A risk factor is anything that changes your chance of getting a disease such as cancer. Different cancers have different risk factors. Some risk factors, like smoking, can be changed.
Others, like a person’s age or family history, can’t be changed. Scientists have found several factors that affect your risk of cancer of the esophagus. Some are more likely to increase the risk for adenocarcinoma of the esophagus and others for squamous cell carcinoma of the esophagus.
But having a risk factor, or even several, does not mean that you will get the disease. Many people with risk factors never develop esophagus cancer, while others with this disease may have few or no known risk factors.
Age:The chance of getting esophageal cancer is low at younger ages and increases with age. Less than 15% of cases are found in people younger than age 55.
Gender: Men are more than 3 times as likely as women to get esophageal cancer.
The stomach normally makes strong acid and enzymes to help digest food. In some people, acid can escape from the stomach into the lower part of the esophagus. The medical term for this is gastroesophageal reflux disease (GERD), or just reflux. In many people, reflux causes symptoms such as heartburn or pain that seem to come from the middle of the chest. In some, though, reflux doesn’t cause any symptoms at all.
People with GERD have a slightly higher risk of getting adenocarcinoma of the esophagus. This risk seems to be higher in people who have more frequent symptoms. But GERD is very common, and the vast majority of people who have it do not go on to develop esophageal cancer. GERD can also cause Barrett’s esophagus, which is linked to an even higher risk (discussed below).
Barrett’s esophagus: If reflux of stomach acid into the lower esophagus goes on for a long time, it can damage the inner lining of the esophagus. This causes the squamous cells that normally line the esophagus to be replaced with gland cells. These gland cells usually look like the cells that line the stomach and the small intestine, and are more resistant to stomach acid. This condition is known as Barrett’s (or Barrett) esophagus.
Tobacco and alcohol:The use of tobacco products, including cigarettes, cigars, pipes, and chewing tobacco, is a major risk factor for esophageal cancer. The more a person uses tobacco and the longer it is used, the higher the cancer risks. Someone who smokes a pack of cigarettes a day or more has at least twice the chance of getting adenocarcinoma of the esophagus than a nonsmoker. The link to squamous cell esophageal cancer is even stronger. The risk of esophageal cancer goes down if tobacco use stops. Drinking alcohol also increases the risk of esophageal cancer. The chance of getting esophageal cancer goes up with more consumption of alcohol. Alcohol affects the risk of the squamous cell type more than the risk of adenocarcinoma.
Obesity:People who are overweight or obese (very overweight) have a higher chance of getting adenocarcinoma of the esophagus. This is in part explained by the fact that people who are obese are more likely to have esophageal reflux.
Diet: Certain substances in the diet may increase esophageal cancer risk. For example, there have been suggestions, as yet not well proven, that a diet high in processed meat may increase the chance of developing esophageal cancer. This may help explain the high rate of this cancer in certain parts of the world.
On the other hand, a diet high in fruits and vegetables is linked to a lower risk of esophageal cancer. The exact reasons for this are not clear, but fruits and vegetables have a number of vitamins and minerals that may help prevent cancer. Drinking very hot liquids frequently may increase the risk for the squamous cell type of esophageal cancer. This might be the result of long-term damage the liquids do to the cells lining the esophagus.
Achalasia: In this condition, the muscle at the lower end of the esophagus (the lower esophageal sphincter) does not relax properly. Food and liquid that are swallowed have trouble passing into the stomach and tend to collect in the esophagus, which becomes stretched out (dilated) over time. The cells lining the esophagus can become irritated from being exposed to foods for longer than normal amounts of time.
Tylosis: This is a rare, inherited disease that causes excess growth of the top layer of skin on the palms of the hands and soles of the feet. People with this condition also develop small growths (papillomas) in the esophagus and have a very high risk of getting squamous cell cancer of the esophagus.