Alcohol and tobacco use, main risk factors of oral cancer

Published Mar 24, 2024

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Health practitioners celebrated World Oral Health Day on March 20, under the theme “A happy mouth is a happy body.” This day is annually commemorated on March 20, and serves to improve the state of oral health by oral health related activities in global communities. The World Health Organisation (WHO) Global Oral Health Status Report of 2022, revealed that oral diseases affect an estimated 3.5 billion people worldwide, with three out of four people affected living in middle income countries. WHO said, most common oral diseases are preventable and can be treated in early stages.

One of the common oral diseases is oral cancer. It affects parts of the mouth, such as the lips, gums, the floor and roof of the mouth, and the oropharynx. Oral cancer is the 13th most common cancer globally. Oral and Maxillofacial Pathology specialist at Sefako Makgatho Health Sciences University, Oral Health Centre, Dr Letlhogonolo Masilo explained the types of cancer: “Types of oral cavity cancers are squamous cell carcinomas (SCC), sarcomas, malignant odontogenic tumours, lymphoma, melanoma and minor salivary gland malignancies,” she said.

The WHO further stated, the global incidence of cancers of the lip and oral cavity is estimated to be 377 713 news cases, while 177 757 deaths occurred in 2020. Oral cancer is common in men and older people, and deadly to males compared to females. “Majority of oral cavity cancers are squamous cell carcinomas, and account for approximately 90% of oral cancers. Oral SCC affects more males than females, with middle-aged to elderly men being most susceptible,” she said.

The organisation said oral cancer risk factors are mainly related to lifestyle, such as tobacco use, alcohol and human papillomavirus infections (HPV).

“Persistence exposure to smoking and excessive alcohol intake are regarded as the main risk factors for the development of oral SCC. There is accumulating evidence that suggests a link between low intake of fresh vegetables and fruits, and a higher risk of oral cancer,” she added “Increased risk of oral cancer is also associated with a high meat and processed meat product intake,” Masilo said.

WHO noted, poor members of society are prone to oral diseases [cancer], because of a lack of access to quality healthcare and socioeconomic status. “Oral cancer is seen often in people from lower socioeconomic groups, and those living in deprived areas. It was believed that unequal distribution was due to higher frequency of smoking, alcohol use and poor diet in these populations,” she continued, “Lack of, or insufficient knowledge of oral cancer is one of the factors that may be contributing to the increase in cases among this group of people. Also, due to limited access to quality healthcare,” said Masilo.

Masilo pointed out that preventive measures to impede oral cancer and early diagnoses include, public awareness of the disease, implementation of programmes that will inform people about the risk factors and symptoms of oral cancer in different socioeconomic groups, high intake of vegetables and fruits; avoid tobacco products and a regular dental check up.

Masilo also added, oral cancer is commonly detected in later stages. “Most oral cancers are diagnosed at a more advanced stage, about 28% of oral cancers are diagnosed at an early stage. If oral cancer has spread to surrounding tissues or organs, and/or the regional lymph nodes, it can lead to death,” she further added, “Oral cancer survival rate is highly dependent on cancer staging. Overall, 68% of patients with oral cancer survive for five years,” Masilo concluded.

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