Known and Possible Causes and Risk Factors for Esophageal Cancer

What Increases My Chance of Getting Esophageal Cancer?

Sculpture that resembles an esophagus
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What are the risk factors for esophageal cancer and what causes this disease?

Causes of Esophageal Cancer

We don't know exactly what causes esophageal cancer, but we have some ideas from looking at the risk factors for the disease (discussed below.)  A risk factor is something that increases the chance of developing a disease.

Some of the risk factors for esophageal are things that cause irritation and damage to the lining of the esophagus.

  We know that chronic inflammation of a tissue can lead to changes in the cells in tissues, which can eventually lead to cancer.

It's important to be aware of these risk factors as the incidence of esophageal cancer appears to be increasing in the United States and worldwide.

Causes May Vary with the Types of Esophageal Cancer

It's also important to note that causes may be different for the 2 major types of esophageal cancer.

  • Squamous cell esophageal cancer - In the past squamous cell cancer was the most common form of esophageal cancer by quite a long way.  This type is more commonly associated with smoking and drinking and trauma to the esophagus.
  • Adenocarcinoma of the esophagus is now the most common form of esophageal cancer.  This type of esophageal cancer is more commonly associated with acid reflux and obesity.

Risk Factors for Esophageal Cancer

Known and possible risk factors for the development of esophageal cancer include:

Age

Roughly 85% of people who develop esophageal cancer are over the age of 55.

Gender

Men are 3 to 4 times more likely to develop esophageal cancer than women.

Race

African Americans are 50% more likely to develop esophageal cancer than Caucasians.

GERD (gastroesophageal reflux disease)

Having gastroesophageal reflux disease GERD is a risk factor for esophageal cancer.

According to the American Cancer Society, 30% of esophageal cancer cases are linked to GERD.  The type of esophageal cancer associated most closely with GERD is adenocarcinoma of the esophagus.

Barrett's Esophagus

Barrett's is a condition of the esophagus in which the cells appear abnormal, and is commonly found in people who have longstanding chronic acid reflux.  People with this condition are 50 times more likely to develop esophageal cancer.  Could you have Barrett's esophagus?

Smoking

Smoking is a significant risk factor for esophageal cancer.  Cigarette and cigar smoke can damage the cells of the esophagus, causing them to change and develop precancerous changes.According to the American Cancer Society, smoking a pack a day doubles your risk factor for esophageal cancer.

Heavy Alcohol Use

Heavy alcohol abuse is also a major risk factor of esophageal cancer, yet not quite as strong as smoking.

Smoking plus Alcohol Use:

The combination of smoking and drinking is a significant risk factor for esophageal cancer and is more than additive.

  In other words, smoking plus heavy drinking accounts for more cases of esophageal cancer than would be expected from adding up the risks from smoking and drinking alone.  The type of esophageal cancer most commonly associated with smoking and drinking is squamous cell carcinoma of the esophagus.

Being Obese or Overweight

Obese men with esophageal cancer are 50% more likely to die from the disease. Being overwight or obese are major risk factors for many diseases, esophageal cancer included.

Drinking Lye

Lye is found in household drain cleaners and is a corrosive agent. Each year many children accidentally ingest these cleaners. Esophageal may occur many years after an accidental ingestion, and people who have had exposure should be monitored for the disease.

Environmental Exposures

Exposure to some chemicals, for example tetrachloroethylene used in drycleaning, may increase the risk of esophageal cancer.

Foods and Food Preparation

A lack of fruits and vegetables in your diet is associated with an increased risk of developing esophageal, and increasing intake of fruits and vegetables to at least 5 servings per day may reduce the risk.  Red and processed meats may also be a risk factor, especially when meats are cooked or grilled at high temperatures (possibly due to formation of heterocyclic amines.)  Betel nuts often consumed in Asia are considered risk factor, as is drinking very hot (temperature wise) liquids.  Check out these tips for reducing carcinogens in cooked meats.

Radiation Therapy to the Chest and Upper Abdomen

Radiation therapy to the chest for conditions such as breast cancer or Hodgkin's disease is a risk factor.  This appears to be a risk for women who have radiation after a mastectomy, but not for women who have radiation to the breast tissue alone after a lumpectomy.

Medical Conditions

Some medical conditions may increase the risk of esophageal cancer including:

  • Achalasia
  • Tylosis
  • Plummer-Vinson syndrome
  • Some gene abnormalities

Medications

The use of bisphosphonates (used for osteoporosis and bone metastases) may increase risk, as may the use of estrogen only hormone replacement therapy.

Summary

Esophageal cancer is on the rise and we don't know exactly why.  Become familiar with the symptoms of esophageal cancer, and what you can do to lower you risk factors for esophageal cancer.

Sources:

American Cancer Society. Risk factors for cancer of the esophagus. Updated 03/02/15. http://www.cancer.org/cancer/esophaguscancer/detailedguide/esophagus-cancer-what-causes

American Society of Clinical Oncology. Cancer.Net. Esophageal Cancer: Risk Factors. 10/2015. http://www.cancer.net/cancer-types/esophageal-cancer/risk-factors

Kamangar, F., Chow, W., Abnet, C., and S. Dawsey. Environmental Causes of Esophageal Cancer. Gastroenterology Clinics of North American. 2009. 38(1):27-vii.

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