Alcohol-containing mouthwash and oropharyngeal cancer - A review of the epidemiology

Background. There has been concern that the use of alcohol-containing mouthwash may increase the risk of developing oropharyngeal cancer, or OPC. The authors examine the epidemiologic literature relating to this issue. Types of Studies Reviewed. The authors identified all nine English-language epidemiologic studies of OPC that made reference to mouthwash. The findings and major strengths and limitations of each study are described. In addition, the authors reanalyzed data from one of the studies. Results. The results of six of the studies reviewed are negative and provide no support for the hypothesis that use of alcohol-containing mouthwash increases the risk of OPC. One of three studies with positive results was a case series and induced a follow-up case-control study, the results of which were negative. The authors reanalyzed the study with the most positive finding resulted from recall bias. Clinical Implications. It is unlikely that the use of mouthwashes that contain alcohol increases the risk of developing OPC.