A review of risk factors for oral cavity cancer: the importance of a standardized case definition.

The aim of this work is to review the literature on risk factors of oral cavity cancer with a special attention to the definition of the cases, in order to highlight special features of these cancers and of their subsites. PubMed database was systematically searched to access relevant articles published between 1980 and 2010. Reference lists of selected papers were examined to identify further articles. One hundred and two studies met the inclusion criteria. Their results were difficult to compare because of the lack of uniformity in defining oral cavity. In addition, few studies examined risk factors other than alcohol and tobacco, and studies differentiating between subsites were rare. Despite these limitations, some characteristics of oral cavity cancers may be emphasized: smoked tobacco seems to be a stronger risk factor for oral cavity cancer than alcohol, and the floor of the mouth seems to be more sensitive to the harmful effects of alcohol and smoked tobacco. Studies limited strictly to oral cavity cancers and distinguishing between subsites are needed to better understand the aetiology of these cancers, and better define risk groups to target prevention efforts and screening.