Environmental Public Health Tracking: Esophageal Cancer Data

The esophagus (the muscular tube that runs from the mouth to the stomach) is lined with cells.  Cancer can form in any of these cells.  Two types of esophageal cancer are squamous cell carcinoma (cancer that begins in flat cells lining the esophagus) and adenocarcinoma (cancer that begins in cells that make and release mucus and other fluids).

In 2014, in the United States, it was estimated that there were 18,170 new cases and 15,450 deaths from esophageal cancer.

The following risk factors may make it more likely a person will develop esophageal cancer:

• Age 65 or older. Age is the main risk factor for esophageal cancer. The chance of getting this disease goes up as you get older. In the United States, most people are 65 years of age or older when they are diagnosed with esophageal cancer.
• Being male. In the United States, men are more than three times more likely to develop esophageal cancer than women.
• Smoking. People who smoke are more likely to develop esophageal cancer.
• Heavy drinking. People who have more than 3 alcoholic drinks each day are more likely than people who don't drink 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. In other words, these two factors act together to increase the risk even more.
• Diet. Studies suggest a diet low in fruits and vegetables may increase the risk of esophageal cancer. However, results from diet studies don't always agree, and more research is needed to better understand how diet affects the risk of developing esophageal cancer.
• Obesity. Being obese increases the risk of adenocarcinoma of the esophagus.
• Acid reflux. Acid reflux is the abnormal backward flow of stomach acid into the esophagus. Reflux is very common. A symptom of reflux is heartburn, but some people don't have symptoms. The stomach acid can damage the tissue of the esophagus. After many years of reflux, this tissue damage may lead to adenocarcinoma of the esophagus in some people.
• Barrett esophagus. Acid reflux may damage the esophagus and over time cause a condition known as Barrett esophagus. The cells in the lower part of the esophagus are abnormal. Most people who have Barrett esophagus don't know it. The presence of Barrett esophagus increases the risk of adenocarcinoma of the esophagus. It is a greater risk factor than acid reflux alone.

Having a risk factor doesn't mean a person will develop cancer of the esophagus. Most people who have risk factors never develop esophageal cancer.

The following factors may decrease the risk of esophageal cancer:

• Avoiding tobacco and alcohol use. Many studies have shown that the risk of esophageal cancer is lower in people who do not use tobacco and alcohol.
• Diet. A diet high in green and yellow fruits and vegetables and cruciferous vegetables (such as cabbage, broccoli, and cauliflower) may lower the risk of squamous cell carcinoma of the esophagus.
• Nonsteroidal anti-inflammatory drugs. Some studies have shown that the use of nonsteroidal anti-inflammatory drugs (NSAIDs) may lower the risk of esophageal cancer. NSAIDS include aspirin and other drugs that reduce swelling and pain. Use of NSAIDs, however, increases the risk of heart attack, heart failure, stroke, bleeding in the stomach and intestines, and kidney damage.
• Radiofrequency ablation. Radiofrequency ablation is being studied in clinical trials for certain patients with Barrett esophagus. This procedure uses radio waves to heat and destroy abnormal cells, which may become cancer.

• National Cancer Institute – Esophageal Cancer
• American Cancer Society – Esophagus Cancer