Causes and risk factors of head and neck cancer

Certain factors increase the risk of head and neck cancer, including smoking or chewing tobacco and drinking alcohol.
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What are risk factors?

Doctors do not know the exact causes of head and neck cancer. But certain things called risk factors can increase the chances of developing it. Having one or more risk factors does not mean you will get a head and neck cancer.

The main risk factors for head and neck cancer are tobacco and alcohol. About 3 out of 4 head and neck cancers (75%) are thought to be linked to tobacco or alcohol use.

Certain risk factors depend on the type of head and neck cancer you have.

If you are worried about head and neck cancer and would like to talk to someone, we're here. You can:

Smoking cigarettes, cigars or pipes

Smoking tobacco increases the risk of developing many types of head and neck cancer. This includes mouth cancer, throat cancer and cancer of the voicebox (larynx). The more cigarettes someone smokes, and the more years they smoke for, the higher the risk. 

Holding a pipe or cigarette on your lip when smoking also increases your risk of developing lip cancer.

Chewing tobacco or betel quid (paan)

Chewing tobacco or betel quid also increases the risk of developing mouth cancer. There are different names for tobaccos that are combined with other chewing products. Betel quid (paan) is one of these. The risk of mouth cancer is higher even if the betel quid does not contain tobacco.

Drinking alcohol

Drinking alcohol is linked to mouth cancer and throat cancer. The more alcohol a person drinks, and the more years they drink for, the higher the risk.

Drinking and smoking together greatly increases the risk of head and neck cancer. People who smoke and drink heavily over several years have the highest risk of developing head and neck cancer.

Sex

Head and neck cancer is much more common in men than in women. In the UK, it is the 4th most common cancer in men. In women, it is the 13th most common cancer.

Age

Like all cancers, the risk of head and neck cancer increases as you get older. It is most common in people aged over 70. It is more likely to develop in people aged over 50, but it can affect younger people from their 30s onwards.

Human papilloma virus (HPV) infection

Cancer of the oropharynx (back of the tongue and tonsils) has become more common over the last 20 years. This is linked to HPV infection.

HPV can affect areas such as the genitals, inside the mouth and the throat. Most people have it at some point, and usually it does not cause any harm. HPV is spread through any sexual contact, including direct skin-to-skin genital contact, as well as the mouth and throat.

It is not always possible to link the virus to sexual contact. There may be other ways of spreading the virus that have not yet been identified.

There are many types of HPV. Only certain types increase the risk of developing cancer. Most people affected by high-risk HPV will not develop cancer. Usually the body’s immune system gets rid of the virus naturally. We do not know exactly why some people go on to develop cancer.

Children in the UK are now offered the HPV vaccination. This is expected to reduce the number of head and neck cancers linked with this virus.

We have information about HPV and cancer.

Epstein Barr virus (EBV) infection

Nasopharyngeal cancer is linked to a virus called the Epstein-Barr virus. This virus causes glandular fever. Only a very small number of people who have had glandular fever develop nasopharyngeal cancer.

Low immunity

Some people with reduced immunity have an increased risk of developing a head and neck cancer. Your immunity may be low if you:

  • are taking medication to suppress your immune system after an organ transplant
  • have a condition such as HIV (human immunodeficiency virus), or AIDS.

    • Sunlight

    Long-term exposure to ultraviolet light from sunlight, sun beds or sunlamps, increases the risk of cancer on the outer lip.

    Occupational exposure

    Long-term exposure to some types of dust and certain chemicals at work increases the risk of developing cancers of the nasopharynx and sinuses. These are:

    • hardwood dust
    • formaldehyde (found in leather and some types of furniture dust)
    • polycyclic aromatic hydrocarbons (PAHs) – chemicals that occur naturally in coal, crude oil, and gasoline.

    Pre-cancerous conditions

    Pre-cancerous conditions of the mouth increase the risk of developing mouth cancer. These include having white patches (leukoplakia) or red patches (erythroplakia) in the mouth that do not go away. They are usually linked to tobacco use. Although erythroplakia is less common, it has a higher risk of developing into mouth cancer.

    Oral health

    The risk of developing mouth cancer is higher in people with poor oral health. Having several teeth missing, bleeding gums and gum disease may increase the risk. This can be made worse by not visiting the dentist regularly, so problems are not noticed early enough.

    Dentures that do not fit properly may also increase the risk of mouth cancer.

    Diet

    A diet that is high in salted fish is a risk factor for nasopharyngeal cancer.

    Some studies show that a diet high in fruit and vegetables may help to protect against some head and neck cancers.

    About our information

    • References

      Below is a sample of the sources used in our head and neck cancer information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

      Machiels J.-P, Leemans C. R. et al. Squamous cell carcinoma of the oral cavity, larynx, oropharynx and hypopharynx. EHNS- ESMO-ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology, 2020. Volume 31, Issue 11, Pages 1462-1475.

      National Institute for Health and Care Excellence (NICE). Cancer of the upper aerodigestive tract: assessment and management in people aged 16 and over. NICE guideline NG36 2016 (updated 2018). 

    • Reviewers

      This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Chris Alcock, Consultant Clinical Oncologist.

      Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

    Date reviewed

    Reviewed: 01 March 2022
    |
    Next review: 01 March 2025
    Trusted Information Creator - Patient Information Forum
    Trusted Information Creator - Patient Information Forum

    Our cancer information meets the PIF TICK quality mark.

    This means it is easy to use, up-to-date and based on the latest evidence. Learn more about how we produce our information.

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