This article appears in Spring Healthy Living 2018.

Historically, smokers and heavy drinkers over age 50 have been the group highest at risk of developing oral cancer, but an unusual and not widely known connection has targeted younger, healthier individuals for the disease.

Oral cancer is skyrocketing among young, healthy nonsmokers due to human papillomavirus, or HPV, which is transmitted sexually and most commonly associated with cervical cancer, said Dr. David Lam, professor and chairman of the Department of Oral and Maxillofacial Surgery at Stony Brook University School of Dental Medicine.

“Oral cancer awareness in the American public is low,” but it is not a rare disease, Lam said. Nearly 50,000 new diagnoses are made in the United States each year.

“One person dies from oral cancer every hour of every day in the United States. The death rate associated with oral cancer remains high, not because it is hard to detect or diagnose, but because it tends to be discovered late in its development,” he said.

The largest risk factor is exposure to “sexually transmitted HPV-16, which is related to the increasing incidence of oropharyngeal cancer, a type of oral cancer affecting the back of the mouth and throat. About 99 percent of people who develop an HPV oral infection will clear the virus on their own. In the remaining 1 percent, their immune system will not clear the virus and it can lay dormant for many years before potentially causing cancer,” Lam said.

Men are four times more likely than women to get HPV-related oral cancer, he added.

While it is more likely your dentist will talk to you about brushing and flossing, a big push is under way to increase awareness and screenings. For those who have never had an oral cancer screening, there is no better time to schedule one than now.

“Be sure to ask that this examination be made a routine part of all future check-ups,” Lam said.

Screenings take less than 10 minutes. During a screening, a clinician looks over the inside of the mouth to check for white patches or mouth sores, feels the tissues in your mouth to check for lumps or other abnormalities, and uses a noninvasive VELscope light to screen for suspicious lesions.

“Early detection saves lives. The majority of people are diagnosed with oral cancer at a late stage where only about 60 percent will live longer than five years. In contrast, over 80 percent will survive longer than five years if diagnosed at an early stage,” Lam said.

Cancer can affect any part of the oral cavity, including the lip, tongue, mouth and throat. Examination by health professionals can detect premalignant changes and cancer at an early stage, where treatment may be less extensive and more successful, Lam said.

Getting immunized against HPV is also advised, with routine vaccination for boys and girls recommended around age 11 or 12. Anyone younger than 26 who has not received the vaccine is also advised to get it.

“These vaccines are most effective if given to individuals before they become sexually active. If you have already been exposed to HPV, the vaccines will not work for you,” Lam said. “HPV vaccines have been well-studied for preventing cervical, vaginal, penile and anal cancers in women and men. Research has shown that the vaccine protects against the common types of HPV that cause oral infections, which means it will most likely also prevent oral cancer, but more research is needed to confirm this.”