Oral Cancer Risk Factors and Diagnosis

Oral Cancer Risk Factors and Diagnosis
Warning symptoms and accurate tests make it easier to find oral cancer early on.
By Chris Iliades, MD
Medically reviewed by Kevin O. Hwang, MD, MPH


About 35,000 people are diagnosed with oral cancer every year , which is roughly 2 percent of all cancers. Men are more than twice as likely to get oral cancer as women, and African-American men have a higher risk than any other Americans.

"Risk factors for lip and oral cancer include excessive sun exposure, tobacco, and excessive alcohol use," says Scott McLean, MD, director of the head and neck cancer program at Henry Ford Hospital in Detroit.

Oral cancer starts in the cells that line the inside of the mouth, and can form on the lips, inside the cheeks, on the gums, the tongue, the bony palate, or the surfaces underneath the tongue. "Lip and oral cancer can occur on any surface lining the lips and oral cavity," explains Dr. McLean.

Oral Cancer Symptoms to Watch
Be aware of these signs; any of them can be an early oral cancer symptom:

* A sore in the mouth that doesn't heal
* A lump or mass in the mouth or in the neck
* Bleeding in the mouth
* White, red, or white-and-red patches in the mouth that don't go away
* Pain while swallowing, chewing, or talking, or pain felt in the ear
* Difficulty swallowing
* Difficulty wearing dentures

The most important thing to know is that oral cancer can be treated much more easily and successfully when caught early. "Many patients do not seek treatment until a lump in the neck develops, which is an indication that the cancer has spread to the lymph nodes in the neck," notes McLean. If you have any of the above symptoms lasting for more than two weeks, see your doctor immediately.

Oral Cancer: Making the Diagnosis
"Diagnosis is made using physical exam, CT scan, and biopsy. Sometimes the biopsy can be done in the office, but patients may require a surgical procedure to take an adequate sample," says McLean. To decide where to take a sample from your mouth, your doctor may use a special dye called toluidine blue, which stains oral cancer cells blue. The doctor may also use special lighting to examine suspicious areas in the mouth and pinpoint the affected tissue. Another option is a brush biopsy. During this procedure, the doctor scrapes cells from the mouth with a brush and then views them under a microscope.

In the future, a simple kind of saliva test might be used to find oral cancer even earlier. According to a study published in 2008 in the journal Clinical Cancer Research, certain kinds of protein biomarkers are found in the saliva of people with oral cancer. The researchers collected saliva samples from 64 healthy people and 64 people with oral cancers. They found the biomarkers in the saliva of 93 percent of the oral cancer patients.

Not smoking and avoiding heavy use of alcohol are the best ways of preventing oral cancer. Knowing oral cancer symptoms and signs is important for detecting the disease early. Remember to always see your doctor or dentist if any possible oral cancer symptoms last for more than two weeks.