Obesity has become a global health crisis, with far-reaching implications for both physical and mental well-being. While many are aware of the increased risk of heart disease, diabetes, and stroke associated with obesity, a growing body of evidence[i] suggests that it may also play a significant role in the development of a range of cancers, including oral cancer.
A significant risk to health
The growing prevalence of both obesity and cancer can be considered a significant health crisis.[ii] In England, a substantial portion of the adult population is overweight or obese, with rates reaching 64.0% and 26.2%, respectively. Obesity is linked to age, deprivation and other socio-economic factors. Gender plays a part too, with 69.2% of men being overweight or obese, compared to 58.6% of women.[iii] Obesity can be caused by lifestyle factors, but is considered a complex condition in which genetics, metabolic disorders and various medications can play a part.[iv]
Half of the global population will develop some form of cancer in their lifetime,[v] and oral cancer ranks as the sixth most common cancer,[vi] affecting 650,000 people per year. The incidence of oral cancer has risen by 49% over the past 10 years, and 10-year survival rates vary between 18% and 57% depending on the location of the cancer and the speed of diagnosis.[vii] Tobacco and alcohol use are the primary risk factors; however, recent research suggests that obesity may also play a role in increasing the risk of developing the disease.vii
Oral cancer encompasses a specific subgroup of neoplasms occurring in the mouth, including the lips, the anterior two-thirds of the tongue, the gingiva, the hard and soft palate, the oral mucosal surfaces, and the floor of the oral cavity. Among these types of oral cancers, more than 90% are classified as oral squamous cell carcinomas (OSCC).[viii]
What are the links?
The connection between obesity and oral cancer emerges from the biological effects of excess body fat. Obesity leads to chronic inflammation throughout the body, which weakens the immune system, impairing its ability to counter abnormal cell growth. Persistent inflammation can damage healthy tissues in the mouth and throat, creating favourable conditions for the development of cancer.vii
Adipose (fat) tissue also produces hormones like insulin and oestrogen in higher amounts, which can fuel the growth of cancer cells.v These hormonal imbalances are particularly concerning when coupled with other lifestyle factors linked to obesity, such as poor nutrition and low physical activity.vii
Diet plays a pivotal role in the obesity-oral cancer connection. A diet high in processed foods, sugar, and unhealthy fats can contribute not only to weight gain but also to an increased risk of oral cancer. Nutrient deficiencies, particularly in antioxidants like vitamins A, C, and E, can weaken the body’s ability to repair cellular damage.v Studies show that a diet rich in fruits, vegetables, and whole grains may help lower this risk by 40-50%.[ix]
The importance of early detection
The importance of early detection Early detection of oral cancer significantly increases the chances of survival, A timely diagnosis results in less invasive treatment, leading to a better quality of life for patients and fewer complications.viii However a general lack of awareness, and challenges in diagnosis can make timely intervention difficult.[x]
Barriers to accessing dental care, such as financial constraints, geographic location, or socioeconomic status can hinder regular check-ups and screenings. Fear of diagnosis, dental anxiety or stigma associated with tobacco, excessive alcohol-use, certain medications and poor nutrition use may also prevent individuals from discussing symptoms.[xi]
Many oral cancers do not present noticeable symptoms in their early stages, making it difficult for patients to recognise when to consult with a medical or dental professional. There is often a lack of awareness about the signs and risk factors of oral cancer among the general public, leading to delayed diagnosis. Additionally, symptoms of oral cancer may resemble those of less serious conditions, resulting in misdiagnosis or delays in seeking appropriate care. Clinicians may not always be adequately trained to recognise the early signs of oral cancer, which can lead to missed opportunities for early detection.x
The BeVigilant™ OraFusion System, from Vigilant Biosciences®, is an easy-to-use, accurate point-of-care system for frontline healthcare clinicians who assess potentially at-risk patients for oral cancer. The system is based on patented technology that detects specific biomarkers clinically shown to be associated with early-stage cancers. With a simple interface, this rapid technology works within 15 minutes to detect oral abnormalities, letting the clinician know whether to monitor or refer a patient for further specialist evaluation.
Maintaining a healthy weight through balanced nutrition and regular physical activity is essential not only for overall health but also for reducing the risk of developing oral cancer. At-risk patients should be made aware of the importance of regular dental check-ups and self-examinations. Learning the signs, and using the right tools to assist in early diagnosis can save lives.
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[i] Peng, J., Hu, Q., Chen, X. et al. Diet-induced obesity accelerates oral carcinogenesis by recruitment and functional enhancement of myeloid-derived suppressor cells. Cell Death Dis 12, 946 (2021). https://doi.org/10.1038/s41419-021-04217-2
[ii] Vucenik I, Stains JP. Obesity and cancer risk: evidence, mechanisms, and recommendations. Ann N Y Acad Sci. 2012 Oct;1271(1):37-43. doi: 10.1111/j.1749-6632.2012.06750.x. PMID: 23050962; PMCID: PMC3476838.
[iii] Obesity Profile: short statistical commentary. Office for Health Improvement and Disparities. May 2024. Available at: https://www.gov.uk/government/statistics/update-to-the-obesity-profile-on-fingertips/obesity-profile-short-statistical-commentary-may-2024 Accessed Sept 2024
[iv] https://www.nhs.uk/conditions/obesity/causes/
[v] 1 in 2 people in the UK will get cancer. Cancer Research UK. February 2015. Available at:
https://news.cancerresearchuk.org/2015/02/04/1-in-2-people-in-the-uk-will-get-cancer/ Accessed September 2024
[vi] Rodríguez-Molinero J, Migueláñez-Medrán BDC, Puente-Gutiérrez C, Delgado-Somolinos E, Martín Carreras-Presas C, Fernández-Farhall J, López-Sánchez AF. Association between Oral Cancer and Diet: An Update. Nutrients. 2021 Apr 15;13(4):1299. doi: 10.3390/nu13041299. PMID: 33920788; PMCID: PMC8071138.
[vii] Mouth Cancer Foundation. Mouth Cancer Facts and Figures. Available at: https://www.mouthcancerfoundation.org/mouth-cancer-facts-and-figures/ Accessed September 2024.
[viii] Peng, J., Hu, Q., Chen, X. et al. Diet-induced obesity accelerates oral carcinogenesis by recruitment and functional enhancement of myeloid-derived suppressor cells. Cell Death Dis 12, 946 (2021). https://doi.org/10.1038/s41419-021-04217-2
[ix] Sankaranarayanan R, Ramadas K, Amarasinghe H, et al. Oral Cancer: Prevention, Early Detection, and Treatment. In: Gelband H, Jha P, Sankaranarayanan R, et al., editors. Cancer: Disease Control Priorities, Third Edition (Volume 3). Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2015 Nov 1. Chapter 5. Available from: https://www.ncbi.nlm.nih.gov/books/NBK343649/ doi: 10.1596/978-1-4648-0349-9_ch5
[x] Saka-Herrán C, Jané-Salas E, Mari-Roig A, Estrugo-Devesa A, López-López J. Time-to-Treatment in Oral Cancer: Causes and Implications for Survival. Cancers (Basel). 2021 Mar 16;13(6):1321. doi: 10.3390/cancers13061321. PMID: 33809427; PMCID: PMC8000007.
[xi] González-Moles MÁ, Aguilar-Ruiz M, Ramos-García P. Challenges in the Early Diagnosis of Oral Cancer, Evidence Gaps and Strategies for Improvement: A Scoping Review of Systematic Reviews. Cancers (Basel). 2022 Oct 10;14(19):4967. doi: 10.3390/cancers14194967. PMID: 36230890; PMCID: PMC9562013.
