Causes and risk factors of head and neck cancer

Certain factors increase the risk of head and neck cancer, including smoking or chewing tobacco and drinking alcohol.

What are risk factors?
Smoking cigarettes, cigars or pipes
Chewing tobacco or betel quid (paan)
Drinking alcohol
Gender
Age
Human papilloma virus (HPV) infection
Epstein Barr virus (EBV) infection
Low immunity
Sunlight
Occupational exposure
Pre-cancerous conditions
Oral health
About our information
How we can help

What are risk factors?

The causes of head and neck cancers are not fully understood. There are certain things that can increase the risk of developing head and neck cancer. These are called risk factors. Having a risk factor does not mean you will get cancer. And not having a risk factor does not mean that you will not get it.

Smoking cigarettes, cigars or pipes

Smoking tobacco increases the risk of developing many types of cancer that affect the head and neck area. This includes: mouth cancers, throat cancers and cancer of the voicebox (larynx). The more cigarettes someone smokes, and the more years they smoke for, the higher the risk.

Holding a pipe or cigarette on your lip when smoking also increases your risk of developing lip cancer.

Chewing tobacco or betel quid (paan)

Chewing tobacco or betel quid increases the risk of developing mouth cancer.

Drinking alcohol

Drinking alcohol is linked to mouth cancer and throat cancer. The more alcohol a person drinks, and the more years they drink for, the higher the risk.

Drinking and smoking together greatly increase the risk of head and neck cancers. People who smoke and drink heavily over several years have the highest risk of developing head and neck cancers.

Gender

Head and neck cancers are more common in men than in women.

Age

The risk of developing a head and neck cancer increases as you get older. It is most common in people over 50, although younger people can be affected too

Human papilloma virus (HPV) infection

Cancers at the back of the tongue and in the tonsils (cancers of the oropharynx) have become more common over the last 20 years.

Many of these cancers are linked to infection with a type of virus called human papilloma virus 16 (HPV 16). HPV affects the skin and moist membranes that line the body, such as the mouth and throat.

HPV is spread through body-to-body contact, often during sex. Exactly how a person gets the virus is uncertain, and it is not always possible to link the virus to sexual contact. It is thought there may be other ways of spreading the virus that have not yet been identified.

We have information about HPV and cancer.

Epstein Barr virus (EBV) infection

Some cancers of the nasopharynx are linked to a type of virus called the Epstein-Barr virus. This is the virus that causes glandular fever. Only a very small number of people who have glandular fever go on to develop nasopharyngeal cancer in their lifetime.

Low immunity

Some people with reduced immunity have an increased risk of developing a head and neck cancer. Your immunity may be low if you:

do not have a healthy diet

are taking medication to suppress your immune system after an organ transplant

have a condition such as HIV (human immunodeficiency virus) or AIDS.

Sunlight

Exposure to sunlight over a prolonged period of time increases the risk of developing cancer on the outside of the lip.

Occupational exposure

Prolonged exposure to some types of dust and certain chemicals at work increases the risk of developing cancers of the nasopharynx and nasal and sinus cancer. These are:

hardwood dust

leather dust

formaldehyde (found in leather and some types of furniture dust).

Pre-cancerous conditions

Pre-cancerous conditions of the mouth increase the risk of a cancer developing in the mouth. These conditions include leukoplakia and erythroplakia. These are white or red patches in the mouth that are often linked to tobacco use.

Eythroplakia (red patches) is less common than leukoplakia (white patches). But having eythroplakia is linked to a higher risk of cancer developing.

Oral health

The risk of developing mouth cancer is slightly higher in people:

with poor oral hygiene

who have dental disease.

About our information

References

Below is a sample of the sources used in our head and neck cancer information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

British Association of Head and Neck Oncologists. Head and Neck Cancer: United Kingdom National Multidisciplinary Guidelines. 2016. Available from: https://www.bahno.org.uk/_userfiles/pages/files/ukheadandcancerguidelines2016.pdf (accessed September 2018).

Brockstein BE, Stenson KM, Song S. Overview of treatment for head and neck cancer. UpToDate https://www.uptodate.com/contents/overview-of-treatment-for-head-and-neck-cancer (accessed Spetember 2018).

National Institute for Health and Care Excellence (NICE). Cancer of the upper aerodigestive tract: assessment and management in people aged 16 and over. 2016. Available from: https://www.nice.org.uk/guidance/ng36 (accessed September 2018).

Reviewers

This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Chris Alcock, Consultant Clinical Oncologist.

Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.