Oral Cancer Major Risk Factor — ORE Part 1 MCQ
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Correct answer: D — Combined tobacco use and alcohol consumption
Combined tobacco use and alcohol consumption is the best answer. Both exposures independently increase the risk of oral squamous cell carcinoma, but the risk is particularly high when they coexist; this interaction is central to UK oral-cancer prevention advice. Tobacco includes smoked and smokeless forms. Coffee, fluoride toothpaste, sugar and dairy products are not established major causal risk factors for oral squamous cell carcinoma. Sugar is relevant to dental caries risk, while fluoride toothpaste is protective against caries, not a recognised oral-cancer risk. In a risk assessment, also consider other recognised factors such as potentially malignant disorders, immunosuppression, ultraviolet exposure for lip cancer, and some HPV-associated disease; none is represented here as the principal exposure combination.
Reference: Department of Health and Social Care et al. Delivering Better Oral Health: An Evidence-Based Toolkit for Prevention, Chapter 12: Alcohol, updated 10 September 2025. https://www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-prevention/chapter-12-alcohol