Esophageal Cancer: Risk Factors

There are roughly 18,000 new cases of esophageal cancer in the United States each year. Close to 15,000 people die of this disease annually.

Esophageal cancer is more common in men than women, and is associated with aging. Squamous cell esophageal carcinoma is also associated with heavy use of both alcohol and tobacco.

Other risk factors include

• Chronic acid reflux Gastroesophageal reflux (GERD) causes about one-third of all esophageal cancers. Chronic acid reflux can also lead to Barrett's esophagus, which has a high propensity for becoming cancerous.

• Diet A diet low in fruits and vegetables appears to contribute to esophageal cancer. Especially implicated are diets lacking in vitamins A, C and B-1 (riboflavin). People with low levels of the mineral selenium have a higher risk of esophageal cancer. Because high doses of selenium can be toxic, experts recommend getting selenium from foods such as fish, whole-grain bread, Brazil nuts and walnuts rather than from supplements.

• Obesity Having a body mass index greater than 25 has been linked to an increased risk of adenocarcinoma.

Esophageal cancer is also associated with certain rare medical conditions, including:

• Achalasia, a failure of the smooth muscles in the esophagus to relax
• Esophageal webs, thin tissue protrusions in the esophagus
• Plummer-Vinson or Paterson-Kelly syndrome
• Tylosis, a rare inherited disorder where excess skin develops on the soles of the feet and palms of the hands. Close to half the people with tylosis eventually develop esophageal cancer. A genetic defect appears to be responsible for both tylosis and the associated cancer.