Head and neck cancer cases are rising: The early signs you should never ignore

Doctors are warning that head and neck cancers are increasingly being diagnosed in younger adults, including non-smokers. The growing role of HPV has made vaccination, early symptom recognition and timely care more urgent.

In Short

• Tobacco, alcohol and betel nut still account for many Indian cases
• HPV-16 can stay silent for years before triggering throat cell changes
• Boys and girls are advised routine vaccination between nine and 12

For decades, head and neck cancer was considered a disease that mainly affected older people with a long history of smoking, chewing tobacco, or drinking alcohol. Today, that picture is changing rapidly. Across India and around the world, doctors are seeing an increasing number of younger patients, including many who have never smoked or used tobacco, being diagnosed with cancers of the mouth, throat, tonsils, and tongue.

This shift has raised new concerns among cancer specialists, especially as many cases are linked to infection with the Human Papillomavirus (HPV), a common virus that is already known to cause cervical cancer. Experts now say HPV is also driving a growing number of cancers in the throat and other parts of the head and neck, making vaccination and early awareness more important than ever.

On World Head and Neck Cancer Day, oncologists are urging people to understand that preventing these cancers is no longer just about avoiding tobacco. Vaccination against HPV, recognising early warning signs, and seeking timely medical care could help detect cancer earlier and improve survival.

WHY ARE HEAD AND NECK CANCER CASES INCREASING?

Tobacco use remains one of the biggest causes of head and neck cancer in India. Smoking, chewing tobacco, heavy alcohol consumption, and betel nut (areca nut) use continue to account for a large number of cases.

However, doctors say another major factor is changing the disease pattern: HPV infection.

HPV is a sexually transmitted virus. Certain high-risk types, particularly HPV-16, can remain in the body for years without causing symptoms. Over time, the virus can trigger abnormal cell changes in the throat, tonsils, and the base of the tongue, eventually leading to cancer. Because of this, many patients who develop HPV-related head and neck cancer have no history of smoking or tobacco use.

WHY HPV VACCINATION MATTERS

Many people associate the HPV vaccine only with preventing cervical cancer in girls and women. However, doctors now stress that vaccination is equally important for boys.

By preventing infection with high-risk HPV strains, the vaccine can reduce the future risk of HPV-related head and neck cancers. Since there is currently no routine screening test to detect HPV infection in the throat before cancer develops, vaccination remains the most effective preventive strategy.

Experts recommend:

• Routine vaccination between 9 and 12 years of age
• Catch-up vaccination up to 26 years for those who missed earlier doses
• Adults aged 27 to 45 years may benefit after discussing their individual risk with their doctor

WHO SHOULD BE SCREENED?

Unlike cervical cancer, there is currently no population-wide screening programme for head and neck cancer.

Instead, doctors recommend regular oral examinations for people at higher risk, including:

• Tobacco users
• Heavy alcohol consumers
• Betel nut or areca nut chewers
• People with previous head and neck cancers
• Individuals with pre-cancerous oral conditions such as leukoplakia or oral submucous fibrosis

Dentists and doctors can examine the mouth and neck during routine check-ups and recommend a biopsy if any suspicious lesion does not heal within two weeks.

WARNING SIGNS THAT SHOULD NEVER BE IGNORED

One of the biggest challenges is that early head and neck cancers often cause only mild symptoms.

Doctors advise seeking medical attention if any of these symptoms last for more than two weeks:

• A mouth ulcer that does not heal
• White or red patches inside the mouth
• A painless lump in the neck
• Persistent hoarseness or voice changes
• Difficulty or pain while swallowing
• Ongoing sore throat
• Unexplained weight loss
• Ear pain on one side without another obvious cause

Early diagnosis can significantly improve treatment outcomes and may reduce the need for extensive surgery, chemotherapy, or complex reconstruction.

OTHER STEPS TO REDUCE RISK

Doctors say vaccination should be part of a broader prevention strategy. People can also lower their risk by:

• Avoiding both smoked and smokeless tobacco
• Limiting alcohol consumption
• Maintaining good oral hygiene
• Practising safe sex to reduce HPV transmission
• Going for regular dental and oral health check-ups, especially if they are at higher risk

AIR POLLUTION MAY ALSO PLAY A ROLE

While tobacco and HPV remain the major risk factors, specialists are also studying the impact of environmental factors. Some experts believe long-term exposure to poor air quality may contribute to the risk of lung and head and neck cancers, even among people who have never smoked. More research is underway, but doctors say reducing exposure to pollution is another important public health goal.

Head and neck cancer is no longer a disease seen only in older tobacco users. The growing role of HPV means younger adults are increasingly being affected, making prevention strategies more important than ever.

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