It is difficult to apportion exact figures on oral cancer cases caused by smoking or drinking as smokers tend to be drinkers and vice versa, said professor André van Zyl, spokesperson for SADA. ‘€œIn large studies of OC, it has been found that almost all patients were drinkers and that over 90% of these were smokers as well. ‘€œ

‘€œWhen alcohol and smoking are combined risk factors, there is an even greater increased risk as compared to alcohol and smoking as separate causes. This means that heavy smokers who are heavy drinkers have a hugely increased risk for oro-pharyngeal cancer (OPC) with a 38-fold increased risk for men and more than 100-fold increased risk for women. This multiplicative risk when being exposed to both substances is largely unknown to the public. Also, 66% of all smoking and alcohol-related cancers can be attributed to heavy consumption or abuse,’€ said Van Zyl.

More men develop smoking and alcohol related OC, probably owing to the fact that, in general, they consume more tobacco and alcohol, Van Zyl noted. People at risk of this type of OC are those over 45 years of age, with the highest risk around the 60-year age mark.

‘€œSmokers and drinkers with OC and OPC have a poorer prognosis than non-smokers and die from the disease faster than non-drinkers and non-smokers.’€

The tongue and the floor of the mouth are the two most common areas for OC to present in cases where it is caused by smoking and alcohol consumption. Up to 75% of OCs occur in these areas.  

Self-examination

SADA encourages the public to regularly self-inspect the oral cavity and, if any suspicious lesions are found the dental practitioner should be visited without delay. Special care should be taken to look out for lesions on the sides of the tongue, under the tongue and behind the lower teeth. More than 60% of all OCs develop in these areas.

Van Zyl said that the easiest way of self-examining is to stick the tongue out as far as possible and to look out for any suspicious lesions or sores. ‘€œIf there is the slightest doubt or, if you cannot stick the tongue out, your dentist must be consulted without delay.’€

Scientists are unequivocal about the importance of smoking and drinking cessation campaigns as part of an overall strategy to lower the cancer burden.

Van Zyl said that when smoking is ceased there is an immediate 50% lowering of the risk for OC development in the following three to five years and, after 10 years, there is no risk for throat cancer. ‘€œCoupled with an increase in physical activity it may well be the only way to successfully fight OC and OPC in a resource poor country such as South Africa.’€

Source: SADA press release