[Aetiology and risk factors for oral cancer, with special reference to tobacco and alcohol use]

Animal experiments, in vitro studies of mechanisms, biological plausibility and massive epidemiological evidence prove that tobacco-smoked and unsmoked - is the major cause of oral cancer in the world. In Hungary today tobacco is mostly smoked in cigarettes, the smoking prevalence being amongst the highest in Europe: it is no surprise that Hungary has the highest rate of oral cancer in the world today. Tobacco use, however, synergises with heavy alcohol use in a dose dependent manner, the effect being supermultiplicative: most of the rising incidence of oral cancer in Europe is probably due to rising alcohol consumption in recent decades in the presence of continuing high levels of tobacco use. Smaller roles can be ascribed to inherited predisposition, environmental agents, poor diet, infections with viruses and fungi and poor oral hygiene/oral health care. The approach to primary prevention is thus clear, and must emphasise tobacco avoidance and sensible use of alcohol, together with good nutrition and dental care.