Eman Allam,Jack Windsor L*
The association between human behaviors and the development of oral cancer is well recognized. Most oral cancer cases and deaths are due to both individual predisposition linked to specific genetic characteristics and the exposure to carcinogens caused by lifestyle behaviors such as tobacco smoking, betel quid or tobacco chewing, alcohol intake, and micronutrient deficiencies. The purpose of this review was to provide insights into the social and behavioral factors associated with the development of oral cancer. These lifestyle factors and behaviors are considered the downstream determinants of oral cancer, while the upstream determinants are those which are common to all cancers such as the community level environmental factors, industrial pollution and contamination, access to the health care system, health insurance, and quality of health care, which are all dependent on the socioeconomic status of the individual. It was concluded that, since the incidence of oral cancer is greatly impacted by behaviors that can be modified, the impact that these behaviors as well as other social determinants has on oral cancer and its outcome needs to be addressed by society.