04 November 2022

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NEJM publishes special report on oral cancer prevention

Mary Guiden

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A working group convened by an agency with ties to the World Health Organization (WHO) found that there is sufficient evidence that quitting tobacco smoking and alcohol consumption or use of areca nut products — with or without tobacco — reduces the elevated risk of oral cancer.

Among the various interventions for quitting use of smokeless tobacco and areca nut products, the team said that behavioral interventions in adults are effective in inducing quitting use of smokeless tobacco. The working group — organized by the International Agency for Research on Cancer (IARC) — also concluded that screening of high-risk populations by clinical oral examination may reduce mortality from oral cancer.

The team’s findings were published as a special report in The New England Journal of Medicine on Oct. 18. The detailed assessments will be published as Volume 19 of the IARC Handbooks of Cancer Prevention, according to a news release.

Dr Béatrice Lauby-Secretan, co-author of the report and deputy head of the evidence synthesis and classification branch at IARC, said that the handbook provides a first-time evaluation of primary and secondary prevention of oral cancer.

In 2020, cancer of the lip and oral cavity was estimated to rank 16th in incidence and mortality worldwide and was a common cause of cancer death in men across much of South and South-East Asia and the Western Pacific. Risk factors for oral cancer are dominated by use of tobacco, both smoked and smokeless, and alcohol consumption. In South-East Asia and the Western Pacific Islands, where oral cancer is highly prevalent, the major risk factors are use of smokeless tobacco and areca nut products. A small proportion of oral cancer cases globally (~2%) is caused by infection with human papillomavirus (HPV), primarily HPV16.

The complete report is on the NEJM website: https://www.nejm.org/doi/10.1056/NEJMsr2210097