Health A-Z

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Harvard Medical School

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What Is It?

Esophageal cancer is the abnormal growth of cells in the esophagus. The esophagus is the tube that carries food and liquid to your stomach.

There are two types of esophageal cancer:

  • Squamous cell carcinoma starts in the cells that line the esophagus. These cells are called squamous cells. This type of cancer can occur anywhere in the esophagus.

  • Adenocarcinoma starts in the lower portion of the esophagus, near the opening to the stomach. It begins when squamous cells are replaced by glandular cells that then begin growing abnormally.

Risk Factors

No one knows for sure what causes esophageal cancer. However, the most significant risk factors include the following:

  • Tobacco use — The longer you smoke and the more you smoke each day, the greater your risk. Patients who develop esophageal cancer may also be at risk for developing other cancers of the head and neck.

  • Alcohol consumption — Chronic or excessive consumption of alcohol, especially when combined with tobacco use, increases the risk. Consumption of hard liquor, rather than beer and wine, may increase risk even more. However, the amount consumed is the biggest factor, not the type of alcohol.

  • Gastroesophageal reflux disease (GERD) — The lining of the stomach contains glandular cells that release acids and enzymes to digest food. Sometimes, these chemicals escape from the stomach and move into the esophagus. This is called reflux or GERD. One symptom of GERD is chronic heartburn.

  • Barrett's esophagus — GERD is believed to irritate squamous cells near the stomach causing them to become glandular cells. This condition is called Barrett's esophagus. Glandular cells are more likely to become cancerous than squamous cells. Barrett's esophagus is the strongest risk factor for esophageal adenocarcinoma. (Squamous cell carcinoma was once the most common type of esophageal cancer. It has been surpassed by adenocarcinomas because of the growing number of cases of Barrett's esophagus.)

Other risk factors include the following:

  • Age — Most people who develop esophageal cancer are over 50.

  • Sex — Esophageal cancer occurs three times more often in men than women.

  • Race — Squamous cell esophageal cancer is more common among African Americans than whites. However, whites have a higher incidence of esophageal adenocarcinoma.

  • Diet — A diet low in fruits and vegetables, as well as certain minerals and vitamins, may raise the risk of esophageal cancer.

  • Chemical irritation — Damage to the esophagus (from swallowing toxic chemicals or prior radiation therapy, for example) increases esophageal cancer risk.

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From Health A-Z, Harvard Health Publications. Copyright 2007 by the President and Fellows of Harvard College. All rights reserved. Written permission is required to reproduce, in any manner, in whole or in part, the material contained herein. To make a reprint request, contact Harvard Health Publications. Used with permission of StayWell.

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