Smokers, heavy alcohol users, and betel nut/tobacco chewers have a higher risk of developing head and neck cancer.3
In the UK, the proportion of cancers linked to tobacco use include:5
- 70% of mouth and pharynx cancers in men
- 55% of mouth and pharynx cancers in women
- 79% of larynx cancers in men and women.
Convincing evidence has linked the diagnosis of cancer to alcohol use. The attributable fraction has been estimated at:13
- 16.9 – 41% of mouth and pharynx cancers
- 27.3 – 44% of laryngeal cancers in men
- 12.2 – 41% of laryngeal cancers in women
- 25.3 – 51% of oesophageal cancers in men
- 11.3 – 51% of oesophageal cancers in women.
The combined effect of drinking alcohol and smoking tobacco greatly increases the relative risk of developing mouth and throat cancers by more than 35 times.13
An imbalanced diet is often associated with smoking and heavy alcohol use, which exacerbates the risk of head and neck cancer.5 Consumption of salted meat and fish such as those included in an Asian style diet have also been implicated.14 Consumption of non-starchy vegetables and fruit is associated with a protective effect against cancers of the digestive tract including cancers of the mouth, larynx, pharynx, oesophagus and stomach.15
Occupational exposure to the following known carcinogens and co-carcinogens have also been linked with development of head and neck cancers:4
- fuel fumes
- dust particles from various sources.
Studies have demonstrated possible genetic vulnerabilities for developing primary or secondary head and neck cancer.16
The human papilloma virus has been recognised as a risk factor for a discrete set of head and neck cancers (oral cavity and oropharyngeal squamous cell cancers), and its recognition has significant preventive and therapeutic implications.6, 14, 17
Many of these risk factors are more prevalent in socially disadvantaged groups, with the risk of developing head and neck cancer often higher among these groups. Tailored interventions are required to promote awareness among these populations about reducing their risk or identifying cancers early.3
Head and neck cancer in Australia between 1982 and 2005 show increasing incidence of potentially HPV-associated oropharyngeal cancers (PDF, 353KB). 2011. British Journal of Cancer18
A study of head and neck cancer treatment and survival among indigenous and non-indigenous people in Queensland, Australia, 1998 to 2004 (PDF, 159KB). 2011. BMC Cancer 19
In your practice setting, outline how you would refer an individual to services and resources aimed at facilitating smoking cessation.
You are asked to explain to nursing students what evidence exists about the risks of alcohol and the development of cancers. Describe how you would summarise and explain current evidence.