Head & Neck Cancers: Risk, Prevention & Screening

Many head and neck cancers arise after prolonged exposure to known risk factors such as tobacco, alcohol, and cancer-causing agents in the workplace. These cancers are generally considered preventable. Others, such as parathyroid cancer, are not associated with any preventable risk factor. Some people who develop head and neck cancers have no known risk factors.

Risk Factors

The following factors have been shown to increase your risk of developing a cancer of the head or neck.

Tobacco and Alcohol Use

People who use tobacco (including cigarettes, cigars, pipes, and smokeless tobacco) or drink alcohol excessively are at much greater risk for developing head and neck cancers. An estimated 85 percent of head and neck cancers are linked to tobacco use. A smoker's risk of developing cancer of the larynx (voice box) or hypopharynx (the top portion of the esophagus) is up to 35 times higher than that of a nonsmoker. Heavy use of alcohol raises the risk of those cancers two to five times. Those who smoke and drink heavily may raise their risk to 100 times that of nonusers.

Men are two to three times more likely than women to develop a head or neck cancer because of their greater use of tobacco and alcohol. However, women are catching up: the rates of head and neck cancers found in women have been rising for several years.

Precancers

Heavy smoking and drinking can cause genetic damage to squamous cells — which form a thin outer layer over structures in the head and neck — leading to the development of precancerous lesions. Not all precancers will progress to cancer, but some do. In many cases, people with precancers who stop using alcohol and tobacco heavily can reverse this process. Memorial Sloan Kettering's clinical investigators are evaluating novel therapies to prevent precancerous lesions from developing into cancerous tumors.

Prolonged Exposure to Sunlight and Other Forms of Radiation

People who have spent a substantial amount of time in the sun are at greater risk for skin cancers of the head and neck region. Extensive radiation in the head and neck from diagnostic x-rays or radiation therapy increases the risk for cancer of the skin, salivary glands, and thyroid in particular.

Other Possible Risk Factors

Other risk factors for head and neck cancer may include poor oral hygiene; exposure to occupational inhalants such as asbestos or wood dust; a diet low in vegetables and fruits; gastroesophageal reflux disease; infection with the human papilloma virus (HPV) or Epstein-Barr virus; and a weakened immune system.

Prevention

Making certain lifestyle changes can significantly lower a person's risk of developing a head and neck cancer. Quitting smoking can substantially reduce the risk, even for those who smoked for many years. People who already have a head and neck cancer and quit using tobacco can reduce the risk of developing a second tumor by as much as 60 percent. People who are exposed to toxic fumes and dust in the work place or in other environments can reduce the risk of head and neck cancer by wearing protective face masks. Companies can also install air-filtering systems to minimize employees' exposure to harmful fumes and dust.

Our head and neck cancer team includes oral cancer experts who are working to promote the early diagnosis and treatment of oral cavity cancers, and are leading a worldwide effort to learn how to prevent them.

Smoking Cessation

Memorial Sloan Kettering's Smoking Cessation Program can help smokers stop, whether they have cancer or just want to improve their health and reduce the risk of cancer. Other groups offer programs and resources that help people take steps toward a healthy lifestyle. The Cancer Information Service (1-800-4-CANCER), the American Lung Association, and the American Cancer Society offer online resources, booklets, and referrals to local programs, as do Nicotine Anonymous and QuitNet.

Screening

Although no screening method has been proven to improve survival for people with head and neck cancers, Memorial Sloan Kettering's doctors advise that all individuals visit their primary care physician for a yearly physical examination of the head and neck and oropharynx (the middle section of the throat that includes the soft palate, the base of the tongue, and the tonsils). Our doctors also recommend a yearly routine dental evaluation that includes examination of the neck and inspection of the oropharynx and the mouth. To learn more, visit our Screening Guidelines for head and neck cancers.

Memorial Sloan Kettering provides numerous prevention, screening, and wellness services. Our Head and Neck Disease Management Team organizes head and neck cancer screening days each year in the spring in conjunction with Oral, Head and Neck Cancer Awareness Week, sponsored by the Yul Brynner Foundation, as a free service to the community and to help increase awareness of head and neck cancers. For dates and location, visit our Public Events Calendar.