What Causes Esophageal Cancer?

This content has been reviewed and approved by

Chandra P. Belani, MD
Deputy Director, Penn State Cancer Institute
Miriam Beckner Professor of Medicine
Penn State University School of Medicine

No one knows exactly what causes esophageal cancer.

Researchers know that esophageal cancer is:

• Three times more common among men than among women.
• Three times more common among African Americans than among Caucasians.
• Ten to 100 times more common in countries such as Iran, northern China, India, and southern Africa than in the United States.

There are some risk factors that may increase your chances of developing esophageal cancer. But these risk factors do not necessarily cause the disease. Some people with one or more risk factors never develop the disease while others develop disease and have no known risk factors. Knowing your risk factors for any disease, however, can help to guide you into the appropriate actions, including changing behaviors and making sure your doctor monitors you for the disease.

The following factors can put an individual at greater risk for developing esophageal cancer:

• Age - The risk increases with age. Those over the age of 60 are at greatest risk.
• Gender - Men have a three times greater risk of developing esophageal cancer than women.
• Tobacco use - Using any form of tobacco raises the risk of esophageal cancer.
• Alcohol use - In Western nations, most esophageal squamous cell cancer results from chronic alcohol abuse.
• Barrett's esophagus - Long-term irritation from heartburn changes the cells at the end of the esophagus.
• Diet - Diets low in fruits and vegetables and certain vitamins and minerals can increase risk for this disease.
• Other irritants - Swallowing caustic irritants such as lye and other substances can burn and destroy cells in the esophagus. Miners, people working in pressurized spaces used in building tunnels, and construction workers, especially those handling brick, concrete, or tile are most likely to be exposed to high levels of silica dust.
• Medical history - Certain diseases, such as achalasia, a disease in which the bottom of the esophagus does not open to release food into the stomach, and tylosis, a rare, inherited disease, increase the risk of esophageal cancer. In addition, anyone who has had other head and neck cancers has an increased chance of developing a second cancer, including esophageal cancer, in this area.
• Obesity - Weighing 20 to 30 pounds more than your ideal weight is linked to an increased risk of adenocarcinoma.