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Only about 3% of all cancers diagnosed in the United States each year occur in the head and neck area. The different cancers that develop around the nose, mouth and throat are referred to as a group - head and neck cancer. The American Cancer Society estimated that about 48,000 men and 17,400 women will develop a head and neck cancer this year.
What causes H&N cancer? For many decades, we have known that tobacco use increases the risk of developing these cancers. Cigarette use is not the only culprit, with other tobacco products increasing risk as well. Many researchers, including a group called the International Head and Neck Cancer Epidemiology Consortium, have identified an association with chewing tobacco, cigars and pipes.
Alcohol is also known to increase the risk. Does the kind of alcohol matter? The answer is frequently debated. The fact is that the more alcohol of any kind consumed, the higher the risk of mouth and throat cancers. The INHANCE group that showed that having three or more drinks per day increased risk of H&N cancer, even in those who never smoked.
Multiple studies, including a recent analysis from the National Institute of Cancer Research in Taiwan, have shown that hard liquor had a stronger link to these types of cancer than wine. But even mouthwashes, which are often made with alcohol as an ingredient, may carry a risk. A study from Uruguay revealed an increased cancer risk with using a mouthwash twice a day or more than 35 years.
Human papillomavirus is another major cause of cancer. It is especially common with cancers around tonsils and back of the throat. North Carolina has some of the highest rates of HPV-related cancers. The rate of HPV-related cancer is about 13 cases of cancer for every 100,000 people in North Carolina.
There is a vaccine designed specifically against HPV infections. The Centers for Disease Control and Prevention estimates that this vaccine can prevent up to 90% of HPV-related cancers. The vaccine was first available for girls because of an increased of cervical cancer in women infected with the virus. However, for men HPV infection increases the risk for head or neck cancers, specifically those in the mouth or throat.
The HPV vaccine is now available for both boys and girls. The vaccine is usually given between ages 11-12, at the same time as the tetanus and meningitis vaccinations. Some people can still receive the vaccine up to age 26.
There are many causes for head and neck cancers, but with the help of lifestyle changes and the HPV vaccine, the number of cases in our area can be reduced.
For more information about head and neck cancers, visit www.cdc.gov/cancer/headneck.
Donette Vicente, MD, is a medical oncologist with the Duke Cancer Network.