Lip Cancer: Risk Factors, Symptoms, and Prevention

Lip cancer is a malignancy of the lip vermillion border, predominantly the lower lip (90%). It is classified as a head and neck cancer (oral cavity) but shares risk factors with skin cancer.

Risk Factors

• UV radiation: Cumulative sun exposure—primary driver for lower lip (more exposed). Outdoor occupations.
• Tobacco: Smoking, smokeless (synergistic with UV).
• Alcohol: Independent and synergistic with tobacco.
• Fair skin, light eyes, inability to tan.
• Immunosuppression: Transplant, HIV.
• HPV (type 16): Increasing role in oropharyngeal; less clear for lip.
• Prior radiation, chronic irritation (pipes, ill-fitting dentures).

Symptoms

• Persistent sore, ulcer, lump, or thickening on lip (often painless initially).
• Bleeding, crusting, non-healing >2 weeks.
• Color change (red, white, speckled).
• Numbness or paresthesia (nerve involvement).
• Cervical lymphadenopathy (advanced).

Diagnosis

• Biopsy (incisional or excisional).
• Imaging (CT/MRI/PET) for staging if invasive features.

Treatment

• Surgery (Mohs micrographic for tissue preservation, wide local excision).
• Radiation (primary or adjuvant).
• Lip reconstruction (local flaps, grafts) for functional/cosmetic outcome.

Prevention

• Lip balm with SPF 30+ daily, reapply.
• Wide-brim hat, shade seeking.
• Tobacco cessation; limit alcohol.
• Regular self-exam; dental/oral cancer screening.

Lower lip cancer has excellent prognosis (5-yr survival >90%) when caught early.