Tongue cancer is most commonly caused by risk factors that damage cells in the tongue, leading to cancer over time. The major established contributors are tobacco use (including cigarettes, cigars, pipes, and smokeless forms) and heavy alcohol consumption, with the combination of tobacco and alcohol posing an especially high risk. Human papillomavirus (HPV) infection, particularly for cancers involving the oropharyngeal region, is also linked to tongue cancer in some cases. Other factors that may contribute include poor oral hygiene, immunosuppression, radiation exposure, certain genetic predispositions, betel quid use in some populations, and age (risk increases with age). It’s important to note that in many cases the exact cause is not clear, and cancer can develop even in people without those risk factors. If you or someone you know is concerned about tongue cancer, look for warning signs such as a persistent sore or lump on the tongue, difficulty swallowing or moving the tongue, mouth pain, numbness, or a white or red patch that won’t heal. Early detection improves outcomes, so report these symptoms to a healthcare provider promptly.