Risk Factors for Head and Neck Cancer

This is the third article in the Understanding Head and Neck Cancer Guide. This guide was developed by the HealthTree Education Team and was last updated and reviewed on May 22, 2026. 

Anything that increases your chance of developing cancer is called a risk factor. Sometimes, risk factors directly cause cancer. For example, chemicals in tobacco directly damage the DNA in cells lining the mouth and throat. Most often, though, risk factors do not directly cause cancer on their own. Instead, many small changes over time lead to the genetic changes that cause cancer.

It is important to remember that having one or more risk factors for head and neck cancer does not guarantee you will develop head and neck cancer. It is also possible to develop head and neck cancer even if you do not have any known risk factors. Researchers are still learning how head and neck cancer develops.

What raises your risk for developing head and neck cancer?

• Tobacco use. Tobacco use is the single most important risk factor for most head and neck cancers. This includes cigarettes, cigars, pipes, and smokeless (chewing) tobacco. Risk increases with the amount and duration of use. About 70–80% of head and neck cancers other than HPV-positive oropharyngeal cancers are linked to tobacco.
• Heavy alcohol use. Heavy alcohol consumption increases the risk of cancers of the mouth, throat, and voice box. The combination of alcohol and tobacco is particularly dangerous, multiplying risk well beyond either exposure alone.
• Human papillomavirus (HPV) infection. Infection with high-risk types of HPV, particularly HPV-16, is the leading cause of oropharyngeal cancer in the United States. HPV-positive cancers tend to occur in younger patients, often in their 50s and 60s, are more common in men than women, and often occur in people who do not smoke.
• Age. Head and neck cancer is most frequently diagnosed in people aged 50 and older, though HPV-positive cancers are increasingly seen in adults under 50.
• Sex. Head and neck cancer is about twice as common in men as in women, partly due to higher rates of tobacco and alcohol use and partly due to higher rates of HPV infection at the back of the throat.
• Epstein-Barr virus (EBV). Infection with EBV is strongly linked to nasopharyngeal cancer, particularly in regions with high incidence such as Southeast Asia, parts of China, and North Africa.
• Betel quid and areca nut. Chewing betel quid (a preparation containing areca nut, betel leaf, and often tobacco) significantly increases the risk of oral cavity cancer. It is common in parts of South and Southeast Asia.
• Occupational and environmental exposures. Long-term exposure to wood dust, leather dust, nickel, formaldehyde, asbestos, and certain industrial chemicals has been linked to cancers of the nasal cavity, paranasal sinuses, and larynx.
• Radiation exposure. Previous radiation therapy to the head and neck, particularly during childhood, can increase the risk of salivary gland and other head and neck cancers later in life.
• Sun exposure. Prolonged exposure to sunlight is the main risk factor for cancer of the lip.
• Personal history of head and neck cancer. People who have had head and neck cancer have a higher risk of developing a second primary cancer in the head and neck, lung, or esophagus, particularly if they continue to smoke or drink.
• Poor oral health. Chronic gum disease, poorly fitting dentures, and lack of regular dental care have been associated with a small increase in oral cancer risk, though it is not clear how much these factors contribute independently.
• Gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux. Chronic acid reflux into the throat and voice box may modestly increase the risk of laryngeal and hypopharyngeal cancers.
• Weakened immune system. People with weakened immune systems, including those who have had organ transplants or who have HIV, are at higher risk for some head and neck cancers.
• Hereditary cancer syndromes. Rare inherited conditions including Fanconi anemia, dyskeratosis congenita, and Li-Fraumeni syndrome significantly increase the lifetime risk of head and neck cancer.
• Race and ethnicity. Rates of head and neck cancer vary by race and geography. Nasopharyngeal cancer is much more common in people of Chinese, Southeast Asian, and North African descent. Oral cancer rates differ across racial and ethnic groups in the United States.

Factors that may lower your risk

Some factors are associated with a lower risk of head and neck cancer:

• Not using tobacco in any form, or quitting if you currently use it
• Limiting alcohol use
• Receiving the HPV vaccine
• Practicing good oral hygiene and seeing a dentist regularly
• Using lip balm with sunscreen and limiting sun exposure to the lips
• A diet rich in fruits and vegetables may be modestly protective