavirus in Head and Neck Cancer
The human papillomavirus (HPV) is a sexually transmitted virus that causes cervical cancer and is being increasingly recognized as a cause of head and neck cancer. As many as 25 percent of mouth cancers and 35 percent of throat cancer may be caused by HPV, and these HPV head and neck cancers do not seem to be related to tobacco or alcohol. According to the Centers for Disease Control, more than 7,000 new cases of HPV related head and neck cancer are diagnosed every year.
“Any study of alcohol and tobacco as causes of head and neck cancer is muddied by the role HPV may be playing. Since some smokers and drinkers may also be HPV positive, it is hard to know the actual cause of some of these cancers unless you know the HPV status of that cancer,” says Maria J. Worsham, PhD, a specialist in molecular genetics of head and neck cancer at Henry Ford Hospital.
Both alcohol and smoking are addictive. It would be a mistake to take from these studies that you can use tobacco for only a few years or drink moderately every day without increasing your risk of head and neck cancer. Nicotine is so addictive that 40 percent of people who have been treated for head and neck cancer still smoke. The best ways to protect yourself from head and neck cancer are to not smoke, drink only in moderation, and practice safe sex.
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