Head And Neck Cancer Causes

Introduction

Head and neck cancer is a group of cancers that develop in the tissues of the head and neck, including the mouth, throat, larynx (voice box), sinuses, and salivary glands. Head and neck cancer represents the third most common cause of cancer death worldwide. These cancers can be life-threatening if not detected early.¹

Over 90% of cases are squamous cell carcinomas, predominantly manifesting in the oropharynx, oral cavity, hypopharynx, or larynx. The aetiology of head and neck cancer arises from the interplay of environmental variables and genetic predisposition making it complex. Below are some of the primary causes of head and neck cancer.

Tobacco smoking

Tobacco smoking is recognised as a primary risk factor for head and neck cancer, with the risk correlating to the severity and length of the smoking habit. Cigarettes contain nitrosamines and polycyclic hydrocarbons, which are carcinogenic components with genotoxic effects, potentially increasing illness risk. These elements may alter the molecular profile of humans and induce cell mutations.²

Smoking cessation lowers the risk of cancer formation. Tobacco use in any form, including secondhand smoke and smokeless tobacco often referred to as tobacco chewing or snuff constitutes significant risk factors for head and neck cancers. Individuals who use both tobacco and alcohol have an elevated risk of acquiring these malignancies compared to those who use either substance alone.^3,4

Alcohol consumption

Alcohol is a solvent that increases mucosal exposure to carcinogens, which in turn increases the amount of these substances taken up by cells. Acetaldehyde, a metabolite associated with alcohol, may disrupt the process of DNA synthesis and repair.

The risk may increase directly with alcohol concentration (e.g., consumption of spirits compared to beer or wine). The impact of the specific kind of alcohol on oral cancer risk remains ambiguous even after accounting for total consumption and alcohol concentration.^5,6

Human papillomavirus (HPV) infection

Human papillomavirus HPV, especially HPV-16, is a significant etiological factor in oropharyngeal malignancies, which affect the posterior pharynx, base of the tongue, and tonsils. Additionally, high-risk HPV types (HR HPV) contribute to approximately 25% of head and neck cancers, regardless of other well-known risk factors like alcohol and tobacco consumption.

The route of transmission of HPV in head and neck cancer remains unclear; nonetheless, sexual conduct is associated with an elevated risk. The presence of viral DNA in tumours supports the link between HPV and head and neck cancer, shown by HPV DNA in oral rinses and specific antibodies.⁷

Poor oral hygiene and dental health

Poor oral health can also lead to the development of oral carcinomas. Development of plaques, most notably supragingival plaques which form above the gum line, can be particularly dangerous. This is due to their significant mutagenic interactions with saliva which can lead to the development of malignancies in the oral cavity. Additionally, individual oral health may also operate as a co-factor in the development of oral cavity carcinomas.

Periodontal problems stemming from inadequate dental hygiene may result in infections that trigger the production of inflammatory mediators, such as cytokines, and the inflammatory responses may facilitate cancer development. The loss of teeth may also contribute to the development of oral cancer, as it alters the oral flora, promoting a decrease in nitrites and nitrates and increasing the synthesis of acetaldehyde, which results in the generation of DNA adducts.⁸

Family history

The impact of family history on the development of head and neck cancer may stem from familial aggregations (the tendency for certain diseases and conditions to develop within families) suggesting that hereditary genetic factors contribute to cancer risk. Multiple genetic variants in genes related to carcinogen metabolism, DNA repair, and many other processes have been linked to the risk of head and neck cancer. The capacity to process carcinogens fluctuates throughout periods of exposure, suggesting a connection between family history and susceptibility to cancer as well as the impact of accumulated exposures.⁹

Diet

The dietary choices may be associated with a lower likelihood of developing the illness. Research connects diet to the onset of cancer, with studies suggesting a probable causal relationship between a decreased risk of head and neck cancer and the intake of non-starchy vegetables, fruits, and foods rich in carotenoids.¹⁰

Life expectancy

The mortality and morbidity linked to these cancers remain elevated, adversely affecting quality of life and increasing treatment costs for these patients. Head and neck cancer may impact general health, emotional well-being, career, social interactions, and family life. Significant alterations in the functioning of the upper aerodigestive tract may also occur, impacting patients' quality of life.

Moreover, comprehending disease progression and manifestation can inform treatment selection, facilitate symptom analysis and rehabilitation, enhance care organisation and quality, and identify factors influencing patient survival, thereby aiding in the assessment of treatment efficacy through elucidation of treatment side effects.¹¹

FAQs

How does the head and neck cancer start?

Head and neck cancer starts when a cell in the head and neck area develops changes in its DNA.

How to avoid head and neck cancer?

By cessation of smoking, and alcohol, eating a well-balanced diet, practising protected sex, and maintaining good oral hygiene.

How curable is head and neck cancer?

Highly curable—often with single-modality therapy (surgery or radiation)—if detected early.

What are the warning signs of neck and head cancer?

A Lump on the back of the neck, jaw, or mouth, mouth ulcer, pain or weakness in the face and neck pain amongst others.

Summary

Head and neck cancer consists of various cancers that appear in the tissues of the head and neck, such as the mouth, throat, larynx, sinuses, and salivary glands. It is the third leading cause of cancer deaths globally. Most cases are squamous cell carcinomas found primarily in the oropharynx, oral cavity, hypopharynx, or larynx. Its causes are linked to environmental factors and genetic predisposition. Tobacco smoking is a high-risk factor; the likelihood of developing cancer increases with the duration and intensity of smoking. Cigarettes contain harmful substances that can lead to cell mutations. Quitting smoking can reduce cancer risks, and both tobacco and alcohol use together raise the risk more than either one alone. Alcohol consumption acts as a solvent, increasing cell exposure to carcinogens.

The human papillomavirus (HPV), especially HPV-16, is linked to oropharyngeal cancers. High-risk HPV types contribute to about 25% of head and neck cancers. Poor oral hygiene can lead to oral cancers. Family history plays a role in head and neck cancer risk, suggesting that genetic factors might contribute. Head and neck cancers significantly affect quality of life and can lead to increased care costs. Understanding disease progression is essential for improving treatment choices and patient outcomes.