Esophageal Cancer Risk Factors

Most individuals who develop esophageal cancer have none of the known risk factors, which are described below.

  • Tobacco use. A history of smoking cigarettes, inhaling cigar smoke or using chewing tobacco is a major risk factor for this disease.
  • Alcohol consumption. Use of alcoholic beverages is not as high a risk factor as cigarette smoking, but the combination of smoking and drinking alcohol raises the risk significantly.
  • Age. Most people who develop esophageal cancer are over the age of 60.
  • Gender. Men develop this cancer at three times the rate for women.
  • Race. African American men are twice as likely to develop esophageal cancer as are Caucasians.
  • Barrett’s esophagus. This condition develops from long-term exposure to stomach acid that occurs with gastric reflux. Individuals with Barrett’s esophagus have a 30-40 percent higher risk for developing esophageal cancer than the general population. Patients with this condition are often followed with regular exams to ensure that cancer has not developed. (see Barrett’s Esophagus and Diagnosing Esophageal Cancer)
  • Gastric reflux. Reflux is stomach acid that flushes up into the lower esophagus, causing irritation. It is also called heartburn. Reflux can cause Barrett’s Esophagus.
  • Diet. A diet high in animal fat is a risk factor for obesity. Obesity and inactivity are risk factors for several cancers, including cancers of the breast, colon, endometrium, kidney and esophagus.
  • Obesity. Overweight individuals have three times the risk of developing adenocarcinoma of the esophagus, one of two common types of esophageal cancer.
  • Exposure to chemicals. Lye, which is found in industrial and household cleaners, especially drain cleaners, is an irritant and risk factor for this disease, if ingested.
  • Previous head or neck malignancy. Patients who have had a previous head or neck cancer are at increased risk of developing a second malignancy in the head and neck region, including the esophagus.
  • Esophageal webs. The development of abnormal protrusions of tissue into the esophagus, also called esophageal webs, occurs in individuals with abnormalities of the tongue, fingernails, spleen and other organs. This condition is called Plummer-Vinson syndrome or Paterson-Kelly syndrome. One in ten individuals with the syndrome develops squamous cell cancer of the esophagus.
  • Achalasia. Six percent of patients with achalasia (a narrowing of the esophagus that occurs when the esophageal sphincter muscle fails to relax) will develop squamous cell esophageal cancer, a common type of esophageal cancer. (see What is Esophageal Cancer?)
  • Rare diseases and conditions. Persons with tylosis, a rare, inherited disease, which causes excessive growth of skin on the palms and soles of the feet, have a 40 percent risk of developing esophageal cancer.
  • Viral infection. The human papillomavirus (HPV) has been implicated in the development of esophageal cancer, primarily in China and Japan.