Page last updated at 23:00 GMT, Monday, 10 August 2009 00:00 UK

Drink blamed for oral cancer rise

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Alcohol is largely to blame for an "alarming" rise in the rate of oral cancers among men and women in their forties, say experts.

Numbers of cancers of the lip, mouth, tongue and throat in this age group have risen by 26% in the past decade.

Alcohol consumption has doubled since the 1950s and is the most likely culprit alongside smoking, says Cancer Research UK.

Each year in the UK around 1,800 people die from the disease.

There are 5,000 newly diagnosed cases per year.

Other risk factors that may be involved include a diet low in fruit and vegetables, and the sexually transmitted human papillomavirus (HPV), which also causes cervical cancer.

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Figures produced by Cancer Research UK show that since the mid-1990s, rates of oral cancers have gone up by 28% for men in their forties and 24% for women.

The charity's health information manager Hazel Nunn said: "These latest figures are really alarming.

"Around three-quarters of oral cancers are thought to be caused by smoking and drinking alcohol.

"Tobacco is, by far, the main risk factor for oral cancer, so it's important that we keep encouraging people to give up and think about new ways to stop people taking it up in the first place.

The trend we are now seeing is likely to be linked to Britain's continually rising drinking levels
Hazel Nunn
Cancer Research UK

"But for people in their 40s, it seems that other factors are also contributing to this jump in oral cancer rates.

"Alcohol consumption has doubled since the 1950s and the trend we are now seeing is likely to be linked to Britain's continually rising drinking levels."

Oral cancer can be treated successfully if diagnosed early enough.

The most common signs of the disease are ulcers, sores, or red or white patches in the mouth that last longer than three weeks, together with unexplained pain in the mouth or ear.

Alcohol Concern chief executive Don Shenker said: "Many people are not aware of the connection between alcohol and cancer, yet as this research shows, it can be a major contributor or cause of the disease.

"While alcoholic liver disease remains the number one killer linked to alcohol, more and more people are suffering from oral cancers - and record drinking levels have undeniably played a part."

He said it was time to introduce tobacco-style health warnings on alcohol.

"It's a consumer issue - people have a right to know the full range of health risks associated with drinking alcohol above recommended guidelines.

"This research will hopefully help people realise the full extent of the damage that alcohol can do, then they're better placed to make informed decisions about how much they drink."

Professor Ian Gilmore, president of the Royal College of Physicians and chair of the Alcohol Health Alliance, said: "These latest figures demonstrate once again that people are being struck down at ever younger ages with alcohol-related illnesses that they might never have previously associated with heavy drinking.

"There is an urgent need to rethink how we communicate the risks of misuse. The first step is to challenge the widespread notion that the only chronic health damage is suffered by a minority of older drinkers."

Professor Alan Maryon-Davis, president of the UK Faculty of Public Health, said: "The really lethal cocktail is drinking strong spirits and smoking - a carcinogenic double whammy for the delicate lining of the mouth and throat. My advice is if you drink, don't smoke - and if you must smoke, avoid spirits."


We asked you for your views on oral cancer. Please find a selection of your comments below.

The emphasis here should be public awareness of oral health and the added risk of drinking and smoking. I am a 38 year old consultant working within the NHS and seven and a half years down the line from being diagnosed with a tongue tumour. I had major surgery with half my tongue removed and then rebuilt from my forearm and a full neck dissection and all lymph nodes removed, tracheostomy and adjuvant radiotherapy. Thankfully I am still here. I didn't drink excessively, neither have I ever smoked and my diet varied and healthy. Promote public awareness, the evidence from the lofty Professor is scant and all drinkers and smokers should be extra vigilant of oral health.
Mark, York

My mouthwash contains alcohol! My toothpaste contains all sorts of chemicals! Comparing trends as a method of identifying a cause seems very unscientific. The total number of migrants has doubled since 1960. I am sure this has a direct link to the increase in skin cancers..!! Daft!!
Andy B, Merseyside, England

At the age of 57 I was diagnosed with tongue cancer. I was a moderate smoker from the age of 15 till the age of 50, when I gave up. I have always had the odd drink, but never to excess, although there have been the odd exceptions. My cancer was Stage 3. The treatment consisted of four chemotherapy sessions followed by 35 consecutive sessions of radiotherapy and two blood transfusions. I am now in remission, my treatment having been completed in November 2008. I have been advised it will take two years for the healing to take place. The treatment itself has left me with many permanent issues, such as aching joints, tinnitus, associated muscle pain within the neck area, saliva glands that no longer work and a lack of taste. For six months I was unable to swallow and had to be fed via a peg tube fitted into my stomach. I urge anyone who is currently a smoker and/or drinker to reconsider any thoughts of "Why should I give up?" My experience should be a warning to all.
John Nelson, Maidstone UK

What concerns me is lack of dentists. If we cannot get a check-up, that's one line of early detection removed.
Iris, Cumbria

My sister Rose died in 1984 at the age of 33 from oral cancer; it was originally misdiagnosed as ordinary mouth ulcers. An operation to remove half of her face was her final option which she could not bring herself to do. Rose consumed alcohol and continued to smoke throughout her life; she is sadly missed.
Chris Straker, Padstow, UK

Regarding the item on oral cancer, do you not think that the pub trade has already been decimated by the smoking ban? Now you are telling people that drinking is the major cause of oral cancer. What do you think that will do for the pub trade? It will kill it. So what you are saying is that drinking will more than likely give people oral cancer. We are struggling in the pub trade with customers staying away due to the smoking ban, now how many pubs will have to close due to this item?
Mick Cox, Bromsgrove

I was diagnosed with oral cancer at 31. I'd previously been a heavy drinker and smoker, although I'd abstained from both for over 3 years before my diagnosis. Most people think that it's just smoking that causes these types of cancer, but alcohol can play a big part too. And when you put the two together, you are actually more than doubling your chances of developing a cancer of this type. I was lucky, it was caught early and easily treated. All I needed was two ops, and five years of regular checkups. But I've seen pictures off the Web of people who left it, and have ended up having major surgery removing parts of the neck and face. My advice is, if you suspect something see your GP straight away. Just like testicular cancer, it's a lot easier to treat in the early stages than if it's just left for far too long.
Simon Metcalfe, Carlisle, UK

I am a newly qualified dentist and I am glad that these alarming statistics are being reported in the national news. Oral cancer is largely preventable and if caught early can be treated, but it has generally had a very low profile compared to breast and cervical cancers for example. Every patient who has a check-up with a dentist is visually screened for oral cancer, and the dentist is best placed to notice the warning signs and refer for investigation. Another important reason to regularly visit your dentist.
Angela Waugh, Elgin, UK

My husband has just completed treatment for cancer of the tongue. He had major surgery and 6 weeks of radiotherapy. He has drunk alcohol in moderation - well below the weekly units recommended. He is only 36. Our dentist didn't spot the problem on two occasions and it was just lucky that he went to the doctor about a painless mark on his tongue. I feel that this illness can strike anyone and can't just be attributed to alcohol.
Sera Byrne, Bradninch, Devon

"Around three-quarters of oral cancers are thought to be caused by smoking and drinking alcohol" - so it's unproven then isn't it? I think Cancer Research should wait until it's been scientifically proven before publishing such scare stories, just the same as the BBC shouldn't publish PR material without checking it out first, you are supposed to be publishing the "truth" after all not just every item that someone feeds you.
Kevin Crossinggum, Bromley, Kent.

My husband died in 2007 at the age of 44 from squamous cell carcinoma of the tongue and neck. He was a heavy drinker and smoked hand rolling tobacco, and these were identified as the cause of his disease. He died seven months after his initial diagnosis having had part of his tongue removed, his neck cut open from ear to ear, 35 radiotherapy treatments, and eventually with half his face eaten away when the cancer returned .It is a horrible, disfiguring and agonising disease, and the survival rates are very poor, and the quality of life if you do survive is severely diminished, with facial deformities, pain, loss of speech, loss of the ability to eat ,just a few of the problems after treatment.
Liz Arrand, Harewood West Yorkshire

So why does alcohol get the blame? Is there any empirical research evidence to back up this claim? Other than there's been a rise in alcohol consumption and that's not research. It took years to make the link between smoking and cancer. What about the rise the number of people having piercings in their mouths, tongues, cheeks and lips and noses. Has anyone checked this out as a cause? I doubt it. Unfortunately this sounds to me like all part of the very well orchestrated lobby, of which Cancer Research UK is a part, by the Government and others to completely control our lives. Drinking is the new smoking. When do you think it will be banned?
Mick, Leeds

11 years ago, my grandmother died from oral cancer. She was an alcoholic and heavy smoker. She was just 72. My parents nursed her until her death in their home and it wasn't a dignified death. In July 2008, my father was diagnosed with oral cancer. He is also an alcoholic and heavy smoker. It was only discovered at Stage 4 and was in most of the mouth, tongue, throat, jawbone and it had spread to the lymph. He had a major operation in which all his teeth and most of his gums, 50% of his tongue, the floor of his mouth and part of his lower jaw were removed. He is still fighting the good fight despite turning down any chemo or radiotherapy but his days was few. I can't do anything for them but I don't have many toxins in my mouth i.e. I don't drink very often or much and I don't smoke. I also go to the dentist regularly and try to eat a healthy diet. The saddest thing is that this cancer is treatable if it's caught in the early stages and my dad knew he was ill at least 5 years ago. It's not a nice way to die.
Tracy, Stevenage, England

My sister (a teetotaller) had a pre-cancerous condition in her mouth which simply went away within a few months of dumping her 'all powerful' 'whitening', 'antibacterial' toothpaste and rinse! The rise in oral cancer is more due to the massive surge in chemical additives in dentifrices, (which of course includes alcohol in mouth rinses). The amount of chemicals in toothpastes is unprecedented, many of the chemicals being known skin irritants. The pity of the health service is that there is no correlation between the sources of chronic irritation and the treatment for its consequences. The corporations who manufacture dentifrices do not bear the burden of the consequences of their products. Many toothpastes now contain bleaching agents which in conjunction with foaming agents and other chemicals have the potential to act as carcinogens. Solution: reduce alcohol AND chemicals in toothpaste etc.
truthseeker-e, london

I'm 32, lived the good life since 18 (drinking most weekends etc.) have never smoked but last month I was diagnosed with cancer. I can't help but think that my lifestyle of the last 14 years has played a major part. Fingers crossed for my recovery but I'm now committed to a major lifestyle change, no booze and as little junk food as possible.
AJ, Australia

After drinking my way through uni, I stopped and thought about why I was doing it. I looked at how much I was drinking and it surprised me. It wasn't good for my health, it meant most of the next day was a write-off and getting home was always going to be a problem. I didn't need it to have a good time when I went out. So I stopped. That was seven years ago and I don't regret my decision at all. I feel better for it and am glad I did it. New medical evidence like this just renews that. What does surprise me is society's attitude towards me when I say I don't drink, like there's something wrong with me. Some groups actually now consider me a social leper based on this!
Ali, Hants

My mother died of oral cancer last year , she had never smoked in her life and drink was only ever consumed on rare occasions like at a family party and then she would only have 2 - 3 drinks, her cancer started on her tongue and spread to the right side of her face it was a very aggressive cancer .
John Charkewycz, Bolton, United Kingdom

I am an oncology research sister working in this area and during my time spent on some head and neck wards I have noticed that this disease is affecting younger people. The public should be kept informed about oral cancers as it affects a very public area of the body. Whenever you meet a person the first place you look at is the face. These cancers are devastating and prevention advice must be given in the advertisement of any alcoholic products.
Carly Munro, Derby



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