How to spot the signs of mouth cancer

Mouth cancer, also known as oral cancer, affects around 8,800 people in the UK each year according to the Oral Health Foundation, and more than 3,000 people died from the illness in 2022. Worldwide, 650,000 people are diagnosed annually. Despite these numbers, there is little awareness of the condition and many patients struggle to get diagnosed, which is concerning as survival rates generally depend on early identification and treatment.   

What is mouth cancer?

Mouth cancer is the most common type of head and neck cancer and can affect areas in and around the mouth, including the lips, tongue, inside the cheeks, roof of the mouth and gums. The most common type of mouth cancer is oral squamous cell carcinoma (OSCC), which accounts for nine out of 10 cases. Squamous cells are found in many places around the body, including the inside of the mouth and under the skin. Squamous cell carcinoma is characterised by abnormal, accelerated growth of squamous cells. When caught early, most cases are curable.

Joss Harding is a dental hygienist and the president elect of the Mouth Cancer Foundation. She explains that vigilance and early detection are vital for improved survival rates.

“If you have a tumour smaller than a thumbnail, you have a 50 per cent chance of surviving longer than five years,” she says. “Unfortunately, because of delays caused by Covid and the fact that a lot of people attend late, patients can already be at an advanced stage before they are referred, so there are more complications and treatment is a lot more dramatic and invasive.”

The mortality rate of OSCC has remained static in recent decades. One of the reasons for this is late diagnosis. A study published in Frontiers journal in 2022, which reviewed papers on diagnostic delays in OSCC, reported that patients waited between 45 days and approximately six months. One of the main causes of delay was patient lack of knowledge about the signs, symptoms and risk factors of oral cancer. Professional delay was also cited as a factor. 

What are the causes and signs of mouth cancer?

There are several lifestyle risk factors for mouth cancer. The main one is smoking, followed by regularly drinking more than 14 units of alcohol a week. Regularly drinking excessive amounts of alcohol can increase the risk of developing mouth cancer fourfold, and those who drink and smoke together are 30 times more likely to develop the disease. The human papilloma virus (HPV) is another significant factor. HPV is primarily transmitted through sexual contact, including any form of oral sex, but some studies suggest other routes, including infected objects or materials, fingers and non-sexual mouth and skin contact. It is estimated that as rates of smoking and alcohol consumption drop, HPV could overtake them as the main risk factor for mouth cancer within a decade.

Poor diet, social deprivation and exposure to sun have also been identified as risk factors, and it is important to understand that mouth cancer can develop in people who have none of the associated risk factors.

Mouth cancer presents in several ways. Signs to look out for include a mouth ulcer that lasts more than three weeks, a red or white patch inside the mouth, unusual lumps, mouth pain, difficulty swallowing or speaking, hoarseness and unexplained weight loss.