Oral cancer is widely associated with smoking, but a senior oncologist is warning that non-smokers are far from immune — and that a dangerous misconception is causing many people to overlook early warning signs until it is too late.

Dr Ankur Nandan Varshney, Senior Consultant Medical Oncologist at Medanta Hospital, Noida, shared his concerns with HT Lifestyle, highlighting the range of risk factors beyond cigarettes that can lead to the disease. "Many patients come with the belief that if they have never smoked, they cannot develop oral cancer. This misconception can sometimes delay diagnosis because people do not recognise their symptoms as potential warning signs," he said.

Tobacco in any form carries risk

While smoking significantly raises the risk of oral cancer, Dr Varshney stressed it is not the only cause. "People who do not smoke can still develop oral cancer due to multiple factors. In India, habits such as chewing tobacco, gutka, and other smokeless tobacco products remain major concerns. Additionally, prolonged exposure to certain irritants, alcohol use, poor nutrition, and infections like human papillomavirus (HPV) can also play a role in increasing risk," he explained.

The misconception that chewing tobacco or using gutka is less harmful than smoking is, in Dr Varshney's view, particularly dangerous. Smokeless tobacco exposes mouth tissues directly to cancer-causing substances and is strongly linked to oral cancers.

"People often focus only on cigarettes, but tobacco in any form can damage cells in the mouth. Avoiding all forms of tobacco is one of the most important steps towards prevention," he said.

Six warning signs to never ignore

Dr Varshney outlined six signs that should prompt immediate attention rather than being dismissed or self-treated.

1. Tobacco in any form

Many people consider smokeless tobacco products such as gutka and chewing tobacco to be a safer alternative to cigarettes — but Dr Varshney cautioned this is a dangerous misconception. These products expose the lining of the mouth directly to cancer-causing substances and are strongly associated with oral cancer development.

2. Persistent mouth ulcers

A mouth ulcer that does not heal within a few weeks — particularly one that recurs or is accompanied by pain, bleeding, or changes in appearance — should not be attributed to stress or spicy food without medical evaluation. While most ulcers are harmless, those that linger require a proper assessment to rule out serious underlying causes.

3. White or red patches in the mouth

Unusual patches, areas of thickened tissue, or changes in the colour of the oral lining can be early indicators of cellular changes. "Unusual patches, thickened areas, or changes in the colour of the oral lining may sometimes indicate early changes in the tissues. Regular self-awareness and dental check-ups can help identify suspicious changes before they progress," Dr Varshney said.

4. Voice changes, difficulty swallowing or jaw problems

Persistent difficulty swallowing, ongoing throat discomfort, unexplained changes in voice, numbness in the mouth, or restricted movement of the jaw are all symptoms that warrant professional evaluation. "These symptoms may occur due to several reasons, but persistent problems should not be self-treated for months without finding the cause," the oncologist noted.

5. HPV infection

The human papillomavirus (HPV) is increasingly being recognised as a contributing factor in oral and throat cancers, not just cervical cancer. Certain high-risk strains of the virus have been directly linked to mouth and throat cancers. Dr Varshney emphasised that awareness about HPV, timely vaccination, safe practices, and regular check-ups can play a meaningful role in reducing this specific risk.

6. Unhealthy lifestyle habits

Poor oral hygiene, excessive alcohol consumption, an unbalanced diet, and unaddressed long-term dental problems all contribute to oral cancer risk in ways many people do not realise. "Maintaining good oral hygiene, limiting alcohol consumption, eating a balanced diet, staying physically active, and addressing long-standing dental issues are important preventive measures. People should also avoid ignoring symptoms simply because they feel healthy or do not have traditional risk factors," Dr Varshney advised.

Why early detection matters

One of the greatest challenges with oral cancer is that many cases are not identified until symptoms become severe, even when earlier warning signs may have been present for months. Dr Varshney urged people not to allow the belief that "it cannot happen to me because I never smoked" to prevent them from seeking timely care.

"Early detection remains one of the strongest tools in cancer care. Any unusual change in the mouth that persists should be checked by a healthcare professional rather than being ignored," he concluded.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.