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Risk Factors for Head and Neck Cancer

Over 65,000 Americans will be diagnosed with cancer of the head or neck this year, accounting for over four percent of new cancer diagnoses nationwide.

Evidence suggests that most cases of head and neck cancer can be linked to lifestyle choices, creating the opportunity to reverse this trend with education, new habits and regular screening.

“Head and neck cancers are the sixth most common in the world,” said Christopher E. Fundakowski, MD, a physician at Jefferson Health - Abington who specializes in cancers of the head and neck. “And in the United States, the majority of cases are found in men.”

Here’s what you need to know about head and neck cancer, and what you can do to minimize your risk.

Lifestyle and Hereditary Risk Factors

“Tobacco and alcohol use are the largest, and most common, risk factors for head and neck cancer,” said Dr. Fundakowski. This is because both tobacco and alcohol contain substances called carcinogens, which can create cancer-causing mutations in the cells of the mouth. “Independently they are both risk factors, but when combined your risk multiplies exponentially.”

Tobacco use is considered unhealthy at any level. However, quitting tobacco quickly improves the health of the cells in your mouth, decreasing the risk of oral cancer. Within 10 to 20 years of quitting, your risk will decrease back toward a normal level.

The National Institute of Alcohol Abuse and Alcoholism defines high-risk consumption as greater than seven drinks per week for women, and 14 drinks per week for men.

In addition to liquor and spirits, alcohol can also be found in innocuous products like mouthwash. The key to using these products safely is following the recommended guidelines and practicing moderation. It is also important to be aware of your family history of head and neck cancer when selecting products that may have an impact on your health.

Most new cases of cancer in the head and neck are the result of alcohol and tobacco use, while the Human Papillomavirus (HPV) causes the majority of tonsil- and tongue-based cancers.

“The majority of people will come across HPV at some point in their life, but not everyone will develop head and neck cancer,” said Dr. Fundakowski. “There are individual immune system responses to the virus that we can’t yet predict, and this is partially the reason why there is not an effective screening test for tonsil cancer at this point in time.”

According to Dr. Fundakowski, 80 percent of HPV-related cancers are vaccine-preventable, but only 50 percent of the eligible U.S. population currently receives the HPV vaccine. The maximum age for receiving the vaccine was recently moved up to 45-years-old. It’s recommended that you talk to your healthcare provider about the HPV vaccine.

Screening Options

Unlike recommendations for colonoscopies and mammograms, there is no set guideline for the beginning of regular head and neck cancer screenings. However, Dr. Fundakowski suggests regular appointments with your primary care provider or an ear, nose and throat (ENT) physician for a check-up.

“Typically the screenings are done by an ENT physician because they are experienced in subtle changes in the head, neck, tongue and lymph nodes,” said Dr. Fundakowski. “They will check the nodes and all of the surfaces where symptoms develop—it is a relatively fast exam.”

Many dentists also perform basic exams during check-ups.

“Because there are no guidelines, you need to know your risk factors,” said Dr. Fundakowski. “If you’re considered high-risk, there is nothing wrong with an annual exam.” And if you notice changes in your voice, lumps, or swelling in your throat, you should seek a doctor immediately.

“We would much rather see you and say there there’s nothing wrong than see you when there is already a problem and it’s advanced,” he added.

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