Esophageal Cancer: Risk Factors

Approved by the Cancer.Net Editorial Board, 09/2022

ON THIS PAGE: You will find out more about the factors that increase the chance of developing esophageal cancer. Use the menu to see other pages.

A risk factor is anything that increases a person’s chance of developing cancer. Although risk factors often influence the development of cancer, most do not directly cause cancer. Some people with several risk factors never develop cancer, while others with no known risk factors do. Knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choices.

The following factors may raise a person’s risk of developing esophageal cancer:

  • Age. People between the ages of 45 and 70 have the highest risk of esophageal cancer.

  • Gender. Men are 3 to 4 times more likely than women to develop esophageal cancer.

  • Race. Black people are twice as likely as white people to develop the squamous cell type of esophageal cancer.

  • Tobacco. Using any form of tobacco, such as cigarettes, cigars, pipes, chewing tobacco, and snuff raises the risk of esophageal cancer, especially squamous cell carcinoma.

  • Alcohol. Heavy drinking over a long period of time increases the risk of squamous cell carcinoma of the esophagus, especially when combined with tobacco use.

  • Barrett's esophagus. This condition can develop in some people who have chronic gastroesophageal reflux disease (GERD) or inflammation of the esophagus called esophagitis, even when a person does not have symptoms of chronic heartburn. Damage to the lining of the esophagus causes the squamous cells in the lining of the esophagus to turn into glandular tissue. People with Barrett's esophagus are more likely to develop adenocarcinoma of the esophagus, but the risk of developing esophageal cancer is still fairly low.

  • Diet/nutrition. A diet that is low in fruits and vegetables and certain vitamins and minerals can increase a person's risk of developing esophageal cancer.

  • Obesity. Being very overweight and having too much body fat can increase a person's risk of developing esophageal adenocarcinoma.

  • Lye. Children who have accidentally swallowed lye have an increased risk of squamous cell carcinoma. Lye can be found in some cleaning products, such as drain cleaners.

  • Achalasia. Achalasia is a condition when the lower muscular ring of the esophagus does not relax during swallowing of food. Achalasia increases the risk of squamous cell carcinoma.

  • Human papillomavirus (HPV). Researchers are investigating HPV as a possible risk factor for esophageal cancer, but there is no clear link that squamous cell esophageal cancer is related to HPV. Sexual activity with someone who has HPV is the most common way someone gets HPV. There are different types of HPV, called strains. Research links some HPV strains more strongly with certain types of cancers. HPV vaccines can prevent people from developing certain cancers. Learn more about HPV and cancer.

The next section in this guide is Screening. It explains how tests may find cancer before signs or symptoms appear. Use the menu to choose a different section to read in this guide.