Summary
Despite advances in oral and oropharyngeal cancer treatment, more focus should be given to the prevention of the disease. Some of the prevention measures for reducing the risk of oral and oropharyngeal cancer include screening for oropharyngeal cancer symptoms, screening for any viral infection, limiting tobacco and alcohol use and maintaining a proper diet.
Introduction
Despite advances in oral and oropharyngeal cancer treatment, the prognosis for oropharyngeal cancer remains poor. Therefore, special attention should be paid to the prevention of oral cancer and oropharyngeal cancer.
Screening for Oropharyngeal Cancer
Cancer screening can help detect oral and oropharyngeal cancer at an early stage when there is a greater chance of successful treatment, optimal results, and fewer side effects. These tests are usually done when the person is healthy and has no specific symptoms.
Oncologists are not only working to detect and diagnose oropharyngeal cancer early but are also developing additional tests to detect and diagnose oral cancer early, leading to better results and faster responses along with fewer side effects.
The primary screening of oral cancer is a systematic oral examination of the oral cavity. Screening should include visual inspection of the face, neck, lips, mucosa, cheek mucosa, gums, the base of the mouth, tongue and palate. An oral mirror can help visualize any surface. Routine screening for these symptoms of oropharyngeal cancer can help detect cancer early and increase the patient’s survival rate1.
Screening for any infections
Oral HPV infection (HPV-16), a sexually transmitted disease, has recently been identified as an important risk factor for oropharyngeal cancer. The prevalence of oropharyngeal cancer in the United States due to oral HPV infection ranges from 80% to 95%. The prevalence of oral HPV infection is related to age, sex, number of sexual partners, and number of cigarettes smoked. Therefore, it is suggested to avoid any such viral infections and go for screening of such viral infections that might lead to increased risk for oropharyngeal cancer.2
Avoiding smoking and tobacco use
Smoking and tobacco consumption are avoidable risk factors for oral cancer. Quitting smoking and avoiding tobacco in any form can help reduce the risk of oropharyngeal cancer. Studies have reported that even patients with pre-cancerous lesions of the oral cavity have decreased risk of malignancy; if patients can be persuaded to reduce their tobacco dependence, they may be less likely to undergo malignant transformation3. Another study has reported that4 using primary care workers to teach adults not to chew betel leaves could be five times more cost-effective in reducing mortality than providing high-tech treatments for cancer patients.
Limit alcohol use
In some studies, excessive alcohol consumption is associated with an increased risk of oropharyngeal cancer. Excessive alcohol consumption may lead to conditions such as mouth ulcers, which are associated with an increased risk of oropharyngeal cancer. Studies have also reported the synergistic effect of alcohol and tobacco in increasing the risk of oropharyngeal cancer.
A significant proportion of oral cancers can be prevented by reducing exposure to these known carcinogens, such as tobacco and alcohol5.
Maintaining proper diet
Dietary changes such as increased intake of fresh fruits, vegetables and trace elements such as vitamins C, A and E may reduce the risk of oral cancer. Reducing the total calories, fat, butter, eggs and starchy foods can further reduce the risk of oral cancer6,7.
References
- 1.Douglas L. Making oral cancer screening a routine part of your patient care Part 1. BDJ Team. Published online May 2015. doi:10.1038/bdjteam.2015.66
- 2.Chaturvedi A, Engels E, Pfeiffer R, et al. Human papillomavirus and rising oropharyngeal cancer incidence in the United States. J Clin Oncol. 2011;29(32):4294-4301. doi:10.1200/JCO.2011.36.4596
- 3.Gupta P, Mehta F, Pindborg J, et al. Primary prevention trial of oral cancer in india: a 10-year follow-up study. J Oral Pathol Med. 1992;21(10):433-439. doi:10.1111/j.1600-0714.1992.tb00970.x
- 4.Warnakulasuriya K, Ekanayake A, Sivayoham S, et al. Utilization of primary health care workers for early detection of oral cancer and precancer cases in Sri Lanka. Bull World Health Organ. 1984;62(2):243-250. https://www.ncbi.nlm.nih.gov/pubmed/6610492
- 5.La V, Tavani A, Franceschi S, Levi F, Corrao G, Negri E. Epidemiology and prevention of oral cancer. Oral Oncol. 1997;33(5):302-312. doi:10.1016/s1368-8375(97)00029-8
- 6.Zain R. Cultural and dietary risk factors of oral cancer and precancer–a brief overview. Oral Oncol. 2001;37(3):205-210. doi:10.1016/s1368-8375(00)00133-0
- 7.Winn D. Diet and nutrition in the etiology of oral cancer. Am J Clin Nutr. 1995;61(2):437S-445S. doi:10.1093/ajcn/61.2.437S