Oral cavity risk factors: experts' opinions and literature support

(1) To assess the knowledge of a group of experts in head and neck cancer regarding risk factors for oral cancer; (2) to describe the quality of the available literature on the topic of oral cancer risk factors; and (3) to compare expert opinion about oral cancer risk factors with the literature.

Survey of head and neck cancer experts and extensive literature review and classification of levels of evidence for published data.

Extensive data demonstrating the level of published literature support for or against many compounds and behaviours are presented. In several cases, there was good correlation between expert opinions and literature support, whereas for others, there was a clear discordance.

Experts in oral cancer are in agreement that tobacco smoking and betel use are significant risk factors for the development of oral cavity carcinoma. There is a lack of agreement about the risks of alcohol, poor-fitting dentures, maté tea, and a diet low in fruits and vegetables. Sufficient data have been published demonstrating the risk associated with each factor; however, it appears that the most current data and research are not as available to medical professionals as they should be. The perceived risks of tobacco chewing and use of khat were not substantiated by a solid foundation of data. A higher degree of concordance among experts was found for riskier health habits such as tobacco, alcohol, and betel chewing, whereas the votes were more dispersed for the risk factors that received lower ratings.