Risk Factors for Oral Tongue Cancer

Tongue squamous cell carcinoma (TSCC) is an aggressive subtype of oral squamous cell carcinoma characterized by early invasion and frequent cervical lymph node metastasis. This study reviews established and potential risk factors for TSCC, including tobacco smoking, alcohol consumption, chronic local trauma, human papillomavirus (HPV) infection, and genetic susceptibility. Tobacco and alcohol show strong dose?response relationships and synergistic effects and remain the most important preventable risk factors. Chronic mucosal trauma, particularly at the lateral border of the tongue, may contribute to carcinogenesis in patients without classical behavioral risk factors, although current evidence is inconsistent. Despite the established etiological role of HPV in oropharyngeal carcinoma, its prevalence and oncogenic activity in TSCC are low, and its causal contribution remains controversial. In contrast, genetic susceptibility and dysregulation of key molecular pathways appear to be more relevant in younger patients and in tumors arising without traditional risk exposures. TSCC therefore represents a multifactorial disease requiring integrated consideration of environmental, local, viral, and genetic factors to improve prevention, risk stratification, and early detection strategies.