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Credit: cancer.gov

This April edition of The C Word tackles the leading causes of esophageal cancer and head and neck cancer. These risk factors, drinking alcohol, using tobacco, and acquiring the human papilloma virus (HPV), revolve around behavioral choices and thus, can be modified.

Cancer of the esophagus is rare and accounts for 1% of all cancers in the U.S. Males are almost four times more likely to be diagnosed with esophageal cancer than females, and males are more prone to die from the disease. For 2021, the American Cancer Society estimates 15,310 new cases of esophageal cancer in males and 3,950 new cases in females, totaling 19,260 new cases. Approximately 15,530 people may die from esophageal cancer in 2021, including 12,410 males and 3,120 females.

About 3/4 (38,800) of the estimated 54,010 new oral cavity and throat (pharynx and larynx/voice box) cancers are expected to occur in males in contrast to 15,210 new cases in females. Of the 10,850 projected head and neck cancer deaths, males (7,620) are twice as likely to die of these cancers compared to females (3,230).

Alcohol

Alcoholic beverages are a known human carcinogen according to the National Toxicology Program at the U.S. Department of Health and Human Services. Seven cancers are associated with drinking alcohol, including cancers of the mouth/oral cavity and voice box (larynx). The association between drinking alcohol and cancer is a “dose-response” relationship. The more alcoholic beverages ingested (frequency) and the longer the length of time consumed (duration), the greater the risk of developing an alcohol-associated cancer. While heavy drinkers are at greatest risk for cancer, even people that drink no more than one drink per day (light drinkers) and binge drinkers have a modest increased risk of some cancers.

Any level of drinking alcohol increases the risk of squamous cell carcinoma of the esophagus. This esophageal cancer increases by 1.3 times for light drinking and is almost 5-times higher for heavy drinking, compared to not drinking alcohol. The combination of consuming alcohol and using tobacco greatly increases the likelihood of developing cancers of the head and neck cancer and of the esophagus.

Tobacco

Like alcohol, tobacco use has a ‘dose-response’ relationship with multiple diseases including cancer. The more tobacco products smoked or chewed and the longer one uses them, the higher the chances of developing cancer, including those of the esophagus, oral cavity, and throat.

Human Papillomavirus (HPV)

Forty types of HPV are spread through direct sexual contact, and cancer-causing HPV types can infect the mouth and the throat. HPV may cause 70% of cancers of the throat and the base of the tongue and tonsils, a region known as the oropharynx. Safe and effective HPV vaccines administered prior to becoming sexually active are recommended for people from ages 9 years through 26 years.