Other risk factors
Professor Crispian Scully continues his series of articles looking at the prevention and detection of mouth cancer.
The effects of environmental factors such as ultraviolet light or air pollution (wood stoves; fossil fuels; volatile carcinogenic compounds formed during cooking) are ill-defined but they may act via the production of free radicals that elicit DNA mutations. The occupations with an increased risk of oral squamous cell carcinoma (OSCC) mostly involve blue collar workers, and they may include;
Other possible risk factors for OSCC include;
– Chronic candidosis
– Diabetes
– Discoid lupus erythematosus
– Dyskeratosis congenital
– Fanconi anaemia
– HIV/AIDS
– Li Fraumeni syndrome
– Plummer-Vinson syndrome
– Scleroderma
– Xeroderma pigmentosum
– DXR (radiotherapy)
– Drugs
– Anti-hypertensives
– Immunosuppressives
– Marijuana
The consumption of adequate portions of fruit and vegetables (five a day) is associated with a reduced risk of OSCC suggesting a diet deficient in antioxidants predisposes to oral pre-cancer and cancer. One study from the USA showed an inverse association between total fruit and vegetable intake and incidence of head and neck cancer. The Mediterranean diet has been shown to be particularly associated with a reduced oral and pharyngeal cancer risk. No single dietary factor alone appears responsible; foodstuffs or drinks containing antioxidants are believed to have anti-carcinogenic effects, though a Cochrane review concluded the evidence is conflicting and insufficient. Similarly, any role of polyphenols and reports of a protective effect of coffee need confirmation.
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