Risk Factors for Oesophageal Cancer

Executive Summary

Risk factors influence the chance of developing cancer among individuals, but individuals with no risk factors also develop cancer. The risk factors associated with oesophageal cancer include age, race, gender, tobacco, obesity, Barrett’s oesophagus, alcohol consumption, swallowing lye, inappropriate diet and nutrition, Human papillomavirus (HPV) infection, and Achalasia. People between 45 and 70 have the highest risk of oesophageal cancer. Black people are twice as likely as white people to have the squamous cell type of oesophageal cancer. Being very overweight and having too much body fat can increase a person’s risk of developing oesophageal adenocarcinoma.

Risk Factors Associated with Oesophageal Cancer.

A risk factor can be anything that influences the development of any cancer. But having a risk factor, or many does not give certainty of having particular cancer. Some people with no risk factors can also develop cancer. 

The following factors may raise a person’s risk of developing oesophageal cancer ​1​:

  • Age: People between 45 and 70 have the highest risk of oesophagal cancer.
  • Race: Black people are twice as likely as white people to have the squamous cell type of oesophagal cancer.
  • Gender: Men are 3 to 4 times more likely than women to develop oesophagal cancer ​2​.
  • Tobacco: Using any form of tobacco, such as cigarettes, cigars, pipes, chewing tobacco, and snuff, raises the risk of oesophagal cancer, especially squamous cell carcinoma.
  • Obesity: Being very overweight and having too much body fat can increase a person’s risk of developing oesophagal adenocarcinoma.
  • Barrett’s oesophagus: This condition can develop in some people with chronic gastroesophageal reflux disease (GERD) or esophagitis inflammation of the oesophagus, even when a person does not have symptoms of chronic heartburn. Damage to the oesophagus lining causes the squamous cells in the oesophagus lining to turn into glandular tissue. People with Barrett’s oesophagus have more chances of developing adenocarcinoma of the oesophagus, but the risk of developing oesophageal cancer is still relatively low ​3​.
  • Alcohol: Heavy drinking over a long period increases the risk of squamous cell carcinoma of the oesophagus, especially when combined with tobacco use ​4​.
  • Lye: Children who have accidentally swallowed lye have a higher risk of squamous cell carcinoma. Lye can be found in a few cleaning products, like drain cleaners.
  • Diet/nutrition: A diet low in fruits and vegetables and specific vitamins and minerals can increase a person’s risk of developing oesophageal cancer.
  • Human papillomavirus (HPV): Researchers are investigating HPV as a risk factor for oesophageal cancer, but there is no clear connection that squamous cell oesophageal cancer is related to HPV ​5​. Sexual activity with someone having HPV is the most common way of transmitting HPV. There are different types of HPV strains. Research links some HPV strains more strongly with some types of cancers. HPV vaccines can help prevent people from developing specific cancers.
  • Achalasia: Achalasia is a condition when the lower muscular ring of the oesophagus does not relax during the swallowing of food. Achalasia increases the chances of squamous cell carcinoma.

References

  1. 1.
    Xie SH, Lagergren J. Risk factors for oesophageal cancer. Best Practice & Research Clinical Gastroenterology. Published online October 2018:3-8. doi:10.1016/j.bpg.2018.11.008
  2. 2.
    Islami F, Kamangar F. Helicobacter pylori and Esophageal Cancer Risk: A Meta-analysis. Cancer Prev Res. Published online October 2008:329-338. doi:10.1158/1940-6207.capr-08-0109
  3. 3.
    Anderson LA. Risk factors for Barrett’s oesophagus and oesophageal adenocarcinoma: Results from the FINBAR study. WJG. Published online 2007:1585. doi:10.3748/wjg.v13.i10.1585
  4. 4.
    Freedman ND, Abnet CC, Leitzmann MF, et al. A Prospective Study of Tobacco, Alcohol, and the Risk of Esophageal and Gastric Cancer Subtypes. American Journal of Epidemiology. Published online March 10, 2007:1424-1433. doi:10.1093/aje/kwm051
  5. 5.
    Ludmir E, Stephens S, Palta M, Willett C, Czito B. Human papillomavirus tumor infection in esophageal squamous cell carcinoma. J Gastrointest Oncol. 2015;6(3):287-295. doi:10.3978/j.issn.2078-6891.2015.001