This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

Risk factors for the development of upper airway tract cancers

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • the majority of upper airway tract (UAT) cancers are triggered by alcohol and tobacco, which together probably account for three-quarters of cases
    • cigarette smoking is associated with increased risk of all of the more common forms of UAT cancer
      • the risk among cigarette smokers may be 10 or more times that for non-smokers
      • pipe or cigar smoking is associated with an even higher excess risk of oral cancer
      • chewing tobacco – with or without areca (betel) nut – is strongly linked with oral and pharyngeal cancer, as well as to some extent with cancer of the larynx and the thyroid
      • more intense use of tobacco increases risk, while ceasing to smoke for 10 years or more reduces it to virtually equal to that among nonsmokers
      • second primaries, i.e. tumours which did not develop from the first one, are more likely with heavier smoking prior to diagnosis
    • high alcohol consumption and smoking have synergistic or multiplicative effects on the risk of head and neck cancer
      • for heavy drinkers who are also heavy smokers, the risk of oral cancer is over 35 times that for those who neither smoke nor drink, and a similar pattern is found with cancer of the larynx
      • alcohol consumption is a particularly important risk factor for cancers of the mouth and pharynx, and to a lesser degree, for cancer of the larynx
        • consumption of 100g of alcohol or more per day (about 12 units – six pints of beer or 12 measures of wine or spirits) multiplies the risk of developing oral cancer at least six-fold, after adjustment for tobacco use; the more alcohol consumed, the greater the risk
    • diet also affects the risk of cancers of the oral cavity, pharynx and larynx
      • frequent consumption of fruit and vegetables is associated with reduced risk
      • poor diet is often associated with heavy smoking and alcohol use, and malnutrition can exacerbate the risk of cancer
      • eating Cantonese-style salted fish increases risk – which may account for high levels of particular forms of head and neck cancer found among some Chinese ethnic groups
    • occupational exposure to asbestos, formaldehyde, nickel, isopropyl alcohol and sulphuric acid mist have been linked with laryngeal cancer
      • exposure to diesel fumes is also associated with an increased risk of laryngeal cancer
      • oral cancer has also been linked to exposure to formaldehyde - there is accumulating evidence that this is an independent risk factor for cancers of the mouth and pharynx
    • viral infection
      • notably human papillomavirus (HPV) – which is known to cause cervical cancer – is implicated in the development of some cancers of the oral cavity, pharynx and larynx
        • HPV could be involved in 30-40% of cases of oropharyngeal cancer in Western countries
        • patients with cancer of the tonsil are particularly likely to show signs of previous HPV infection
        • HPV-positive tumours have a better prognosis than those associated with smoking and alcohol


  1. NICE (November 2004). Improving outcomes in head and neck cancers - The Manual.

Create an account to add page annotations

Add information to this page that would be handy to have on hand during a consultation, such as a web address or phone number. This information will always be displayed when you visit this page

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.


Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.