by Simon Young, DDS, MD, PhD,University of Texas Health Science Center at Houston

Oral Cancer Awareness Month is observed every April, and it highlights the urgent need for early detection. According to the American Cancer Society, oral and oropharyngeal cancers still claim about one life every hour in the U.S. This year, 59,600 Americans will be diagnosed with oral or oropharyngeal cancer. Many people are unaware of symptoms because early stages often cause no pain and may be inconspicuous. Most cases are diagnosed late, when treatment is harder and survival drops.

Here is what the latest data shows and why this month matters.

Causes of oral cancer

Oral cancer develops in the cells lining the mouth when changes lead to uncontrolled growth. In many cases, this process occurs gradually, with normal tissue progressing through precancerous stages before becoming invasive cancer.

The most well-established risk factors remain tobacco use and alcohol consumption, particularly when used together. These exposures account for a large proportion of oral cavity cancers.

At the same time, the broader landscape of head and neck cancer is evolving.Human papillomavirus(HPV) has become a major cause of cancers in the back of the throat (often referred to as throat cancers), especially in the tonsils and base of tongue. However, HPV is associated with only a small proportion of cancers that arise in the oral cavity itself.

Other contributing factors may include chronic inflammation, sun exposure for lip cancers, and individual susceptibility. In some patients, oral cancer can still develop without any clearly identifiable risk factors, which underscores the importance of routine examinations and early detection.

Symptoms of oral cancer

Oral cancer can be difficult to detect early because it is often painless in its initial stages. Many patients do not notice symptoms until the disease has progressed.

Common symptoms include:

Any symptom that does not resolve within two weeks should be evaluated by a dental or medical professional.

Risk factors for oral cancer

Oral cancer risk is influenced by a combination of lifestyle, viral, and patient-specific factors.

The most significant risk factors include tobacco use in all forms and heavy alcohol consumption. HPV infection has become an increasingly important contributor, particularly in oropharyngeal cancers (those in the back of the throat as noted earlier, especially in the tonsils and base of tongue).

Additional risk factors include increasing age, male sex, and limited access to routine dental care, which can delay detection of early changes. Certain visible changes in the mouth can also signal higher risk, including persistent white patches (called leukoplakias) or red patches (called erythroplakias) on the oral tissues. These areas are sometimes referred to medically as precancerous lesions and may have a higher likelihood of developing into cancer over time.

While many patients have identifiable risk factors, it is important to recognize that oral cancer can still occur in individuals without any obvious exposures, which is why regular oral examinations remain important.

Getting an oral cancer diagnosis

Early detection plays a critical role in improving outcomes for patients with oral cancer. Diagnosis typically begins with a clinical examination, during which any suspicious lesion is identified and evaluated.

If a concerning area is found, a biopsy is performed to determine whether cancer is present. Imaging studies such as CT, MRI, or PET scans are then used to assess the extent of disease and guide treatment planning.

Key medical concepts HPV