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Oral Cancer: Causes and Symptoms & The Oral Cancer Exam

What is oral cancer?

The term oral cancer includes cancers of the mouth and the pharynx (the back of the throat).

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What puts someone at risk for developing oral cancer?

Tobacco and alcohol use. Most cases of oral cancer are linked to cigarette smoking, heavy alcohol use, or the use of both tobacco and alcohol together. Using tobacco plus alcohol poses a much greater risk than using either substance alone.

HPV. Infection with the sexually transmitted human papillomavirus (specifically the HPV 16 type) has been linked to a subset of oral cancers.

Age. Risk increases with age. Oral cancer most often occurs in people over the age of 40.

Sun exposure. Cancer of the lip can be caused by sun exposure.

Diet. A diet low in fruits and vegetables may play a role in oral cancer development.

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What are the possible signs and symptoms of oral cancer?

  • A sore, irritation, lump or thick patch in the mouth, lip, or throat
  • A white or red patch in the mouth
  • A feeling that something is caught in the throat
  • Difficulty chewing or swallowing
  • Difficulty moving the jaw or tongue
  • Numbness in the tongue or other areas of the mouth
  • Swelling of the jaw that causes dentures to fit poorly or become uncomfortable
  • Pain in one ear without hearing loss

A person who has any of these symptoms for more than 2 weeks should see a dentist or doctor for an oral cancer exam. Most often, symptoms like those listed above do not mean cancer. An infection or another problem can cause the same symptoms. But it's important to have the symptoms checked out—because if it is cancer, it can be treated more successfully if it's caught early.

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What is the oral cancer exam?

An oral cancer examination can detect early signs of cancer. The exam is painless and takes only a few minutes.

During the exam, a dentist or doctor checks the face, neck, lips, tongue, mouth, and the back of the throat for possible signs of cancer.

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Additional Reading

Review articles on oral cancer

Cohan DM, Popat S, Kaplan SE, Rigual N, Loree T, Hicks WL Jr. Oropharyngeal Cancer: Current Understanding and Management. Curr Opin Otolaryngol Head Neck Surg. 17(2):88–94, 2009.

Crozier E, Sumer BD. Head and Neck Cancer. Med Clin North Am. 94(5):1031–1046, 2010.

Curado MP, Hashibe M. Recent Changes in the Epidemiology of Head and Neck Cancer. Curr Opin Oncol. 21(3):194–200, 2009.

Mehanna H, Paleri V, West CM, Nutting C. Head and Neck Cancer—Part 1: Epidemiology, Presentation, and Prevention. BMJ 341:c4684, 2010.

Mehanna H, West CM, Nutting C, Paleri V. Head and Neck Cancer—Part 2: Treatment and Prognostic Factors. BMJ 341:c4690, 2010.

Tobacco and alcohol use & oral cancer

Baan R, Straif K, Grosse Y, Secretan B, El Ghissassi F, Bouvard V, Altieri A, Cogliana V; WHO International Agency for Research on Cancer Monograph Working Group. Carcinogenicity of Alcoholic Beverages. Lancet Oncol 8(4):292–293, 2007.

Goldstein BY, Chang SC, Hashibe M, La Vecchia C, Zhang ZF. Alcohol Consumption and Cancers of the Oral Cavity and Pharynx from 1988 to 2009: An Update. Eur J Cancer Prev. 19(6):431–465, 2010.

International Agency for Research on Cancer. IARC Monograph on the Evaluation of Carcinogenic Risks to Humans. Volume 83. Tobacco Smoke and Involuntary Smoking. Lyon, 2004.

International Agency for Research on Cancer. IARC Monograph on the Evaluation of Carcinogenic Risks to Humans. Volume 89. Smokeless Tobacco and Some Tobacco-specific N-Nitrosamines. Lyon, 2007.

Lubin JH, Purdue M, Kelsey K, Zhang ZF, Winn D, Wei Q, Talamini R, Szeszenia-Dabrowska N, Sturgis EM, Smith E, Shangina O, Schwartz SM, Rudnai P, Neto JE, Muscat J, Morgenstern H, Menezes A, Matos E, Mates IN, Lissowska J, Levi F, Lazarus P, La Vecchia C, Koifman S, Herrero R, Franceschi S, WünschFilho V, Fernandez L, Fabianova E, Daudt AW, Maso LD, Curado MP, Chen C, Castellsague X, Brennan P, Boffetta P, Hashibe M, Hayes RB. Total Exposure and Exposure Rate Effects for Alcohol and Smoking and Risk of Head and Neck Cancer: A Pooled Analysis of Case-control Studies. Am J Edidemiol. 170(8):937–947, 2009. (Epub 9/10/2010). 

Pelucchi C, Gallus S, Garavello W, Bosetti C, La Vecchia C. Alcohol and Tobacco Use, and Cancer Risk for Upper Aerodigestive Tract and Liver. Eur J Cancer Prev. 17(4):340–344, 2008.


HPV and oral cancer

Allen CT, Lewis JS Jr., El-Mofty SK, Haughey BH, Nussenbaum B. Human Papillomavirus and Oropharynx Cancer: Biology, Detection and Clinical Implications. Laryngoscope 120(9):1756–1772, 2010.

International Agency for Research on Cancer. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Volume 90. Human Papillomaviruses. Lyon, 2007.

Marur S, D'Souza G, Westra WH, Forastiere AA. HPV-associated Head and Neck Cancer: A Virus-related Cancer Epidemic. Lancet Oncol 11(8):781–789, 2010. (Epub 05/05/2010).

Stelow EB, Jo VY, Stoler MH, Mills SE. Human Papillomavirus-associated Squamous Cell Carcinoma of the Upper Aerodigestive Tract. Am J Surg Pathol. 34(7):e15–24, 2010.

Age and oral cancer

Howlader N, Noone AM, Krapcho M, Neyman N, Aminou R, Waldron W, Altekruse SF, Kosary CL, Ruhl J, Tatalovich Z, Cho H, Mariotto A, Eisner MP, Lewis DR, Chen HS, Feuer EJ, Cronin KA, Edwards BK (eds). SEER Cancer Statistics Review, 1975-2008, National Cancer Institute. Bethesda, MD,, based on November 2010 SEER data submission, posted to the SEER web site, 2011.

Sun exposure and cancer of the lip

Silverman S Jr. Epidemiology. In: Oral Cancer. 3rd ed. Silverman S Jr. (ed). Atlanta, GA: American Cancer Society. 1989, 1–7.

Diet and nutrition & cancer

Chainani-Wu N, Epstein J, Touger-Decker R. Diet and Prevention of Oral Cancer: Strategies for Clinical Practice. J Am Dent Assoc. 142(2):166–169, 2011.

Davidson PG, Touger-Decker R. Chemopreventive Role of Fruits and Vegetables in Oropharyngeal Cancer. Nutr Clin Pract. 24(2):250–260, 2009.

Lucenteforte E, Garavello W, Bosetti C, La Vecchia C. Dietary Factors and Oral and Pharyngeal Cancer Risk. Oral Oncol. 45(6):461–467, 2009. (Epub 11/05/2008).

See other items in the "Oral Cancer: What African American Men Need to Know" campaign

Print Materials:

Are you at Risk for Oral Cancer? What African American Men Need to Know 
Brochure: Are You at Risk for Oral Cancer? What African American Men Need to Know
This brochure alerts African American men to their risk for oral cancer, lists the signs and symptoms, and discusses the importance of early detection.

The Oral Cancer Exam 
Oral Cancer Exam Card
A companion to the brochure, this card describes the steps of an oral cancer examination.

Oral Cancer: What African American Men Need to Know (small poster) 
Poster (8.5" x 11")
This 8.5x11 poster is designed to raise African American men's awareness of their risk for oral cancer and the importance of early detection.


Video: Are You at Risk for Oral Cancer? What African American Men Need to Know (3:10)

Audio: Oral Cancer Public Service Announcements

Widgets: African American Men and Oral Cancer

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This publication is not copyrighted. Make as many copies as you need.

NIH Publication No: 12-6424
August 2012

NIH...Turning Discovery Into Health 



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This page last updated: October 24, 2014