- Tobacco and alcohol are the most significant etiological factors and most likely have synergistic effect (2).
- Human papilloma virus (HPV) is associated with oropharyngeal cancer, but is very seldom implicated in cancer of the oral cavity (8).
- Poor oral hygiene and dental status (8)
Chewing leaves from the betel plant is widely practiced in India and parts of Pakistan for its stimulating effect. The combination of chewing betel and tobacco has a potent carcinogenic effect and is the cause for the significant amount of oral cancer cases in parts of Asia.
Use of snuff as a risk factor has not been adequately documented (8).
There is no well-defined hereditary risk for squamous epithelial carcinomas (9).