Epidermiology, Risk Factor and Treatment of Oral Cancer

Abstract

The neoplastic condition known as oral cancer affects the lips, tongue, buccal mucosa, and upper and lower gums. Assessing oral cancer involves a number of steps and necessitates in-depth understanding of the molecular networks that underlie its growth and progression. The purpose of this study is to present current knowledge regarding the causes, symptoms, and management of oral cancer. In conclusion, oral cancer is a common condition that has serious repercussions for those who are afflicted. A broad To stop this condition from developing and occurring, it is essential to understand pre-malignant lesions, risk factors, and early detection.

Introduction

I. Overview

Oral cancer is the ninth most common malignant neoplasm globally and second in mortality after cardiovascular disease, making it a significant public health concern. It's particularly crucial for oral and maxillofacial professionals to understand its causes, prevention, and treatment. Despite progress in research, oral cancer remains among the top 10 most prevalent cancers.

II. Epidemiology

• Global Impact: Developing countries contribute to 66% of cases, with India, Pakistan, Bangladesh, and Sri Lanka alone accounting for 25% of global diagnoses.

• In the U.S. (2019): 53,000 new cases and 10,860 deaths.

• Europe (2004): Only 15,500 cases (5.5% of total cancers).

• Higher incidence is seen in Arab countries in Western and Southeast Asia.

III. Risk Factors

Oral cancer is multifactorial, involving genetic, environmental, and lifestyle-related causes:

1. Tobacco Use

• Leading risk factor for oral and head-neck cancers.

• Includes smoking, smokeless tobacco, and secondhand smoke.

• Strong links to cancers of the lips, gums, and cheeks.

2. Alcohol

• Contains carcinogenic compounds (e.g., acetaldehyde).

• Causes DNA damage and genetic mutations.

• Alcohol and tobacco combined increase risk significantly.

3. HPV Infection

• HPV-16 is the major strain linked to oropharyngeal cancers.

• Common in younger, non-smoking males (ages 35–55).

• Symptoms: trouble swallowing, persistent sore throat, hoarseness, enlarged lymph nodes.

4. Diet & Nutrition

• Poor nutrition, low intake of antioxidants (vitamins A, C, E, beta-carotene), and iron deficiency (e.g., Plummer-Vinson syndrome) increase risk.

• High sugar intake and lack of fruits/vegetables are associated with higher cancer prevalence.

5. Chronic Inflammation

• Ongoing inflammation can lead to epithelial malignancies.

• Persistent infections or autoimmune disorders can trigger chronic inflammation and potential carcinogenesis.

6. Other Risk Factors

• Poor oral hygiene, long-term denture irritation, genetic predisposition, and exposure to asbestos or heavy metals.

• UV radiation, particularly UV-B, is linked to lip cancer.

IV. Diagnosis

a) Biopsy

• Tissue biopsy remains the gold standard.

• Liquid biopsy (e.g., ctDNA, CTCs) is emerging as a less invasive alternative.

• Brush biopsy offers a non-invasive way to assess suspicious lesions.

b) Physical Examination

• Includes visual inspection and palpation of oral and surrounding tissues.

• Detects swelling, lumps, or discoloration.

c) Imaging

• CT Scan: Good for assessing bone involvement; puff cheek method improves imaging.

• MRI: Better for soft tissue, perineural spread, and early nerve invasion.

V. Treatment Options

1. Surgery

• Primary treatment to remove the tumor and surrounding tissues.

• Clear surgical margins are key to preventing recurrence.

2. Radiation Therapy

• Uses targeted beams to damage cancer cell DNA.

• Advanced methods aim to minimize damage to healthy tissue.

• Also used for palliative care to relieve symptoms.

3. Chemotherapy

• Drugs like Cisplatin and 5-Fluorouracil (5-FU) are commonly used.

• Often combined with radiation for better outcomes.

• Side effects: nausea, fatigue, weight loss, infection risk.

4. Chemoprevention

• Involves antioxidants and natural compounds (e.g., green tea extract, vitamins A, C, E).

• Used especially in high-risk patients or those with precancerous lesions.

Conclusion

Due to the high morbidity and mortality rates of oral cancer, more effective strategies and treatment plans are required. Surgery is the primary treatment strategy for patients with oral cancer, with radiotherapy and chemotherapy reserved for patients who cannot tolerate surgery. This study also shows epidemiology, risk factors, and treatment on oral cancer. There are a number of risk factors that may be involved in the development of oral cancer, with tobacco smoking, alcohol consumption, and HPV being the most studied risk factors. In addition, inflammation and genetic susceptibility are thought to play a crucial role.

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Copyright

Copyright © 2025 Ms. Madhavi Kudale, Ms. Pooja Gaikwad, Ms. Shweta Shitole, Ms. Lakade Sarika , Mr. Nitin Gawai. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.