Oral cancer accounts for approximately 3 percent of all cancers in the United States. Approximately 30,000 cases are diagnosed each year, and about 8,000 patients die annually due to oral cancer. The incidence of oral cancer is increasing.
Oral cancer occurs twice as often in the African-American population as in Caucasians.
About 95 percent of oral cancers occur in people over 40 years of age. The average age at the time of diagnosis is about 60 years old, although oral cancer is now occurring more frequently in much younger patients.
For decades, oral cancer affected six men for every one woman (6:1). However, today, this ratio has changed to 2:1, and is most likely due to the increased use of tobacco and alcohol by women.
Clinical studies have linked tobacco use (cigarettes and cigars) to an increase in oral cancer. Other risk factors may include heavy alcohol use. Cancers involving the tonsils and base of tongue (known as oropharyngeal cancer) are strongly associated with human papilloma virus (HPV16) infection. The more risk factors a person has, the greater the chance that oral cancer will develop. Non-smokers under the age of 50 are currently the fastest growing segment of the oral cancer population.
Many oral cancers develop from pre-malignant conditions of the mouth, such as white or red patches. If detected and treated early at this precancerous stage, there is a high probability the precancer will not develop into oral cancer.
At the NYU Oral Cancer Center, we are conducting clinical studies to understand why certain precancers progress to oral cancer as well as genomic studies to identify high risk oral precancers.
Up to 40 percent of oral cancer survivors have a recurrence of the cancer or develop a new cancer. The risk of recurrence is highest for people who use tobacco or drink excessive levels of alcohol.
The five-year survival rate is approximately 50 percent. This is because oral cancers can be aggressive and difficult to treat. Oral cancers are often diagnosed at an advanced stage after the cancer has spread (metastasized) to the lymph nodes of the neck.
The incidence of oral cancers of the anterior part of the mouth (lips, tongue, hard palate areas) – the area associated with heavy use of tobacco and alcohol – has declined in conjunction with a general decline in smoking. However, cancers located in the oropharynx – those mostly associated with HPV16 infection – are increasing.