The most important risk factor for developing head and neck cancer is tobacco use (Jethwa & Khariwala 2017). Combined tobacco and alcohol use has a synergistic effect on the risk of developing head and neck cancer, with people who frequently smoke and consume alcohol being at the highest risk (Hashibe et al. 2009).

Risk factors for developing head and neck cancer include:

• smoking, chewing tobacco or chewing betel quid
• alcohol consumption
• HPV exposure (Kobayashi et al. 2018)
• UV skin exposure (for skin cancer)
• pre-existing oral lesions
• poor oral hygiene
• age (over 40 years)
• sex (male)
• Epstein-Barr virus infection in genetically predisposed individuals (for nasopharyngeal cancer)
• immunosuppression
• ionising radiation exposure
• inherited conditions including Fanconi’s anaemia, ataxia-telangiectasia syndrome, Bloom’s syndrome and Li-Fraumeni cancer syndrome
• poor nutrition.

People with lower income and other disadvantaged groups are at greater risk of head and neck cancer. This includes Aboriginal and Torres Strait Islander people, who are more likely to develop head and neck cancer, including oral cancer, than non-Aboriginal people.