Risk factors for oropharyngeal cancer

A risk factor is something that increases the risk of developing cancer. It could be a behaviour, substance or condition. Most cancers are the result of many risk factors. Human papillomavirus (HPV) infection is the most important risk factor for oropharyngeal cancer. Until recently, smoking tobacco was the most important risk factor.

More men than women develop oropharyngeal cancer. Oropharyngeal cancer linked to an HPV infection tends to be seen in people 40 to 59 years of age. When this cancer is not linked to HPV, the risk for it usually increases with age and often develops in people older than 55 years of age.

Risk factors are generally listed in order from most to least important. But in most cases, it is impossible to rank them with absolute certainty.

Risk factors

Human papillomavirus (HPV)

Smoking tobacco

Drinking alcohol

Combined tobacco and alcohol

Certain genetic conditions

There is convincing evidence that the following factors increase your risk for oropharyngeal cancer.

Human papillomavirus (HPV)

Most oropharyngeal cancers are caused by a human papillomavirus (HPV) infection. HPV infections are very common because the virus is easily passed by skin-to-skin contact with any HPV-infected area of the body. It is mainly spread through sexual contact, including oral sex.

Most sexually active people will be exposed to HPV at some time in their life. Certain sexual behaviours and having many sex partners can increase a person’s chance of getting HPV. It can be present for years without symptoms. The virus can cause warts (called papillomas) in different parts of the body, including the genitals.

Find out more about HPV.

Smoking tobacco

Smoking tobacco is a major risk factor for oropharyngeal cancer. All forms of tobacco, including cigarettes, cigars and pipes, increase your risk. The risk for oropharyngeal cancer increases with the amount and length of time you smoke.

Continuing to smoke after treatment for oropharyngeal cancer increases the risk of developing a second oropharyngeal cancer.

Drinking alcohol

Drinking alcohol is also a major risk factor for oropharyngeal cancer. The risk of developing oropharyngeal cancer increases with the amount of alcohol you drink.

Combined tobacco and alcohol

Smoking tobacco and drinking alcohol together increases the risk for oropharyngeal cancer more than either smoking tobacco or drinking alcohol alone.

Certain genetic conditions

The following genetic conditions increase the risk of head and neck cancer, including oropharyngeal cancer.

Fanconi anemia is a rare genetic condition that affects the bone marrow so it can’t make normal blood cells.

Congenital dyskeratosis is a rare genetic condition that causes abnormally shaped fingernails and toenails, a lacy rash on the face and chest, white patches in the mouth and often bone marrow failure.

Possible risk factors

The following factors have been linked with oropharyngeal cancer, but there is not enough evidence to show for sure that they are risk factors. More research is needed to clarify the role of these factors for oropharyngeal cancer.

  • second-hand smoke
  • smokeless tobacco
  • family history
  • diet low in vegetables and fruit
  • drinking very hot beverages such as maté
  • areca nut and betel quid

Questions to ask your healthcare team

To make the decisions that are right for you, ask your healthcare team questions about risks.

Expert review and references

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  • Habbous S, Chu KP, Lau H, et al . Human papillomavirus in oropharyngeal cancer in Canada: analysis of 5 comprehensive cancer centres using multiple imputation. . CMAJ . 2017 .
  • reeH . International Agency for Research on Cancer (IARC). Volume 51: Coffee, tea, mate, methylxanthines and methylglyoxal. 1997: http://monographs.iarc.fr/ENG/Monographs/vol51/mono51.pdf.
  • International Agency for Research on Cancer (IARC). Volume 100C: Arsenic, metals, fibres and dusts: a review of human carcinogens. 2012: http://monographs.iarc.fr/ENG/Monographs/vol100C/mono100C.pdf.
  • International Agency for Research on Cancer (IARC). Volume 100E: Personal Habits and Indoor Combustions. 2012: http://monographs.iarc.fr/ENG/Monographs/vol100E/mono100E.pdf.
  • Mayne, S. T., Morse, D.E. & Winn, D.M . Cancers of the oral cavity and pharynx. Schottenfeld, D. & Fraumeni, J. F. Jr. (Eds.). Cancer Epidemiology and Prevention. 3rd ed. New York: Oxford University Press; 2006: 35:674-693.
  • Mendenhall WM, Werning JW, Pfister DG . Cancer of the head and neck. DeVita VT Jr, Lawrence TS, & Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 38: 422-473.
  • Mourad WF, Hu KS, Choi WH, et al . Cancer of the oropharynx: General principles and management. Harrison LB, Sessions RB, Kies MS (eds.). Head and Neck Cancer: A Multidisciplinary Approach. 4th ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2014: 17A: 373 - 414.
  • National Toxicology Program . 14th Report on Carcinogens . Department of Health and Human Services ; 2016 .

Reducing your risk for oropharyngeal cancer

Ways of reducing your risk for oropharyngeal cancer include not smoking tobacco and limiting alcohol intake. Learn how to lower your risk of developing oropharyngeal cancer.