FACTS AND FIGURES
For more than a decade there has been an increase in the incidence of oral and oropharyngeal cancer. There were 4,400 estimated new cases of oral and oropharyngeal cancer in 2015.1 At the time of writing, the 2016 Canadian Cancer Statistics were not yet available. Incidence rates for oropharyngeal squamous cell carcinoma (OSCC) have significantly increased in numerous countries around the world. The magnitude of increase in OSCC incidence among men is significantly higher at younger ages (< 60 years) than older ages in the United States, Australia, Canada, Slovakia, Denmark, and the United Kingdom.2
We understand that there are two primary and distinct pathways that have been identified as etiologic factors in the development of oral and oropharyngeal cancer. One is through the use of tobacco and alcohol—the dominant risk factors with which the dental professional is familiar. A more recent etiology is exposure to persistent infection of a high-risk strain of the human papillomavirus (HPV), specifically HPV-16. Due to the decline in tobacco smoking, HPV-negative, smoking-related oropharyngeal cancer is decreasing while HPV-associated oropharyngeal cancer is increasing.3
In fact, researchers are predicting that, if incidence trends continue, the annual number of HPV-positive oropharyngeal cancer diagnoses will surpass the annual number of cervical cancer diagnoses by the year 2020.3 Under 7 % of people do get oral cancers with no identified etiology. It is currently believed that these cases are likely related to some genetic predisposition.4
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