Risk Factors

What increases your risk for esophageal cancer? Dr. Hochwald explains.

Some people are more likely to develop esophageal cancer than others, especially those with the following risk factors:

  • Age over 65: The risk for esophageal cancer increases with age. Most people with esophageal cancer in the U.S. are over age 65.
  • Being male: Men are more than three times as likely as women to develop esophageal cancer.
  • Smoking: Smokers are twice as likely as non-smokers to develop cancer of the esophagus. Heavy smokers are most at risk.
  • Heavy drinking: People who consume more than three alcoholic drinks a day are more likely to develop squamous cell carcinoma of the esophagus. Heavy drinkers who smoke are at a much higher risk than heavy drinkers who don't smoke.
  • Poor diet: Low intake of fruits and vegetables may increase the risk of esophageal cancer.
  • Obesity: People who are overweight have an increased risk of adenocarcinoma of the esophagus.
  • Acid reflux: Acid reflux, the abnormal backward flow of stomach acid into the esophagus, is very common. Heartburn is a symptom of reflux, but some people don't have symptoms. Stomach acid can damage the tissue of the esophagus. After many years, this tissue damage may lead to adenocarcinoma of the esophagus.
  • Barrett’s esophagus: Acid reflux may damage the esophagus and, over time, cause a condition in the lower esophagus known as Barrett's esophagus. Most people who have it, don't know it. The abnormal cells of Barrett's esophagus increase the risk of adenocarcinoma. It's a greater risk factor for esophageal cancer than acid reflux alone.

Researchers continue to study these and other possible risk factors, such as smokeless tobacco. Having a risk factor doesn't mean that a person will develop cancer of the esophagus. In fact, most people with risk factors never develop esophageal cancer.

While you cannot change your sex or age, you can take steps to reduce or eliminate other risk factors:

  • Avoid tobacco: If you smoke, quit now. Smoking has been linked to as many as one in five cases of esophageal cancer. Find the support and guidance you need by calling the New York State Smokers’ Quitline at Roswell Park, at 1-866-NY-QUITS (1-866-697-8487).
  • Limit alcohol intake
  • Eat a high-fiber diet and reduce fats and red meat
  • Maintain a healthy weight
  • Exercise regularly

Barrett’s Esophagus

Barrett's esophagus is a precursor for esophageal cancer. Dr. Nwogu explains the advanced techniques used to diagnose and treat this condition.

This condition typically occurs in people who suffer chronic gastroesophageal reflux disease (GERD). Over time, the tissue lining of the esophagus is replaced by tissue similar to intestinal lining. Determining which people with the condition are most likely to develop cancer — and should seek treatment — isn’t always clear. Anyone with Barrett’s esophagus should have a periodic upper GI endoscopy with a biopsy. A pathologist will examine the tissue sample to assess how abnormal the cells look, a condition known as dysplasia. The abnormal cells may be called high-grade (more likely to cause cancer) or low-grade (less likely to cause cancer. Having Barrett’s esophagus with high-grade dysplasia is a pre-cancerous condition and most people should be treated in a timely manner.