Table of ContentsView AllTable of ContentsGeneticsSquamous Cell CarcinomaAdenocarcinomaFrequently Asked QuestionsNext in Esophageal Cancer GuideWhat Is Esophageal Cancer?
Table of ContentsView All
View All
Table of Contents
Genetics
Squamous Cell Carcinoma
Adenocarcinoma
Frequently Asked Questions
Next in Esophageal Cancer Guide
The exact cause ofesophageal canceris unknown, but genetics appears to play a role. Several risk factors for the disease have also been identified.
These vary depending on the type of cancer, with acid reflux (GERD), Barrett’s esophagus, and obesity linked with adenocarcinoma, and the combination of smoking and excess alcohol intake associated with the majority of squamous cell carcinomas.
There are also tremendous geographical variations in the incidence of these cancers, and different risk factors appear to be more important in different regions of the world.
Since the disease is often diagnosed in the later stages when it is more difficult to treat, having an awareness of the risk factors, as well as being familiar with thesymptoms of esophageal cancer,is important to detect the disease as early as possible.
For reasons unknown, the incidence of adenocarcinoma of the esophagus has recently shown a dramatic increasein developed countries.
Verywell
Understanding Risk
A risk factor for a disease refers to something that is associated with an increased chance of developing the disease but doesn’t mean that itcausesthe disease. Esophageal cancer begins when DNA damage (gene mutations) occur in normal esophageal cells so that the cells grow in an out of control fashion.
Having a risk factor does not mean that you will develop esophageal cancer, and people without any risk factors can and do develop the disease at times.
Some of the risk factors for esophageal cancer are things that cause irritation and damage to the lining of the esophagus,and we are learning that chronic inflammation can lead to changes in tissue that eventually lead to cancer. Some risk factors, such as tobacco, containcarcinogens(cancer-causing substances) that can directly damage DNA.
Squamous cell cancers begin in the surface cells (squamous cells) that line theesophagus.These cancers are more common in the upper part of the esophagus and are the most common type worldwide.
There are several risk factors for this type of esophageal cancer.
Age
Most squamous cell carcinomas occur in people between ages 45 and 70, and these cancers are uncommon in young people.
Sex
While cancer of the esophagus is more common in people assigned male at birth than in people assigned female at birth overall, the reverse is true for squamous cell carcinoma in the United States.
Race
In the United States, squamous cell carcinomas are much more common in Black people than in white,while the opposite is true for adenocarcinomas.
Geography
The incidence of both types of esophageal cancer varies significantly around the world. The highest incidence of squamous cell carcinoma of the esophagus is in what’s been coined the “Asian Esophageal Cancer Belt.“This region includes areas such as Turkey, Iran, Kazakhstan, and central and northern China. The incidence is also very high in southeastern Africa.
Smoking
Squamous cell carcinomas of the esophagus are roughly five times more common in people who smoke.Smoking is not, however, a risk factor for esophageal cancer in all parts of the world. For example, in China, it appears that smoking plays only a small role; dietary factors appear more important.
Heavy Alcohol Use
Like smoking, alcohol intake is a significant risk factor for squamous cell carcinoma of the esophagus in some parts of the world but not others.
Heavy alcohol intake is associated with a 1.8- to 7.4-fold increase in risk.
Low to moderate alcohol intake, according to a 2018 study,is actually associated with a lower risk of developing the disease than for those who abstain.
Smoking Plus Heavy Alcohol Use
The combination of smoking and drinking is the most significant risk factor for squamous cell carcinoma and is thought to account for around 90 percent of cases worldwide. The risk is higher than would be expected if you were to add up the risk of smoking plus heavy drinking alone (instead of being additive, the risk is multiplied).
Environmental Exposures
Exposure to some chemicals—tetrachloroethyleneused in dry cleaning, for example—may increase the risk of esophageal cancer.
Drinking Lye (Drain Cleaner)
Lye is found in household drain cleaners and is a corrosive agent. Each year many children accidentally ingest these products. Esophageal cancer may occur many years after an accidental ingestion.
Achalasia
Achalasiais a condition in which the muscular band around the lower part of the esophagus (the lower esophageal sphincter) doesn’t relax properly to allow food to leave the esophagus and enter the stomach. This results in food remaining in and stretching the lower esophagus.
Achalasia is associated with a high risk of esophageal cancer, with cancer often occurring 15 to 20 years after thediagnosis.
Radiation Therapy to the Chest and Upper Abdomen
Radiation therapy to the chest for conditions such as breast cancer or Hodgkin’s disease may increase risk.While people who have had radiation after a mastectomy have an elevated risk, this does not appear to be the case for those who have radiation to remaining chest or breast tissue after a lumpectomy.
History of Head and Neck or Lung Cancer
A personal history of cancer is associated with a higher risk of esophageal cancer, particularly squamous cell carcinomas of the head, neck, and lungs.
Drinking Hot Beverages
Drinking very hot beverages (much warmer than a typical cup of coffee) has long been thought to carry an increased risk. A 2018 study supported this belief, though drinking tea at high temperatures was a risk only when combined with excessive alcohol intake or smoking.
Diet
Diet—especially a diet low in fruits and vegetables, and high in red and/or processed meat—is associated with a higher risk of both types of esophageal cancer, but the link is stronger with squamous cell carcinoma. With meats, the method of cooking also appears to be important, and cooking or grilling at high temperatures is associated with greater risk. Betel and areca nuts have also been associated with the development of esophageal cancer.
In China, foods high in nitrates may double the risk.The risk is also higher for those who have vitamin and mineral deficiencies (especially folate, vitamin C, and molybdenum) in developing countries.
Human Papillomavirus Infection (HPV)
Human papillomavirus(HPV), the virus that causes cervical as well as some other cancers, may possibly be related to the development of squamous cell carcinoma.While researchers are uncertain if the virus is causative, it has been found in up to a third of esophageal cancers in Asia and parts of Africa. Thus far, HPV does not appear to be linked with esophageal cancer in the United States.
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Adenocarcinomas occur most often in the lower third of the esophagus and begin in glandular cells.Ordinarily, the lower third of the esophagus is lined with squamous cells, but chronic damage (such as chronic acid reflux) results in the transformation of these cells so that they appear more like the cells that line the stomach and intestines. Over time, these cells may becomeprecancerous cellsand then cancer cells. Adenocarcinomas have now surpassed squamous cell carcinomas in the United States, the United Kingdom, Australia, and Western Europe.
Like squamous cell cancers, adenocarcinomas are most common in people between ages 50 and 70.
In the United States, adenocarcinomas are eight times more common in people assigned male at birth than in people assigned female at birth.
The incidence of adenocarcinoma of the esophagus is highest in Western Europe, North America (particularly the United States), and Australia.
Gastroesophageal Reflux Disease (GERD)
Acid reflux, or gastroesophageal reflux disease (GERD), is a significant risk factor for esophageal adenocarcinoma, with roughly 30 percent of these cancers thought to be linked to the condition. It’s thought that between 0.5% and 1% of people with GERD will develop esophageal cancer.
Barrett’s Esophagus
Barrett’s esophagusis a condition in which the normal cells of the lower esophagus (squamous cells) are replaced with glandular cells like those present in the stomach and intestines. It is usually found in people who have longstanding chronic acid reflux and occurs in 6 percent to 14 percent of people with chronic GERD.
Though estimates vary, roughly 1 in 100 to 1 in 200 people with Barrett’s esophagus will develop esophageal cancer each year.
Like adenocarcinoma, Barrett’s esophagus is increasing in the United States.
Some studies (but not all)have shown a reduction in the risk of esophageal adenocarcinoma in people who have Barrett’s esophagus who have taken non-steroidal anti-inflammatory drugs (such as Advil, ibuprofen,proton pump inhibitors(such as Prilosec, omeprazole), orstatin drugs(such as Lipitor, atorvastatin).
Hiatal Hernia
Overweight
Having overweight increases the risk of adenocarcinoma of the esophagus.According to a2015 review, people with abody mass index(BMI) of 25 to 29 are about 50% more likely to develop cancer, while those living with obesity (BMI of 30 or higher) are roughly twice as likely to develop esophageal cancer.
BMIis a dated, flawed measure. It does not take into account factors such as body composition, ethnicity, sex, race, and age.Even though it is a biased measure, BMI is still widely used in the medical community because it’s an inexpensive and quick way to analyze a person’s potential health status and outcomes.
Having type 2 diabetes may also increase risk, but it’s uncertain whether this is related to diabetes itself or co-occurring obesity.
Smoking is linked to the development of adenocarcinoma of the esophagus, but less so than squamous cell cancers.
Medications
Some medications are associated with either an increased or decreased risk of adenocarcinoma of the esophagus. The use of bisphosphonates (used for osteoporosis) may increase risk,as may the use of estrogen-only hormone replacement therapy. In contrast, the use of aspirin is associated with a decreased risk.
The best thing you can do to lower your risk of esophageal cancer is avoid tobacco and alcohol. Other lifestyle choices that help prevent esophageal cancer include following a healthy diet and exercise regimen to maintain a healthy body weight and getting treated for acid reflux and Barrett’s esophagus.
The most common symptoms people experience with esophageal cancer are difficulty swallowing, chest pain, unexpected weight loss, chronic cough, hoarseness, vomiting, and bleeding into the esophagus.
38 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Domper Arnal MJ, Ferrández Arenas Á, Lanas Arbeloa Á.Esophageal cancer: Risk factors, screening and endoscopic treatment in Western and Eastern countries.World J Gastroenterol. 21(26):7933–7943. doi:10.3748/wjg.v21.i26.7933Harris C, Croce B, Munkholm-Larsen S.Esophageal cancer.Ann Cardiothorac Surg. 6(2):190. doi:10.21037/acs.2017.03.01Chai J, Jamal MM.Esophageal malignancy: a growing concern.World J Gastroenterol. 18(45):6521–6526. doi:10.3748/wjg.v18.i45.6521Huang FL, Yu SJ.Esophageal cancer: Risk factors, genetic association, and treatment. Asian J Surg. 41(3):210-215.Kuwano H, Kato H, Miyazaki T, et al.Genetic alterations in esophageal cancer. Surg Today. 35(1):7-18.Ellis A, Risk JM, Maruthappu T, Kelsell DP.Tylosis with oesophageal cancer: Diagnosis, management and molecular mechanisms.Orphanet J Rare Dis. 2015;10:126. doi:10.1186/s13023-015-0346-2Dibb M, Ang YS.Targeting the cell cycle in esophageal adenocarcinoma: an adjunct to anticancer treatment.World J Gastroenterol. 17(16):2063–2069. doi:10.3748/wjg.v17.i16.2063Zhang Y.Epidemiology of esophageal cancer.World J Gastroenterol. 19(34):5598–5606. doi:10.3748/wjg.v19.i34.5598Abnet CC, Arnold M, Wei WQ.Epidemiology of Esophageal Squamous Cell Carcinoma. Gastroenterology. 154(2):360-373.Lubpairee T, Poh CF, Laronde DM, Rosin MP, Zhang L.Oral Squamous Cell Carcinomas are Associated with Poorer Outcome with Increasing Ages.J Oncol Res Ther. 3(4):132.Bradford PT.Skin cancer in skin of color.Dermatol Nurs. 21(4):170–178.Zhang HZ, Jin GF, Shen HB.Epidemiologic differences in esophageal cancer between Asian and Western populations.Chin J Cancer. 31(6):281–286. doi:10.5732/cjc.011.10390Gallaway MS, Henley SJ, Steele CB, et al.Surveillance for Cancers Associated with Tobacco Use — United States, 2010–2014. MMWR Surveill Summ 67(No. SS-12):1–42.Castro, C., Peleteiro, B. & Lunet, N.Modifiable factors and esophageal cancer: a systematic review of published meta-analyses. Gastroenterol 53: 37.Launoy G, Milan CH, Faivre J, Pienkowski P, Milan CI, Gignoux M.Alcohol, tobacco and oesophageal cancer: effects of the duration of consumption, mean intake and current and former consumption.Br J Cancer. 75(9):1389–1396. doi:10.1038/bjc.1997.236Vaughan TL, Stewart PA, Davis S, Thomas DB.Work in dry cleaning and the incidence of cancer of the oral cavity, larynx, and oesophagus.Occup Environ Med. 54(9):692–695. doi:10.1136/oem.54.9.692Lupa M, Magne J, Guarisco JL, Amedee R.Update on the diagnosis and treatment of caustic ingestion.Ochsner J. 9(2):54–59.Torres-Aguilera M, Remes Troche JM.Achalasia and esophageal cancer: risks and links.Clin Exp Gastroenterol. 11:309–316. doi:10.2147/CEG.S141642Ahsan H, Neugut AI.Radiation therapy for breast cancer and increased risk for esophageal carcinoma. Ann Intern Med. 128(2):114-7.Heroiu Cataloiu AD, Danciu CE, Popescu CR.Multiple cancers of the head and neck.Maedica (Buchar). 8(1):80–85.Yu C, Tang H, Guo Y, et al.Hot Tea Consumption and Its Interactions With Alcohol and Tobacco Use on the Risk for Esophageal Cancer: A Population-Based Cohort Study. Ann Intern Med. 168(7):489-497.Ma L, Hu L, Feng X, Wang S.Nitrate and Nitrite in Health and Disease.Aging Dis. 9(5):938–945. doi:10.14336/AD.2017.1207Bucchi D, Stracci F, Buonora N, Masanotti G.Human papillomavirus and gastrointestinal cancer: A review.World J Gastroenterol. 22(33):7415–7430. doi:10.3748/wjg.v22.i33.7415Mahoney JL, Condon RE.Adenocarcinoma of the esophagus.Ann Surg. 205(5):557–562. doi:10.1097/00000658-198705000-00015Demeester SR.Epidemiology and biology of esophageal cancer.Gastrointest Cancer Res. 3(2 Suppl):S2–S5.Tobias JS, Hochhauser D (2013).Cancer and its management(6th ed.). p. 254. ISBN 978-1-11871-325-9El-Serag HB, Mason AC, Petersen N, Key CR.Epidemiological differences between adenocarcinoma of the oesophagus and adenocarcinoma of the gastric cardia in the USA.Gut. 50(3):368–372. doi:10.1136/gut.50.3.368Abbas G, Krasna M.Overview of esophageal cancer.Ann Cardiothorac Surg. 6(2):131–136. doi:10.21037/acs.2017.03.03Zhang Y.Epidemiology of esophageal cancer.World J Gastroenterol. 2013;19(34):5598–5606. doi:10.3748/wjg.v19.i34.5598Thrift AP.Barrett’s Esophagus and Esophageal Adenocarcinoma: How Common Are They Really?Dig Dis Sci. 63(8):1988-1996.van Soest EM, Dieleman JP, Siersema PD, Sturkenboom MC, Kuipers EJ.Increasing incidence of Barrett’s oesophagus in the general population.Gut. 54(8):1062–1066. doi:10.1136/gut.2004.063685Thrift AP, Anderson LA, Murray LJ, et al.Nonsteroidal Anti-Inflammatory Drug Use is Not Associated With Reduced Risk of Barrett’s Esophagus. Am J Gastroenterol. 111(11):1528-1535.Kamangar F, Chow WH, Abnet CC, Dawsey SM.Environmental causes of esophageal cancer.Gastroenterol Clin North Am. 38(1):27–vii. doi:10.1016/j.gtc.2009.01.004Domper arnal MJ, Ferrández arenas Á, Lanas arbeloa Á.Esophageal cancer: Risk factors, screening and endoscopic treatment in Western and Eastern countries. World J Gastroenterol. 21(26):7933-43.Seo GH, Choi HJ.Oral Bisphosphonate and Risk of Esophageal Cancer: A Nationwide Claim Study.J Bone Metab. 22(2):77–81. doi:10.11005/jbm.2015.22.2.77American Cancer Society.Survival rates for esophageal cancer.American Cancer Society.Can esophageal cancer be prevented?American Cancer Society.Signs and symptoms of esophageal cancer.Additional ReadingMayne, Susan T., et. al.Carbonated Soft Drink Consumption and Risk of Esophageal Adenocarcinoma. Journal of the National Cancer Institute. 98 (1) 72-75.Sardana, R., Chhikara, N., Tanwar, B,.and A. Panghal.Dietary Impact on Esophageal Cancer in Humans: A Review.Food and Function.
38 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Domper Arnal MJ, Ferrández Arenas Á, Lanas Arbeloa Á.Esophageal cancer: Risk factors, screening and endoscopic treatment in Western and Eastern countries.World J Gastroenterol. 21(26):7933–7943. doi:10.3748/wjg.v21.i26.7933Harris C, Croce B, Munkholm-Larsen S.Esophageal cancer.Ann Cardiothorac Surg. 6(2):190. doi:10.21037/acs.2017.03.01Chai J, Jamal MM.Esophageal malignancy: a growing concern.World J Gastroenterol. 18(45):6521–6526. doi:10.3748/wjg.v18.i45.6521Huang FL, Yu SJ.Esophageal cancer: Risk factors, genetic association, and treatment. Asian J Surg. 41(3):210-215.Kuwano H, Kato H, Miyazaki T, et al.Genetic alterations in esophageal cancer. Surg Today. 35(1):7-18.Ellis A, Risk JM, Maruthappu T, Kelsell DP.Tylosis with oesophageal cancer: Diagnosis, management and molecular mechanisms.Orphanet J Rare Dis. 2015;10:126. doi:10.1186/s13023-015-0346-2Dibb M, Ang YS.Targeting the cell cycle in esophageal adenocarcinoma: an adjunct to anticancer treatment.World J Gastroenterol. 17(16):2063–2069. doi:10.3748/wjg.v17.i16.2063Zhang Y.Epidemiology of esophageal cancer.World J Gastroenterol. 19(34):5598–5606. doi:10.3748/wjg.v19.i34.5598Abnet CC, Arnold M, Wei WQ.Epidemiology of Esophageal Squamous Cell Carcinoma. Gastroenterology. 154(2):360-373.Lubpairee T, Poh CF, Laronde DM, Rosin MP, Zhang L.Oral Squamous Cell Carcinomas are Associated with Poorer Outcome with Increasing Ages.J Oncol Res Ther. 3(4):132.Bradford PT.Skin cancer in skin of color.Dermatol Nurs. 21(4):170–178.Zhang HZ, Jin GF, Shen HB.Epidemiologic differences in esophageal cancer between Asian and Western populations.Chin J Cancer. 31(6):281–286. doi:10.5732/cjc.011.10390Gallaway MS, Henley SJ, Steele CB, et al.Surveillance for Cancers Associated with Tobacco Use — United States, 2010–2014. MMWR Surveill Summ 67(No. SS-12):1–42.Castro, C., Peleteiro, B. & Lunet, N.Modifiable factors and esophageal cancer: a systematic review of published meta-analyses. Gastroenterol 53: 37.Launoy G, Milan CH, Faivre J, Pienkowski P, Milan CI, Gignoux M.Alcohol, tobacco and oesophageal cancer: effects of the duration of consumption, mean intake and current and former consumption.Br J Cancer. 75(9):1389–1396. doi:10.1038/bjc.1997.236Vaughan TL, Stewart PA, Davis S, Thomas DB.Work in dry cleaning and the incidence of cancer of the oral cavity, larynx, and oesophagus.Occup Environ Med. 54(9):692–695. doi:10.1136/oem.54.9.692Lupa M, Magne J, Guarisco JL, Amedee R.Update on the diagnosis and treatment of caustic ingestion.Ochsner J. 9(2):54–59.Torres-Aguilera M, Remes Troche JM.Achalasia and esophageal cancer: risks and links.Clin Exp Gastroenterol. 11:309–316. doi:10.2147/CEG.S141642Ahsan H, Neugut AI.Radiation therapy for breast cancer and increased risk for esophageal carcinoma. Ann Intern Med. 128(2):114-7.Heroiu Cataloiu AD, Danciu CE, Popescu CR.Multiple cancers of the head and neck.Maedica (Buchar). 8(1):80–85.Yu C, Tang H, Guo Y, et al.Hot Tea Consumption and Its Interactions With Alcohol and Tobacco Use on the Risk for Esophageal Cancer: A Population-Based Cohort Study. Ann Intern Med. 168(7):489-497.Ma L, Hu L, Feng X, Wang S.Nitrate and Nitrite in Health and Disease.Aging Dis. 9(5):938–945. doi:10.14336/AD.2017.1207Bucchi D, Stracci F, Buonora N, Masanotti G.Human papillomavirus and gastrointestinal cancer: A review.World J Gastroenterol. 22(33):7415–7430. doi:10.3748/wjg.v22.i33.7415Mahoney JL, Condon RE.Adenocarcinoma of the esophagus.Ann Surg. 205(5):557–562. doi:10.1097/00000658-198705000-00015Demeester SR.Epidemiology and biology of esophageal cancer.Gastrointest Cancer Res. 3(2 Suppl):S2–S5.Tobias JS, Hochhauser D (2013).Cancer and its management(6th ed.). p. 254. ISBN 978-1-11871-325-9El-Serag HB, Mason AC, Petersen N, Key CR.Epidemiological differences between adenocarcinoma of the oesophagus and adenocarcinoma of the gastric cardia in the USA.Gut. 50(3):368–372. doi:10.1136/gut.50.3.368Abbas G, Krasna M.Overview of esophageal cancer.Ann Cardiothorac Surg. 6(2):131–136. doi:10.21037/acs.2017.03.03Zhang Y.Epidemiology of esophageal cancer.World J Gastroenterol. 2013;19(34):5598–5606. doi:10.3748/wjg.v19.i34.5598Thrift AP.Barrett’s Esophagus and Esophageal Adenocarcinoma: How Common Are They Really?Dig Dis Sci. 63(8):1988-1996.van Soest EM, Dieleman JP, Siersema PD, Sturkenboom MC, Kuipers EJ.Increasing incidence of Barrett’s oesophagus in the general population.Gut. 54(8):1062–1066. doi:10.1136/gut.2004.063685Thrift AP, Anderson LA, Murray LJ, et al.Nonsteroidal Anti-Inflammatory Drug Use is Not Associated With Reduced Risk of Barrett’s Esophagus. Am J Gastroenterol. 111(11):1528-1535.Kamangar F, Chow WH, Abnet CC, Dawsey SM.Environmental causes of esophageal cancer.Gastroenterol Clin North Am. 38(1):27–vii. doi:10.1016/j.gtc.2009.01.004Domper arnal MJ, Ferrández arenas Á, Lanas arbeloa Á.Esophageal cancer: Risk factors, screening and endoscopic treatment in Western and Eastern countries. World J Gastroenterol. 21(26):7933-43.Seo GH, Choi HJ.Oral Bisphosphonate and Risk of Esophageal Cancer: A Nationwide Claim Study.J Bone Metab. 22(2):77–81. doi:10.11005/jbm.2015.22.2.77American Cancer Society.Survival rates for esophageal cancer.American Cancer Society.Can esophageal cancer be prevented?American Cancer Society.Signs and symptoms of esophageal cancer.Additional ReadingMayne, Susan T., et. al.Carbonated Soft Drink Consumption and Risk of Esophageal Adenocarcinoma. Journal of the National Cancer Institute. 98 (1) 72-75.Sardana, R., Chhikara, N., Tanwar, B,.and A. Panghal.Dietary Impact on Esophageal Cancer in Humans: A Review.Food and Function.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Domper Arnal MJ, Ferrández Arenas Á, Lanas Arbeloa Á.Esophageal cancer: Risk factors, screening and endoscopic treatment in Western and Eastern countries.World J Gastroenterol. 21(26):7933–7943. doi:10.3748/wjg.v21.i26.7933Harris C, Croce B, Munkholm-Larsen S.Esophageal cancer.Ann Cardiothorac Surg. 6(2):190. doi:10.21037/acs.2017.03.01Chai J, Jamal MM.Esophageal malignancy: a growing concern.World J Gastroenterol. 18(45):6521–6526. doi:10.3748/wjg.v18.i45.6521Huang FL, Yu SJ.Esophageal cancer: Risk factors, genetic association, and treatment. Asian J Surg. 41(3):210-215.Kuwano H, Kato H, Miyazaki T, et al.Genetic alterations in esophageal cancer. Surg Today. 35(1):7-18.Ellis A, Risk JM, Maruthappu T, Kelsell DP.Tylosis with oesophageal cancer: Diagnosis, management and molecular mechanisms.Orphanet J Rare Dis. 2015;10:126. doi:10.1186/s13023-015-0346-2Dibb M, Ang YS.Targeting the cell cycle in esophageal adenocarcinoma: an adjunct to anticancer treatment.World J Gastroenterol. 17(16):2063–2069. doi:10.3748/wjg.v17.i16.2063Zhang Y.Epidemiology of esophageal cancer.World J Gastroenterol. 19(34):5598–5606. doi:10.3748/wjg.v19.i34.5598Abnet CC, Arnold M, Wei WQ.Epidemiology of Esophageal Squamous Cell Carcinoma. Gastroenterology. 154(2):360-373.Lubpairee T, Poh CF, Laronde DM, Rosin MP, Zhang L.Oral Squamous Cell Carcinomas are Associated with Poorer Outcome with Increasing Ages.J Oncol Res Ther. 3(4):132.Bradford PT.Skin cancer in skin of color.Dermatol Nurs. 21(4):170–178.Zhang HZ, Jin GF, Shen HB.Epidemiologic differences in esophageal cancer between Asian and Western populations.Chin J Cancer. 31(6):281–286. doi:10.5732/cjc.011.10390Gallaway MS, Henley SJ, Steele CB, et al.Surveillance for Cancers Associated with Tobacco Use — United States, 2010–2014. MMWR Surveill Summ 67(No. SS-12):1–42.Castro, C., Peleteiro, B. & Lunet, N.Modifiable factors and esophageal cancer: a systematic review of published meta-analyses. Gastroenterol 53: 37.Launoy G, Milan CH, Faivre J, Pienkowski P, Milan CI, Gignoux M.Alcohol, tobacco and oesophageal cancer: effects of the duration of consumption, mean intake and current and former consumption.Br J Cancer. 75(9):1389–1396. doi:10.1038/bjc.1997.236Vaughan TL, Stewart PA, Davis S, Thomas DB.Work in dry cleaning and the incidence of cancer of the oral cavity, larynx, and oesophagus.Occup Environ Med. 54(9):692–695. doi:10.1136/oem.54.9.692Lupa M, Magne J, Guarisco JL, Amedee R.Update on the diagnosis and treatment of caustic ingestion.Ochsner J. 9(2):54–59.Torres-Aguilera M, Remes Troche JM.Achalasia and esophageal cancer: risks and links.Clin Exp Gastroenterol. 11:309–316. doi:10.2147/CEG.S141642Ahsan H, Neugut AI.Radiation therapy for breast cancer and increased risk for esophageal carcinoma. Ann Intern Med. 128(2):114-7.Heroiu Cataloiu AD, Danciu CE, Popescu CR.Multiple cancers of the head and neck.Maedica (Buchar). 8(1):80–85.Yu C, Tang H, Guo Y, et al.Hot Tea Consumption and Its Interactions With Alcohol and Tobacco Use on the Risk for Esophageal Cancer: A Population-Based Cohort Study. Ann Intern Med. 168(7):489-497.Ma L, Hu L, Feng X, Wang S.Nitrate and Nitrite in Health and Disease.Aging Dis. 9(5):938–945. doi:10.14336/AD.2017.1207Bucchi D, Stracci F, Buonora N, Masanotti G.Human papillomavirus and gastrointestinal cancer: A review.World J Gastroenterol. 22(33):7415–7430. doi:10.3748/wjg.v22.i33.7415Mahoney JL, Condon RE.Adenocarcinoma of the esophagus.Ann Surg. 205(5):557–562. doi:10.1097/00000658-198705000-00015Demeester SR.Epidemiology and biology of esophageal cancer.Gastrointest Cancer Res. 3(2 Suppl):S2–S5.Tobias JS, Hochhauser D (2013).Cancer and its management(6th ed.). p. 254. ISBN 978-1-11871-325-9El-Serag HB, Mason AC, Petersen N, Key CR.Epidemiological differences between adenocarcinoma of the oesophagus and adenocarcinoma of the gastric cardia in the USA.Gut. 50(3):368–372. doi:10.1136/gut.50.3.368Abbas G, Krasna M.Overview of esophageal cancer.Ann Cardiothorac Surg. 6(2):131–136. doi:10.21037/acs.2017.03.03Zhang Y.Epidemiology of esophageal cancer.World J Gastroenterol. 2013;19(34):5598–5606. doi:10.3748/wjg.v19.i34.5598Thrift AP.Barrett’s Esophagus and Esophageal Adenocarcinoma: How Common Are They Really?Dig Dis Sci. 63(8):1988-1996.van Soest EM, Dieleman JP, Siersema PD, Sturkenboom MC, Kuipers EJ.Increasing incidence of Barrett’s oesophagus in the general population.Gut. 54(8):1062–1066. doi:10.1136/gut.2004.063685Thrift AP, Anderson LA, Murray LJ, et al.Nonsteroidal Anti-Inflammatory Drug Use is Not Associated With Reduced Risk of Barrett’s Esophagus. 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Heroiu Cataloiu AD, Danciu CE, Popescu CR.Multiple cancers of the head and neck.Maedica (Buchar). 8(1):80–85.
Yu C, Tang H, Guo Y, et al.Hot Tea Consumption and Its Interactions With Alcohol and Tobacco Use on the Risk for Esophageal Cancer: A Population-Based Cohort Study. Ann Intern Med. 168(7):489-497.
Ma L, Hu L, Feng X, Wang S.Nitrate and Nitrite in Health and Disease.Aging Dis. 9(5):938–945. doi:10.14336/AD.2017.1207
Bucchi D, Stracci F, Buonora N, Masanotti G.Human papillomavirus and gastrointestinal cancer: A review.World J Gastroenterol. 22(33):7415–7430. doi:10.3748/wjg.v22.i33.7415
Mahoney JL, Condon RE.Adenocarcinoma of the esophagus.Ann Surg. 205(5):557–562. doi:10.1097/00000658-198705000-00015
Demeester SR.Epidemiology and biology of esophageal cancer.Gastrointest Cancer Res. 3(2 Suppl):S2–S5.
Tobias JS, Hochhauser D (2013).Cancer and its management(6th ed.). p. 254. ISBN 978-1-11871-325-9
El-Serag HB, Mason AC, Petersen N, Key CR.Epidemiological differences between adenocarcinoma of the oesophagus and adenocarcinoma of the gastric cardia in the USA.Gut. 50(3):368–372. doi:10.1136/gut.50.3.368
Abbas G, Krasna M.Overview of esophageal cancer.Ann Cardiothorac Surg. 6(2):131–136. doi:10.21037/acs.2017.03.03
Zhang Y.Epidemiology of esophageal cancer.World J Gastroenterol. 2013;19(34):5598–5606. doi:10.3748/wjg.v19.i34.5598
Thrift AP.Barrett’s Esophagus and Esophageal Adenocarcinoma: How Common Are They Really?Dig Dis Sci. 63(8):1988-1996.
van Soest EM, Dieleman JP, Siersema PD, Sturkenboom MC, Kuipers EJ.Increasing incidence of Barrett’s oesophagus in the general population.Gut. 54(8):1062–1066. doi:10.1136/gut.2004.063685
Thrift AP, Anderson LA, Murray LJ, et al.Nonsteroidal Anti-Inflammatory Drug Use is Not Associated With Reduced Risk of Barrett’s Esophagus. Am J Gastroenterol. 111(11):1528-1535.
Kamangar F, Chow WH, Abnet CC, Dawsey SM.Environmental causes of esophageal cancer.Gastroenterol Clin North Am. 38(1):27–vii. doi:10.1016/j.gtc.2009.01.004
Domper arnal MJ, Ferrández arenas Á, Lanas arbeloa Á.Esophageal cancer: Risk factors, screening and endoscopic treatment in Western and Eastern countries. World J Gastroenterol. 21(26):7933-43.
Seo GH, Choi HJ.Oral Bisphosphonate and Risk of Esophageal Cancer: A Nationwide Claim Study.J Bone Metab. 22(2):77–81. doi:10.11005/jbm.2015.22.2.77
American Cancer Society.Survival rates for esophageal cancer.
American Cancer Society.Can esophageal cancer be prevented?
American Cancer Society.Signs and symptoms of esophageal cancer.
Mayne, Susan T., et. al.Carbonated Soft Drink Consumption and Risk of Esophageal Adenocarcinoma. Journal of the National Cancer Institute. 98 (1) 72-75.Sardana, R., Chhikara, N., Tanwar, B,.and A. Panghal.Dietary Impact on Esophageal Cancer in Humans: A Review.Food and Function.
Mayne, Susan T., et. al.Carbonated Soft Drink Consumption and Risk of Esophageal Adenocarcinoma. Journal of the National Cancer Institute. 98 (1) 72-75.
Sardana, R., Chhikara, N., Tanwar, B,.and A. Panghal.Dietary Impact on Esophageal Cancer in Humans: A Review.Food and Function.
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