Causes of Head and Neck Cancer

By: Dr. Stefanie Horne, MD

Southwest Ohio ENT Specialists


Head and neck cancer (often referred to generally as “throat cancer”) is most commonly Squamous Cell Carcinoma. This type of cancer is most often caused by smoking and/or Human Papilloma Virus (HPV) infection. It affects the lining of the mouth or throat. 


There are other types of head and neck cancers. Some arise from the skin (skin cancers) or the salivary glands. Those types of cancers share similar workup and treatment as squamous cell carcinoma. Your ENT physician is a specialist in head and neck cancer and will review the specifics of your cancer diagnosis. 



Just as it affects the lungs, smoking affects the lining of the upper airway. The tobacco exposure causes damage to the cells that line the surface of the mouth and throat.  This damage occurs every time there is an exposure to tobacco. The longer a patient smokes and the more a patient smokes, the higher the risk is to develop squamous cell carcinoma.  If the cell damage from tobacco exposure is not repaired by the body, changes in the tissue begin as dysplasia (surface tissue changes) and then progress to cancer over time.  Alcohol abuse while smoking is higher risk than smoking alone for the development of head and neck cancer. 


Human Papilloma Virus (HPV infection): 

HPV is a sexually transmitted virus that is very common. Condoms do not fully protect from HPV infection, so the prevalence of HPV is much higher than other sexually transmitted diseases. There are several different “strains” of the virus, some of which can be cancer causing if the virus is not cleared after the infection. When the virus is not cleared by the immune system, it remains in the tissues and causes cell damage. These changes begin as surface changes (dysplasia) and then progress to cancer over many years. It can take up to 20 years to develop head and neck cancer from an HPV exposure, therefore most head and neck cancers are diagnosed in middle aged or older adults. Head and neck cancers caused by HPV infection alone have a lower stage and better prognosis than smoking related cancers.  


HPV infection with high risk “strains” of the virus can be avoided with the Gardasil Vaccination. This vaccination is very effective at preventing infection from the HPV virus ( This is now recommended for all children starting at age 9 and can be given up to age 45.  It protects against HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58. These are the HPV types that cause head and neck cancers, cervical cancers and genital warts. 


Other less common causes of squamous cell carcinoma include marijuana abuse, alcohol abuse, genetic causes and chronic trauma to an area of the mouth or throat.

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