Risk Factors of Laryngeal and Hypopharyngeal Cancer

Executive Summary

Risk factors influence the chance of developing cancer (laryngeal and hypopharyngeal cancers) among individuals, but individuals with no risk factors also develop cancer. The common risk factors for laryngeal and hypopharyngeal cancers include use of alcohol, use of tobacco, age (people aged 55 to 65 and above are at a high risk of developing laryngeal and hypopharyngeal cancers), gender (4 to 5 times more common in men than women), race and ethnicity (common among African Americans and non-Hispanic whites than Asian/ pacific islanders, Hispanics, or Alaska Natives/American Indians), people suffering from HPV (human papillomavirus infection), poor diet (people with deficiency of vitamin A and E and other vital nutrients are at more risk), occupational exposures, Plummer-Vinson syndrome, excess body weight, and gastroesophageal reflux disease. Other common risk factors include genetic disorders such as Dyskeratosis congenita and Fanconi anaemia.

Risk Factors Associated with Laryngeal and Hypopharyngeal Cancers

Risk factors refer to the factors that can increase a person’s chance or probability of developing cancer or any illness. Risk factors are not seen as the direct cause of cancer or any disease but can influence its development. We can see that some people with no risk of laryngeal or hypopharyngeal cancers develop the disease, whereas some others with several risk factors don’t. People should closely watch themselves and understand the factors that can be risky for their health and well-being. A good understanding of the factors that can be risky and communicating it on time with your care provider would help you make better healthcare choices and an informed, comfortable lifestyle.

Laryngeal and hypopharyngeal cancers are categorized as mouth and throat or head and neck cancers. Below are some of the major and minor factors that can increase a person’s risk of developing a laryngeal or hypopharyngeal cancer ​1​:

  • ALCOHOL USE: alcohol consumption is considered one of the most critical risk factors for developing different head and neck cancers, including laryngeal or hypopharyngeal cancers ​2​. People who don’t smoke are comparatively at a lower risk of developing such cancers. Moderate to heavy consumption of liquor can be harmful and can make a person susceptible to cancer and other major diseases.
  • TOBACCO USE: tobacco use is considered a primary reason for most cancers associated with the head and neck region. Using different tobacco substances, cigars, cigarettes, pipes, snuff can increase a person’s risk of head and neck cancers. Surveys state that around 85% of head and neck tumor cases are associated with tobacco use. Second-hand smoking (like smoking marijuana) is also considered a health risk.

People having the habit of using both tobacco and alcohol are at a much higher risk of developing laryngeal and hypopharyngeal cancers (most head and neck cancers). If we take the history of most patients with any head and neck tumour, we can see that most of them have a habit of consuming either alcohol or tobacco and sometimes both. The more a person smokes and drinks, the more the risk. 

People are urged to quit these habits to lead a healthy lifestyle. You can seek professional help and counselling programs if you think of quitting.

Other major and minor factors that can raise a person’s risk of developing laryngeal and hypopharyngeal cancer are:

  • AGE: People aged 55 to 65 and above are at a high risk of developing laryngeal and hypopharyngeal cancers. The disease is not so common among young people, but there are exceptions. 
  • GENDER: laryngeal and hypopharyngeal cancers are 4 to 5 times more common in men than women. This is high because alcohol consumption and tobacco use are more common among men than women. But at present, women are also seen using tobacco and alcohol; hence they are also susceptible.  
  • RACE and ETHNICITY: Laryngeal and hypopharyngeal cancers are more common among African Americans and non-Hispanic whites (black and white people) than Asian/ pacific islanders, Hispanics, or Alaska Natives/American Indians. 
  • HPV (human papillomavirus infection): HPV is a group of around 150 viruses. People having HPV infections are at a higher risk of head and neck cancer ​3​. The infection can cause cancerous growth in the cervix, vulva, vagina, penis, anus etc. An HPV infection can also cause non-cancerous or benign warts in different parts of the body. Most commonly, HPV infection is seen to cause throat (oropharynx) cancers. But usually, HPV infection is only viewed as a minor risk factor for causing laryngeal and hypopharyngeal cancers.
  • POOR DIET: A diet deficient in vitamins like A and E and other vital nutrients are seen to increase a person’s risk of laryngeal and hypopharyngeal cancer. Consuming food rich in essential vitamins and minerals, including eating fresh vegetables and fruits, can prevent the occurrence of such cancers.
  • OCCUPATIONAL EXPOSURES: Wood dust, paint fumes, and some chemicals used in the metalworking, petroleum, construction, and textile sectors can raise the risk of laryngeal and hypopharyngeal cancers. Asbestos is a mineral fibre that was once widely utilized as an insulator in various applications. Asbestos exposure is a major cause of lung cancer and mesothelioma (cancer in the chest or abdomen lining). Although several studies have established a link between asbestos exposure and laryngeal cancer, not all have come to the same conclusion.
  • PLUMMER-VINSON SYNDROME: This rare condition involves iron deficiency and causes difficulty in swallowing food materials. Hence people with the disease often suffer from anaemia. Plummer-Vinson syndrome increases a person’s risk of hypopharyngeal esophageal cancers. 
  • EXCESS BODY WEIGHT: excessive body weight or obesity can raise a person’s risk of laryngeal, hypopharyngeal cancers and other lifestyle disorders. Eating a plant-based diet including non-starchy vegetables, fruits, whole grains, and regular exercise can help people lose their excess body weight.
  • GASTROESOPHAGEAL REFLUX DISEASE: Gastroesophageal reflux disease occurs when stomach acid backs up into the oesophagus (GERD). GERD can induce heartburn and increase the risk of esophageal cancer. GERD is also linked to an increased risk of hypopharyngeal carcinoma, though further research is needed to confirm this observation.

GENETIC SYNDROMES AND THEIR RISK

People with certain genetic disorders are at a high risk of developing cancers associated with the head and neck region like throat cancer, hypopharyngeal cancer etc.

DYSKERATOSIS CONGENITA: Aplastic anaemia, skin rashes, malformed fingernails, and toenails are symptoms of this hereditary condition. When people with this syndrome are young, they have an extremely high chance of acquiring head and neck cancers, especially mouth and throat cancers.

FANCONI ANAEMIA: Early blood difficulties are common in people with this genetic disease, leading to severe leukaemia or myelodysplastic syndrome. They also have a greater risk of oral and throat cancers, such as laryngeal and hypopharyngeal tumors.

References

  1. 1.
    Echanique KA, Evans LK, Han AY, Chhetri DK, St. John MA. Cancer of the Larynx and Hypopharynx. Hematology/Oncology Clinics of North America. Published online October 2021:933-947. doi:10.1016/j.hoc.2021.05.005
  2. 2.
    Purdue MP, Hashibe M, Berthiller J, et al. Type of Alcoholic Beverage and Risk of Head and Neck Cancer—A Pooled Analysis Within the INHANCE Consortium. American Journal of Epidemiology. Published online December 8, 2008:132-142. doi:10.1093/aje/kwn306
  3. 3.
    Castellsagué X, Alemany L, Quer M, et al. HPV Involvement in Head and Neck Cancers: Comprehensive Assessment of Biomarkers in 3680 Patients. JNCIJ. Published online January 28, 2016:djv403. doi:10.1093/jnci/djv403