Key Points for This Section

Esophageal cancer is a disease in which malignant (cancer) cells form in the tissues of the esophagus. Esophageal cancer is found more often in men. Smoking, heavy alcohol use, and Barrett esophagus can affect the risk of developing esophageal cancer.

Esophageal cancer is a disease in which malignant (cancer) cells form in the tissues of the esophagus.

The esophagus is the hollow, muscular tube that moves food and liquid from the throat to the stomach. The wall of the esophagus is made up of several layers of tissue, including mucous membrane, muscle, and connective tissue. Esophageal cancer starts in the inside lining of the esophagus and spreads outward through the other layers as it grows.

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The stomach and esophagus are part of the upper digestive system.

The two most common types of esophageal cancer are named for the type of cells that become malignant (cancerous):

• Squamous cell carcinoma: Cancer that begins in squamous cells, the thin, flat cells lining the esophagus. This cancer is most often found in the upper and middle part of the esophagus but can occur anywhere along the esophagus. This is also called epidermoid carcinoma.
• Adenocarcinoma: Cancer that begins in glandular (secretory) cells. Glandular cells in the lining of the esophagus produce and release fluids such as mucus. Adenocarcinomas usually form in the lower part of the esophagus, near the stomach.

Esophageal cancer is found more often in men.

Men are about three times more likely than women to have esophageal cancer. There are more new cases of esophageal adenocarcinoma each year and fewer new cases of squamous cell carcinoma. Squamous cell carcinoma of the esophagus is found more often in blacks than in whites. The chance of developing esophageal cancer increases with age.

Smoking, heavy alcohol use, and Barrett esophagus can affect the risk of developing esophageal cancer.

Anything that increases the chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. People who think they may be at risk should discuss this with their doctor.

Risk factors for squamous cell esophageal cancer include the following:

• Using tobacco.
• Drinking a lot of alcohol.
• Being malnourished (lacking nutrients and/or calories).
• Being infected with human papillomavirus (HPV).
• Having tylosis.
• Having achalasia.
• Having swallowed lye (a chemical found in some cleaning fluids).
• Drinking very hot liquids on a regular basis.

Risk factors for esophageal adenocarcinoma include the following:

• Having gastroesophageal reflux disease (GERD).
• Having Barrett esophagus.
• Having a history of using drugs that relax the lower esophageal sphincter (the ring of muscle that opens and closes the opening between the esophagus and the stomach).
• Being overweight.

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