Esophageal Cancer: Risk, Prevention & Screening

A variety of physiological, lifestyle, and environmental factors can make some individuals more likely to develop esophageal cancer than others. Although there is no sure way to prevent esophageal cancer, there are things you can do to reduce your risk.

Risk Factors

The following are the most common risk factors for esophageal cancer.

Age

Esophageal cancer is most often diagnosed in people over age 50.

Gender

Esophageal cancer is more common in men than in women, but the gender gap is narrowing.

Tobacco and Alcohol Use

Use of tobacco in any form can increase your risk of developing esophageal cancer — particularly squamous cell carcinoma. The more you smoke and the longer you smoke, the greater your risk of esophageal cancer.

The same is true of heavy use of alcohol over a long period of time. The combination of smoking with heavy alcohol use is the most significant risk factor for squamous cell carcinoma of the esophagus, greatly increasing your chances of developing the disease.

Barrett’s Esophagus

This condition, caused by long-term reflux of acid from the stomach into the esophagus, increases the risk of esophageal adenocarcinoma.

Race

Squamous cell cancer of the esophagus is more common among blacks than whites. Adenocarcinoma is more common in white men than men of other races.

Obesity

Being overweight is a risk factor for esophageal adenocarcinoma.

Ingestion of Lye

Accidental ingestion of cleaning liquids containing lye may increase a person's chances of getting squamous cell esophageal cancer, especially if the accident occurred in childhood.

Vitamin Deficiencies

Some studies have linked esophageal cancer with deficiencies in beta carotene, vitamin E, selenium, or iron.

History of Other Illnesses

A variety of other illnesses and medical conditions have been associated with an increased risk of esophageal cancer. These include:

• Cancers of the head, neck, or lungs
• Human papillomavirus (HPV) infection
• Achalasia, a condition in which the valve between the esophagus and the stomach does not open properly, leading to the collection of food at the base of the esophagus. This increases a person’s likelihood of developing squamous cell carcinoma.
• Tylosis, a very rare inherited disease that causes excess skin growth on the palms of the hands and the soles of the feet. People with this disease have a high risk of developing esophageal squamous cell cancer and should be screened regularly.
• Esophageal webs, abnormal bands of tissue that extend inward into the esophagus, making it difficult to swallow.

Preventing Esophageal Cancer

There is no sure way to prevent esophageal cancer, but doctors recommend certain behaviors and warn against others to lower risk. Most of them are also ways to preserve your overall health:

• Quit smoking. The habit is a known risk factor for esophageal cancer and other malignancies.
• Stop drinking alcohol, or try to cut back.
• Consult a doctor if you experience persistent heartburn that may be a sign of gastroesophageal reflux disease (GERD).
• Commit to a regular exercise program and avoid becoming overweight.

Screening

Screening refers to any test that is given to detect disease before it begins to cause symptoms.

Screening for esophageal cancer is not recommended for most people. However, your doctor may recommend regular endoscopic screening for adenocarcinoma if you have been diagnosed with Barrett’s esophagus or are at high risk of esophageal cancer for other reasons.

Memorial Sloan-Kettering recommends that patients with Barrett’s esophagus undergo screening for esophageal cancer every three years. Our doctors regularly perform this procedure. Learn more about endoscopic screening in our section on Diagnosis & Staging.

Because the symptoms of esophageal cancer only tend to arise when the disease is advanced, screening may enable your doctor to identify the disease earlier, when treatment can be more effective.