Esophageal cancer symptoms, risk factors, and FAQs
See your UCHealth providers if you have any of these symptoms:
- Trouble swallowing
- Chest pain
- Weight loss
- Chronic cough
- Bone pain (if cancer has spread to the bone)
- Bleeding into the esophagus. This blood then passes through the digestive tract, which may turn the stool black. Over time, this blood loss can lead to anemia (low red blood cell levels), which can make a person feel tired.
Source: American Cancer Society
Although there are many different risk factors for esophageal cancer, what defines a risk factor is pretty simple: whatever increases the chances of getting the disease.
However, it’s important to note that not all risk factors are the same for all diseases, not everyone who has risk factors get esophageal cancer, and not everyone who gets the disease will have any risk factors. Some risk factors, including lifestyle choices like smoking and alcohol use, can be controlled while others like age and family history cannot.
Below are several known factors that can increase your risk of getting adenocarcinoma or squamous cell carcinoma of the esophagus.
Statistically speaking, the older a person is, the higher the chance of getting esophageal cancer. More than 85% of cases are found in people older than age 55.
Men are more likely than women to get esophageal cancer.
Tobacco and alcohol use
Tobacco products are a major risk factor for esophageal cancer. The frequency of tobacco usage is directly proportional to the amount of cancer risk.
Compared to a non-smoker, smoking at least a pack of cigarettes a day more than doubles a smoker’s chance of getting adenocarcinoma, even if the usage stops. The chance of getting squamous cell esophageal cancer is even higher, but quitting does decrease the risk.
Alcohol consumption also increases the risk of esophageal cancer. And, as with smoking, the higher the usage, the higher the risk. Drinking alcohol tends to increase the risk of getting squamous cell carcinoma more than adenocarcinoma.
Combining both smoking and drinking alcohol increases the chances of getting squamous cell carcinoma much more than using either by itself.
Gastroesophageal reflux disease (GERD)
When stomach acid escapes into the lower part of the esophagus it results in gastroesophageal reflux disease (GERD). For most people, reflux causes a feeling of heartburn or pain in their chest. GERD results in a slightly higher risk of getting adenocarcinoma and seems to be higher in people with more frequent symptoms. However, most of the people who have GERD don’t end up getting esophageal cancer. GERD can also cause Barrett’s esophagus which is linked to an even higher risk.
If someone suffers from reflux for a long time, the inner lining of their esophagus becomes damaged and their normal squamous cells become gland cells. This is known as Barrett’s (or Barrett) esophagus.
Being overweight or obese results in a higher likelihood of getting adenocarcinoma of the esophagus.
Certain foods, like processed meat, may increase the chance of developing esophageal cancer, but eating lots of fruits and vegetables seems to lower that same risk. Frequently drinking very hot liquids may also increase the risk for squamous cell carcinoma.
Staying physically active may lower the risk of esophagus cancer.
Achalasia results when the muscle between the lower esophagus and the stomach fails to properly relax, allowing food to stay in that area longer than usual. Over time, the lower esophagus stretches out and the lining of the esophagus becomes irritated.
Achalasia elevates the risk of esophageal cancer many times above normal. It typically takes about 15 to 20 years for cancer to appear after the onset of achalasia.
Tylosis causes thickening of the skin on the palms of the hands and soles of the feet along with small growths called papillomas in the esophagus. People with this inherited disease are at a very high risk of getting squamous cell carcinoma.
This rare syndrome causes webs to form in the upper part of the esophagus.
History of certain other cancers
People with a history of other cancers associated with smoking, such as lung cancer, mouth cancer, and throat cancer, face a higher risk of getting squamous cell carcinoma of the esophagus as well.