Virginia Commonwealth University

VCU Massey Cancer Center

Causes, risk factors and prevention

What causes esophageal cancer?

No one knows exactly what causes esophageal cancer. At the top of the esophagus is a muscle, called the sphincter, that releases to let food or liquid go through. The lower part of the esophagus is connected to the stomach. Another muscle is located at this connection that opens to allow the food to enter the stomach. This muscle also works to keep food and juices from the stomach from backing into the esophagus. When these juices do back up, reflux, commonly known as heartburn, occurs.

Long-term reflux can change the cells in the lower end of the esophagus. This condition is known as Barrett’s esophagus. If these cells are not treated, they are at much higher risk of developing into cancer cells.

 

What are the risk factors for esophageal cancer?

The following factors can put an individual at greater risk for developing esophageal cancer:

  • Age – the risk increases with age, with persons over the age of 60 being at greatest risk for developing esophageal cancer.
  • Gender – men have a three times greater risk of developing esophageal cancer than women.
  • Tobacco use – using any form of tobacco raises the risk of esophageal cancer. The longer tobacco is used, the greater the risk, with the greatest risk among people who have indulged in long-term drinking with tobacco use. Scientists believe that these substances increase each other’s harmful effects, making people who do both especially susceptible to developing the disease.
  • Alcohol use – chronic and/or long-term heavy drinking is another major risk factor for esophageal cancer.
  • Barrett’s esophagus – long-term irritation from reflux, commonly known as heartburn, changes the cells at the end of the esophagus. This condition is precancerous condition and raises the risk of developing adenocarcinoma of the esophagus.
  • Diet – diets low in fruits and vegetables and certain vitamins and minerals can increase risk for this disease.
  • Other irritants – swallowing caustic irritants such as lye and other substances can burn and destroy cells in the esophagus. The scarring and damage done to the esophagus can put a person at greater risk for developing cancer.
  • Medical history – certain diseases, such as achalasia, a disease in which the bottom of the esophagus does not open to release food into the stomach, and tylosis, a rare, inherited disease, increase the risk of esophageal cancer. In addition, anyone who has had other head and neck cancers has an increased chance of developing a second cancer in this area, which includes esophageal cancer.