Rak przełyku – Etiologia i przyczyny

Rak przełyku
Etiologia i przyczyny

Rak przełyku, zajmujący szóste miejsce pod względem śmiertelności nowotworowej na świecie, dzieli się głównie na dwa typy histologiczne: rak płaskonabłonkowy (SCC) oraz gruczolakorak. W krajach rozwijających się dominuje SCC, natomiast w krajach rozwiniętych obserwuje się wzrost częstości gruczolakoraka. Kluczowymi czynnikami ryzyka dla SCC są palenie tytoniu (zwiększające ryzyko 3-7-krotnie, odpowiedzialne za 35% przypadków), nadmierne spożycie alkoholu (powyżej 3 drinków dziennie) oraz ich synergistyczne działanie. Dla gruczolakoraka istotne są otyłość (odpowiedzialna za ponad 25% przypadków w Wielkiej Brytanii), choroba refluksowa przełyku (GERD) oraz przełyk Barretta, który zwiększa ryzyko rozwoju raka 30-60-krotnie. Inne czynniki to dieta uboga w owoce i warzywa, spożywanie bardzo gorących napojów (>65°C), ekspozycja na czynniki środowiskowe i zawodowe (np. azbest, rozpuszczalniki), a także predyspozycje genetyczne i zakażenia HPV.

Etiologia raka przełyku

Rak przełyku jest poważnym nowotworem złośliwym, zajmującym szóste miejsce pod względem śmiertelności spośród wszystkich nowotworów na świecie. Mimo że dokładna przyczyna raka przełyku nie jest jeszcze w pełni poznana, zidentyfikowano szereg czynników ryzyka, które przyczyniają się do jego rozwoju¹². Choroba ta wykazuje znaczącą zmienność geograficzną i histologiczną, a czynniki etiologiczne różnią się w zależności od typu histologicznego³⁴.

Typy histologiczne raka przełyku

Rak przełyku klasyfikowany jest głównie na dwa typy histologiczne: rak płaskonabłonkowy (squamous cell carcinoma, SCC) oraz gruczolakorak (adenocarcinoma)³. W ostatnich dekadach w krajach zachodnich, w tym w Stanach Zjednoczonych, obserwuje się znaczący spadek częstości występowania raka płaskonabłonkowego, przy jednoczesnym wzroście częstości występowania gruczolakoraka⁴. Rak płaskonabłonkowy jest nadal dominującym typem w krajach rozwijających się, podczas gdy gruczolakorak występuje częściej w krajach rozwiniętych⁵.

Czynniki ryzyka związane z trybem życia

Palenie tytoniu

Palenie tytoniu jest jednym z głównych czynników ryzyka rozwoju raka przełyku, szczególnie typu płaskonabłonkowego¹. Osoby palące mają około 3-7 razy wyższe ryzyko zachorowania na raka przełyku w porównaniu do osób niepalących⁶. Badania wykazały, że 35% przypadków raka przełyku jest spowodowanych paleniem tytoniu⁷. Szkodliwe toksyny i substancje chemiczne obecne w dymie tytoniowym powodują podrażnienie komórek wyściełających przełyk, zwiększając prawdopodobieństwo ich transformacji nowotworowej⁸. Ryzyko to wzrasta wraz z ilością wypalanego tytoniu i czasem jego stosowania⁹.

Używanie tytoniu w każdej postaci, w tym papierosów, cygar, fajek czy tytoniu do żucia, zwiększa ryzyko zachorowania na raka przełyku¹⁰. Chociaż palenie jest silniej związane z rakiem płaskonabłonkowym, zwiększa również ryzyko gruczolakoraka, choć w mniejszym stopniu¹¹.

Spożycie alkoholu

Nadmierne spożycie alkoholu jest drugim kluczowym czynnikiem ryzyka rozwoju raka przełyku, szczególnie typu płaskonabłonkowego¹. Przewlekłe i/lub intensywne spożywanie alkoholu powoduje podrażnienie i stan zapalny błony śluzowej przełyku, co z czasem może prowadzić do rozwoju raka⁸¹². Ryzyko zachorowania wzrasta wraz z ilością spożywanego alkoholu – osoby spożywające więcej niż 3 drinki dziennie mają znacząco wyższe ryzyko¹².

Szczególnie niebezpieczne jest łączenie spożycia alkoholu z paleniem tytoniu. Te dwa czynniki działają synergistycznie, znacząco zwiększając ryzyko zachorowania na raka przełyku, zwłaszcza typu płaskonabłonkowego¹⁴. Badania wskazują, że kombinacja tytoniu i alkoholu ma silny efekt synergistyczny, a ponad trzy czwarte przypadków raka przełyku u mężczyzn jest związanych z jednoczesnym paleniem i intensywnym piciem alkoholu⁴.

Nadwaga i otyłość

Nadwaga i otyłość są silnymi czynnikami ryzyka rozwoju gruczolakoraka przełyku⁷¹³. Ponad 25% przypadków raka przełyku w Wielkiej Brytanii jest spowodowanych nadwagą lub otyłością⁷. Otyłość może przyczynić się do rozwoju raka przełyku poprzez zwiększenie ryzyka choroby refluksowej przełyku oraz zapalenia przełyku¹⁰.

Otyłość brzuszna ma szczególne znaczenie ze względu na silny związek z tym typem raka, a także z GERD i przełykiem Barretta¹³. Badania wykazały, że nadmierna masa ciała może prowadzić do stanu zapalnego w przełyku, który z czasem może przekształcić się w raka¹⁴.

Dieta i nawyki żywieniowe

Dieta odgrywa istotną rolę w etiologii raka przełyku. Niskie spożycie owoców i warzyw jest czynnikiem ryzyka zarówno dla raka płaskonabłonkowego, jak i gruczolakoraka przełyku¹⁸. Dieta bogata w przetworzone mięsa i uboga w świeże owoce i warzywa może zwiększać ryzyko rozwoju raka przełyku¹⁵.

Spożywanie bardzo gorących napojów (powyżej 65°C) może również zwiększać ryzyko raka przełyku, szczególnie typu płaskonabłonkowego, poprzez powodowanie termicznych uszkodzeń nabłonka przełyku¹⁶¹³. Podobnie, konsumpcja pikli i żywności bogatej w nitrozoaminy (obecne w produktach takich jak piwo, ryby i przetworzone mięsa) może zwiększać ryzyko¹³.

Dieta uboga w owoce i warzywa⁸
Spożywanie bardzo gorących napojów (powyżej 65°C)¹⁷
Konsumpcja żywności konserwowanej, szczególnie pikli¹⁸
Dieta bogata w przetworzone mięsa¹⁹

Czynniki medyczne i choroby współtowarzyszące

GERD i refluks żołądkowo-przełykowy

Przewlekła choroba refluksowa przełyku (GERD – gastroesophageal reflux disease) jest jednym z najważniejszych czynników ryzyka rozwoju gruczolakoraka przełyku¹²⁰. Długotrwałe działanie kwasu żołądkowego na śluzówkę przełyku może prowadzić do jej uszkodzenia i zmian komórkowych, które z czasem mogą przekształcić się w raka²¹.

Ryzyko rozwoju raka przełyku wzrasta wraz z czasem trwania i częstotliwością objawów refluksu²². U osób z długotrwałą zgagą ryzyko rozwoju gruczolakoraka przełyku jest znacząco wyższe¹⁰. Badania wykazały, że objawowy GERD jest najsilniejszym znanym czynnikiem ryzyka rozwoju gruczolakoraka przełyku i jego prekursora – przełyku Barretta²³.

Przełyk Barretta

Przełyk Barretta jest najczęstszym stanem przedrakowym przełyku¹⁷. Rozwija się on w wyniku długotrwałego podrażnienia przełyku spowodowanego przewlekłym, nieleczonym refluksem żołądkowo-przełykowym¹⁰. W stanie tym komórki wyściełające dolną część przełyku ulegają zmianie (metaplazji), przypominając komórki jelitowe¹¹.

Osoby z przełykiem Barretta mają znacząco wyższe ryzyko rozwoju gruczolakoraka przełyku – szacuje się, że jest ono 30-60 razy wyższe niż w populacji ogólnej²⁴. Ryzyko to wzrasta jeszcze bardziej, jeśli przełykowi Barretta towarzyszy objawowy GERD¹¹. Około 1-5% osób z przełykiem Barretta rozwinie raka przełyku²⁵.

Achalazja i zaburzenia motoryki przełyku

Achalazja jest zaburzeniem motoryki przełyku, charakteryzującym się brakiem perystaltyki w dystalnej części przełyku i brakiem relaksacji dolnego zwieracza przełyku²⁶. Stan ten powoduje zaleganie pokarmu w przełyku, co może prowadzić do przewlekłego podrażnienia jego śluzówki¹⁷.

Osoby z achalazją mają znacznie podwyższe ryzyko rozwoju raka przełyku – według niektórych badań ryzyko to jest wielokrotnie wyższe niż w populacji ogólnej²⁷. Rak przełyku u osób z achalazją rozwija się zazwyczaj 15-20 lat po postawieniu diagnozy achalazji²⁸.

Inne schorzenia i stany chorobowe

Inne stany medyczne, które mogą zwiększać ryzyko raka przełyku, obejmują:

Zespół Plummera-Vinsona (zespół Patersona-Kellyego) – rzadkie schorzenie charakteryzujące się niedoborem żelaza i tworzeniem się błon w górnej części przełyku⁸. Około 10% osób z tym zespołem rozwinie raka płaskonabłonkowego przełyku¹⁷.
Tyloza – rzadka, dziedziczna choroba skóry, charakteryzująca się nadmiernym rogowaceniem skóry dłoni i stóp²⁹. Osoby z tylozą mają bardzo wysokie ryzyko rozwoju raka płaskonabłonkowego przełyku²⁷.
Przebyte nowotwory głowy i szyi – osoby, które miały raka płuc, jamy ustnej lub gardła, mają wyższe ryzyko rozwoju raka płaskonabłonkowego przełyku³⁰.
Wcześniejsza radioterapia klatki piersiowej – ekspozycja na promieniowanie jonizujące związana z wcześniejszą radioterapią może zwiększać ryzyko rozwoju raka przełyku¹⁷.

Czynniki genetyczne i rodzinne

Czynniki genetyczne odgrywają istotną rolę w patogenezie raka przełyku, szczególnie w przypadku raka płaskonabłonkowego²⁸. Mimo że większość przypadków raka przełyku nie jest dziedziczna, zidentyfikowano szereg zespołów genetycznych i mutacji, które zwiększają ryzyko rozwoju tego nowotworu.

Badania wykazały, że osoby z dodatnim wywiadem rodzinnym w kierunku raka przełyku mają prawie dwukrotnie większe ryzyko rozwoju raka płaskonabłonkowego przełyku (OR=1,85, 95% CI: 1,42-2,41)³¹. Ryzyko to wzrasta wraz z liczbą krewnych pierwszego stopnia dotkniętych rakiem przełyku. Szczególnie wysokie ryzyko (8-krotnie wyższe) obserwuje się u osób, których oboje rodzice chorowali na raka przełyku³¹.

Rzadkie zespoły genetyczne związane ze zwiększonym ryzykiem raka przełyku to:

Tyloza – dziedziczna choroba skóry związana z bardzo wysokim ryzykiem raka płaskonabłonkowego przełyku²⁸.
Zespół Blooma i anemia Fanconiego – rzadkie zespoły genetyczne zwiększające ryzyko raka przełyku³.
Zespół Cowdena i zespół Peutza-Jeghersa – rzadkie choroby dziedziczne zwiększające ryzyko nowotworów przewodu pokarmowego, w tym raka przełyku³².

Badania genetyczne wykazały, że rak przełyku rozwija się w wyniku akumulacji mutacji w wielu różnych genach, w tym w onkogenach i genach supresorowych nowotworów³³. Chociaż dokładne mechanizmy genetyczne nie są jeszcze w pełni poznane, podkreśla się rolę interakcji czynników genetycznych i środowiskowych w patogenezie raka przełyku.

Czynniki infekcyjne

Wirus brodawczaka ludzkiego (HPV)

Zakażenie wirusem brodawczaka ludzkiego (HPV) jest uważane za potencjalny czynnik ryzyka rozwoju raka płaskonabłonkowego przełyku, choć związek ten nie jest tak silny jak w przypadku innych nowotworów, np. raka szyjki macicy¹⁰³⁰.

Badania wykazały, że markery zakażenia HPV są obecne w niektórych przypadkach raka przełyku, szczególnie w regionach Azji i Afryki Południowej³⁰. Jednak w krajach zachodnich, w tym w USA, związek między zakażeniem HPV a rakiem przełyku jest mniej wyraźny³⁰.

HPV jest powszechnym wirusem, który może powodować zmiany tkankowe w strunach głosowych, jamie ustnej oraz na dłoniach, stopach i narządach płciowych¹⁰. Infekcja niektórymi typami HPV może zwiększać ryzyko rozwoju raka płaskonabłonkowego przełyku¹⁴.

Zakażenie Helicobacter pylori

Rola zakażenia Helicobacter pylori w patogenezie raka przełyku jest złożona i nie do końca poznana. Niektóre badania sugerują, że infekcja H. pylori może zmniejszać ryzyko rozwoju gruczolakoraka przełyku poprzez ograniczenie wydzielania kwasu żołądkowego³⁴.

Z drugiej strony, przewlekłe zakażenie H. pylori może prowadzić do zanikowego zapalenia żołądka, co jest czynnikiem ryzyka raka płaskonabłonkowego przełyku. Badania wykazały, że pacjenci z zanikiem żołądka mają około 3 razy większe ryzyko rozwoju raka przełyku²³.

Czynniki środowiskowe i zawodowe

Narażenie na określone czynniki środowiskowe i zawodowe może zwiększać ryzyko rozwoju raka przełyku¹⁷. Ekspozycja na różne substancje chemiczne, w tym rozpuszczalniki stosowane w czyszczeniu na sucho, może zwiększać ryzyko zachorowania na raka przełyku, szczególnie przy długotrwałym narażeniu²⁹.

Inne czynniki środowiskowe obejmują:

Narażenie zawodowe na określone chemikalia, takie jak rozpuszczalniki, krzemionka, azbest i spaliny²⁶. Ryzyko raka przełyku jest 2-16 razy wyższe u osób narażonych zawodowo na azbest²⁶.
Przypadkowe lub zamierzone spożycie substancji żrących, takich jak ług, które powoduje zwężenia i blizny w przełyku²⁷.
Zanieczyszczenie żywności mykotoksynami, szczególnie fumonizynami, które są produkowane przez grzyby rosnące na zbożach, zwłaszcza kukurydzy²¹.
Spalanie biomasy w gospodarstwie domowym, które zostało sklasyfikowane jako prawdopodobnie rakotwórcze dla ludzi³⁵.
Spożywanie nieuzdatnionej wody z różnych źródeł, w tym studni, cystern i rzek, co wiąże się z około dwukrotnym wzrostem ryzyka raka płaskonabłonkowego przełyku w różnych regionach³⁵.

Niski status społeczno-ekonomiczny jest również związany ze zwiększonym ryzykiem raka przełyku, szczególnie typu płaskonabłonkowego¹⁷. W analizach wewnątrzkrajowych niski status społeczno-ekonomiczny wiąże się z 1,5-2-krotnym wzrostem ryzyka zarówno raka płaskonabłonkowego, jak i gruczolakoraka przełyku³⁵.

Czynniki demograficzne

Wiek i płeć

Rak przełyku występuje częściej u osób starszych. Ryzyko zachorowania wzrasta wraz z wiekiem, a większość przypadków diagnozowana jest u osób powyżej 55 roku życia⁹. Około 40% przypadków raka przełyku rozwija się u osób w wieku 75 lat i starszych⁷.

Mężczyźni są znacznie bardziej narażeni na rozwój raka przełyku niż kobiety³⁶. Stosunek zachorowań u mężczyzn do kobiet wynosi około 3:1¹⁵. Różnica ta może wynikać z większej ekspozycji mężczyzn na czynniki ryzyka, takie jak palenie tytoniu i spożywanie alkoholu¹⁹.

Rasa i pochodzenie etniczne

Występowanie różnych typów raka przełyku wykazuje zróżnicowanie rasowe i etniczne. W Stanach Zjednoczonych biali mężczyźni są bardziej narażeni na gruczolakoraka przełyku, podczas gdy czarni mężczyźni mają wyższe ryzyko rozwoju raka płaskonabłonkowego¹⁵.

Rak przełyku jest znacznie częstszy w niektórych regionach świata, takich jak Chiny i inne kraje Dalekiego Wschodu, niż w Europie³⁷. Różnice te mogą być związane zarówno z czynnikami genetycznymi, jak i środowiskowymi, w tym z dietą, nawykami żywieniowymi i ekspozycją na określone patogeny.

Mechanizmy molekularne i patogeneza

Rak przełyku rozwija się w wyniku złożonych interakcji między czynnikami genetycznymi a środowiskowymi, które prowadzą do nagromadzenia mutacji DNA w komórkach wyściełających przełyk³³. Proces ten obejmuje aktywację onkogenów i inaktywację genów supresorowych nowotworów, co prowadzi do niekontrolowanego wzrostu komórek³³.

Główne mechanizmy patogenetyczne obejmują:

Przewlekłe podrażnienie i zapalenie przełyku spowodowane przez czynniki takie jak reflux, alkohol, dym tytoniowy i gorące napoje, co może prowadzić do uszkodzenia DNA i inicjacji procesu nowotworowego³³.
Metaplazję nabłonka przełyku, jak w przypadku przełyku Barretta, gdzie normalne komórki płaskonabłonkowe są zastępowane przez komórki gruczołowe przypominające te obecne w żołądku i jelitach¹¹.
Mutacje w genach regulujących cykl komórkowy, apoptozę i naprawę DNA, które przyczyniają się do rozwoju i progresji raka³³.
Ekspozycję na karcynogeny zewnętrzne, takie jak wielopierścieniowe węglowodory aromatyczne z dymu tytoniowego, które mogą bezpośrednio uszkadzać DNA²¹.

Badania nad genomem raka przełyku wykazały, że komórki nowotworowe często posiadają zmiany w wielu różnych genach³³. Jednak nie jest jeszcze jasne, czy istnieją specyficzne zmiany genetyczne, które można znaleźć we wszystkich (lub większości) raków przełyku³³.

Profilaktyka i modyfikacja czynników ryzyka

Chociaż nie można całkowicie zapobiec rakowi przełyku, istnieją sposoby na znaczne zmniejszenie ryzyka jego rozwoju². Główne podejścia do zapobiegania rakowi przełyku obejmują zdrowy styl życia, w tym zaprzestanie palenia, zwiększenie aktywności fizycznej, spożywanie warzyw oraz ograniczenie spożycia alkoholu i kalorii¹.

Strategie profilaktyczne obejmują:

Unikanie tytoniu w każdej postaci (papierosy, cygara, fajki, e-papierosy, tytoń do żucia)³⁸.
Ograniczenie spożycia alkoholu lub całkowita abstynencja³⁸.
Utrzymanie zdrowej masy ciała poprzez zbilansowaną dietę i regularną aktywność fizyczną³⁹.
Zwiększenie spożycia owoców i warzyw, które mogą mieć działanie ochronne¹⁹.
Leczenie i monitorowanie refluksu żołądkowo-przełykowego (GERD) w celu zapobiegania długotrwałemu zapaleniu przełyku³⁶.
Regularne badania kontrolne dla osób z przełykiem Barretta w celu wczesnego wykrycia ewentualnych zmian nowotworowych¹⁶.
Stosowanie niesteroidowych leków przeciwzapalnych (NLPZ, w tym aspiryny i ibuprofenu), które mogą zmniejszać ryzyko rozwoju zarówno raka płaskonabłonkowego, jak i gruczolakoraka przełyku³⁸.

Badania sugerują, że dieta śródziemnomorska może zmniejszać ryzyko raka przełyku (płaskonabłonkowego u mężczyzn)⁴⁰. Inne czynniki ochronne przeciwko przełykowi Barretta i gruczolakorakowi przełyku mogą obejmować dietę bogatą w błonnik, antyoksydanty, owoce i warzywa, kwas foliowy, witaminę C, inhibitory pompy protonowej oraz NLPZ²⁰.

Podsumowanie czynników ryzyka

Etiologia raka przełyku jest złożona i wieloczynnikowa, a różne czynniki ryzyka mogą wpływać na rozwój różnych typów histologicznych tego nowotworu. Główne czynniki ryzyka dla poszczególnych typów raka przełyku to:

Dla raka płaskonabłonkowego przełyku:

Palenie tytoniu⁴
Spożywanie alkoholu (szczególnie w połączeniu z paleniem)⁴
Dieta uboga w owoce i warzywa³
Spożywanie bardzo gorących napojów¹⁶
Żucie betelu/paan⁴¹
Zakażenie HPV (w niektórych regionach)³⁰
Achalazja i inne zaburzenia motoryki przełyku¹⁷
Zespół Plummera-Vinsona¹⁷
Tyloza¹⁷

Dla gruczolakoraka przełyku:

Choroba refluksowa przełyku (GERD)⁴²
Przełyk Barretta⁴²
Otyłość i nadwaga²⁰
Palenie tytoniu (mniejszy wpływ niż w przypadku SCC)²⁸
Przepuklina rozworu przełykowego⁴³
Ekspozycja na określone leki²⁸

Wspólne czynniki ryzyka dla obu typów raka przełyku to:

Wiek powyżej 55 lat⁹
Płeć męska³⁶
Dieta uboga w owoce i warzywa⁸
Wcześniejsza radioterapia klatki piersiowej lub szyi¹⁸
Dodatni wywiad rodzinny w kierunku raka przełyku⁴⁴
Niski status społeczno-ekonomiczny³⁵

Zrozumienie tych czynników ryzyka jest kluczowe dla opracowania skutecznych strategii profilaktycznych i programów wczesnego wykrywania raka przełyku, co może przyczynić się do poprawy rokowania i zmniejszenia śmiertelności związanej z tym nowotworem.

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Materiały źródłowe

#1 Etiology and Prevention of Esophageal Cancer
https://pmc.ncbi.nlm.nih.gov/articles/PMC5040887/
Esophageal cancer (EC) occurs commonly, especially in Asia, and is the sixth leading cause of cancer deaths worldwide. […] The major risk factors for esophageal squamous cell carcinoma (ESCC) are tobacco smoking and alcohol drinking, which act synergistically. […] A common etiological factor for both EC and some other cancers are low levels of intake of fruits and vegetables. […] The major etiological factor for EAC is gastroesophageal reflux, which is also an etiological factor for gastric cardia adenocarcinoma (GCA). […] The etiology of EC includes tobacco smoking, alcohol drinking, low levels of intake of fruits and vegetables as well as gastroesophageal reflux and susceptibility genes. […] A healthy lifestyle including smoking cessation, increasing physical activity, consumption of vegetables as well as reduction of alcohol intake and caloric consumption are major approaches to the prevention of EC.
#2 Causes of oesophageal cancer – NHS
https://www.nhs.uk/conditions/oesophageal-cancer/causes/
It’s not always clear what causes oesophageal cancer. […] Many oesophageal cancers are also linked to lifestyle. For example, you’re more likely to get it if you’re overweight, smoke or drink too much alcohol. […] If you have Barrett’s oesophagus you’re slightly more likely to get oesophageal cancer. But this is not common. It’s sometimes called a pre-cancerous condition. […] You cannot always prevent oesophageal cancer. But making healthy changes can lower your chances of getting it.
#3 Esophageal Cancer – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK459267/
Esophageal cancer is classified into 2 main types based on histologic features: squamous cell carcinoma and adenocarcinoma. In recent decades, the incidence of esophageal squamous cell carcinoma has decreased. In contrast, esophageal adenocarcinoma has risen significantly in the United States, particularly in the distal esophagus and gastroesophageal junction, mainly due to the prevalence of Barrett’s esophagus. […] Risk factors for esophageal squamous cell carcinoma include smoking, alcohol consumption, and a diet low in fruits and vegetables. In contrast, esophageal adenocarcinoma high-risk factors include Barrett esophagus, smoking, high body mass index, and gastroesophageal reflux disease. […] In the US, smoking, alcohol consumption, and a diet low in fruits and vegetables are the main risk factors for esophageal SCC. Poor nutrition, low fruit and vegetable intake, and drinking hot beverages may increase the risk in developing countries. Other factors associated with esophageal SCC include human papillomavirus (HPV) infection, preexisting anatomical diseases, previous SCC of the aerodigestive tract, and genetic syndromes (eg, tylosis, Bloom syndrome, and Fanconi anemia). Some studies have also linked oral bisphosphonates to esophageal SCC and adenocarcinoma.
#4 Esophageal cancer – Wikipedia
https://en.wikipedia.org/wiki/Esophageal_cancer
Causes of the squamous-cell type include tobacco, alcohol, very hot drinks, poor diet, and chewing betel nut. The most common causes of the adenocarcinoma type are smoking tobacco, obesity, and acid reflux. In addition, for patients with achalasia, candidiasis (overgrowth of the esophagus with the fungus candida) is the most important risk factor. […] The two main types (i.e. squamous-cell carcinoma and adenocarcinoma) have distinct sets of risk factors. Squamous-cell carcinoma is linked to lifestyle factors such as smoking and alcohol. Adenocarcinoma has been linked to effects of long-term acid reflux. Tobacco is a risk factor for both types. Both types are more common in people over 60 years of age. […] The two major risk factors for esophageal squamous-cell carcinoma are tobacco (smoking or chewing) and alcohol. The combination of tobacco and alcohol has a strong synergistic effect. Some data suggest that about half of all cases are due to tobacco and about one-third to alcohol, while over three-quarters of the cases in men are due to the combination of smoking and heavy drinking. Risks associated with alcohol appear to be linked to its aldehyde metabolite and to mutations in certain related enzymes.
#4 Esophageal Cancer: Practice Essentials, Background, Anatomy
https://emedicine.medscape.com/article/277930-overview
Esophageal cancer is a disease in epidemiologic transition. Until the 1970s, the most common type of esophageal cancer in the United States was squamous cell carcinoma, which has smoking and alcohol consumption as risk factors. Since then, there has been a steep increase in the incidence of esophageal adenocarcinoma, for which the most common predisposing factor is gastroesophageal reflux disease (GERD). […] Major risk factors for SCC include alcohol consumption and tobacco use. Most studies have shown that alcohol is the primary risk factor but smoking in combination with alcohol consumption can have a synergistic effect. […] The etiology of esophageal carcinoma is thought to be related to exposure of the esophageal mucosa to noxious or toxic stimuli, resulting in a sequence of dysplasia to carcinoma in situ to carcinoma. In Western cultures, retrospective evidence has implicated cigarette smoking and chronic alcohol exposure as the most common etiologic factors for squamous cell carcinoma. High body mass index, GERD, and resultant Barrett esophagus are often the associated factors for esophageal adenocarcinoma.
#5 Esophageal cancer – Wikipedia
https://en.wikipedia.org/wiki/Esophageal_cancer
Causes of the squamous-cell type include tobacco, alcohol, very hot drinks, poor diet, and chewing betel nut. The most common causes of the adenocarcinoma type are smoking tobacco, obesity, and acid reflux. In addition, for patients with achalasia, candidiasis (overgrowth of the esophagus with the fungus candida) is the most important risk factor. […] The two main types (i.e. squamous-cell carcinoma and adenocarcinoma) have distinct sets of risk factors. Squamous-cell carcinoma is linked to lifestyle factors such as smoking and alcohol. Adenocarcinoma has been linked to effects of long-term acid reflux. Tobacco is a risk factor for both types. Both types are more common in people over 60 years of age. […] The two major risk factors for esophageal squamous-cell carcinoma are tobacco (smoking or chewing) and alcohol. The combination of tobacco and alcohol has a strong synergistic effect. Some data suggest that about half of all cases are due to tobacco and about one-third to alcohol, while over three-quarters of the cases in men are due to the combination of smoking and heavy drinking. Risks associated with alcohol appear to be linked to its aldehyde metabolite and to mutations in certain related enzymes.
#6 Esophageal Cancer – Symptoms, Causes, Complications & Prevention PACE Hospitals – Best Hospitals in Hitech City, Hyderabad, India | Near Madhapur, Kukatpally, KPHB, Kondapur, Gachibowli, Jubilee Hills, Banjara HillsPACE Hospitals Contact
https://www.pacehospital.com/esophageal-cancer-symptoms-causes-complications-and-prevention
Occupational exposure (to silica and asbestos) […] Low socioeconomic status […] Tobacco use […] Cigarette smoking is connected with esophageal squamous cell carcinoma more strongly than with esophageal adenocarcinoma. […] The risk of esophageal cancer is around three-seven times higher for current smokers […] Alcohol consumption […] In the 1970s and 1980s, researchers established alcohol as a significant cause of esophageal cancer and the interaction with cigarette smoking can double the risk. […] Opium use […] Although opium in its natural state is not mutagenic, smoking opium however may create carcinogenic polycyclic aromatic hydrocarbons or other chemicals. […] Hot foods and drinks […] Esophageal cancer has been linked to repeated thermal harm from consuming hot meals and beverages.
#7 Risks and causes of oesophageal cancer | Cancer Research UK
https://www.cancerresearchuk.org/about-cancer/oesophageal-cancer/causes-risks
Your risk of developing oesophageal cancer depends on many things including your age, lifestyle and other medical conditions. […] Anything that can increase your risk of cancer is called a risk factor. Those that lower the risk are called protective factors. […] Cancer of the oesophagus is more common in older people. Around 40 out of 100 oesophageal cancers (around 40%) develop in people aged 75 and over. […] Men are more likely to have oesophageal cancer than women. […] Smoking increases your risk of the 2 main types of oesophageal cancer squamous cell cancer and adenocarcinoma. Around 35 out of 100 oesophageal cancer cases (around 35%) in the UK are caused by smoking. […] Being overweight or obese increases your risk of getting oesophageal adenocarcinoma. More than 25 out of 100 oesophageal cancers (more than 25%) in the UK are caused by being overweight or obese. The more overweight you are the higher your risk.
#8 Oesophageal cancer | NHS inform
https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/oesophageal-cancer/
The exact cause of oesophageal cancer is unknown, but the following things can increase your risk: […] The exact cause of oesophageal cancer is unknown, but certain things can increase the risk of it developing. […] Drinking too much alcohol causes irritation and inflammation in the lining of the oesophagus. […] Tobacco smoke contains many harmful toxins and chemicals. These substances irritate the cells that make up the lining of the oesophagus, which increases the likelihood that they will become cancerous. […] If you’re overweight or obese, your risk of developing cancer of the oesophagus is higher than people of a healthy weight. […] Not eating enough fruit and vegetables may increase your risk of getting oesophageal cancer. […] Certain rare medical conditions can also increase your chances of developing cancer of the oesophagus, including: achalasia where the oesophagus loses the ability to move food along, causing vomiting and acid reflux […] Paterson-Brown Kelly syndrome (also called Plummer Vinson syndrome) a condition that can cause iron deficiency anaemia and small growths in the throat […] tylosis an inherited skin condition.
#9 Esophageal Cancer Risk Factors | Esophagus Cancer Risk | American Cancer Society
https://www.cancer.org/cancer/types/esophagus-cancer/causes-risks-prevention/risk-factors.html
Age […] The chance of getting esophageal cancer increases with age. Fewer than 15% of cases are found in people younger than age 55. […] Men are more likely than women to get esophageal cancer. […] The use of tobacco products, including cigarettes, cigars, pipes, and chewing tobacco, is a major risk factor for esophageal cancer. The more a person uses tobacco and the longer it is used, the higher the cancer risk. […] Drinking alcohol also increases the risk of esophageal cancer. The more alcohol someone drinks, the higher their chance of getting esophageal cancer. Alcohol increases the risk of squamous cell carcinoma more than the risk of adenocarcinoma. […] People with GERD have a slightly higher risk of getting adenocarcinoma of the esophagus. […] People with Barretts esophagus are at a much higher risk than people without this condition to develop adenocarcinoma of the esophagus.
#10 Esophageal Cancer: Symptoms, Causes & Treatment
https://my.clevelandclinic.org/health/diseases/6137-esophageal-cancer
Esophageal cancer or oesophageal cancer, depending on where you live is the 10th most common cancer in the world. […] Healthcare providers dont know the exact cause, but theyve identified risk factors that increase the chance of developing esophageal cancer, including: […] Tobacco use: This includes smoking and using smokeless tobacco. […] Alcohol use: Chronic and/or heavy use of alcohol increases the risk of esophageal cancer. […] Obesity: Being overweight or having obesity may cause inflammation in your esophagus that could become cancer. […] Barretts esophagus and chronic acid reflux: Barretts esophagus is a change in the cells at the lower end of your esophagus that occurs from chronic untreated acid reflux. Even without Barretts esophagus, people with long-term heartburn have a higher risk of esophageal cancer.
#11 Esophageal cancer – Wikipedia
https://en.wikipedia.org/wiki/Esophageal_cancer
The long-term erosive effects of acid reflux (an extremely common condition, also known as gastroesophageal reflux disease or GERD) have been strongly linked to this type of cancer. Longstanding GERD can induce a change of cell type in the lower portion of the esophagus in response to erosion of its squamous lining. This phenomenon, known as Barrett’s esophagus, seems to appear about 20 years later in women than in men, possibly due to hormonal factors. […] Having symptomatic GERD or bile reflux makes Barrett’s esophagus more likely, which in turn raises the risk of further changes that can ultimately lead to adenocarcinoma. Bile reflux containing unconjugated bile acids, including deoxycholic acid and chenodeoxycholic acid, appears to contribute to esophageal adenocarcinoma carcinogenesis by inducing oxidative stress and DNA damage. […] Tobacco smoking increases risk, but the effect in esophageal adenocarcinoma is slight compared to that in squamous cell carcinoma, and alcohol has not been demonstrated to be a cause.
#12 Azthena logo with the word Azthena
https://www.news-medical.net/health/Causes-of-esophageal-cancer.aspx
The exact causes of esophageal cancer are unknown. However, some risk factors raise the likelihood of acquiring esophageal cancer. […] Studies have shown that cigarette smoking and chronic alcohol consumption are the best known risk factors for esophageal cancer. […] There are many risk factors for esophageal cancer, these include tobacco, excessive alcohol consumption, age, gastroesophageal reflux disorder and so forth. […] Any form of tobacco may raise the risk of esophageal cancer. […] People who have more than 3 alcoholic drinks each day are more likely to get esophageal cancer. […] Long term heavy drinking leads to irritation and inflammation in the lining of the esophagus. This inflammation may eventually lead to cancer. […] Acid reflux disorder called Gastroesophageal reflux disorder (GERD) may be the commonest predisposing factor for adenocarcinoma of the esophagus.
#13 Esophageal cancer – Wikipedia
https://en.wikipedia.org/wiki/Esophageal_cancer
Other relevant risk factors include regular consumption of very hot drinks (over 65 C or 149 F) and ingestion of caustic substances. High levels of dietary exposure to nitrosamines (chemical compounds found both in tobacco smoke and certain foodstuffs) also appear to be a relevant risk factor. Unfavorable dietary patterns seem to involve exposure to nitrosamines through processed and barbecued meats, pickled vegetables, etc., and a low intake of fresh foods. Other associated factors include nutritional deficiencies, low socioeconomic status, and poor oral hygiene. Chewing betel nut (areca) is an important risk factor in Asia. […] Being obese or overweight is strongly associated with risk of developing esophageal adenocarcinoma, and may in fact be the strongest of any type of obesity-related cancer, though the reasons for this remain unclear. Abdominal obesity seems to be of particular relevance, given the closeness of its association with this type of cancer, as well as with both GERD and Barrett’s esophagus.
#14 Preventing Esophageal Cancer | NYU Langone Health
https://nyulangone.org/conditions/esophageal-cancer/prevention
In Barretts esophagus, a condition seen usually in people who have had GERD for a long time, squamous cells in the lower esophagus become damaged. Over time, these cells are replaced by glandular cells, which are better able to stand up to the acid. This complication of GERD increases your risk of developing a form of adenocarcinoma. […] Being obese can contribute to GERD, because excess abdominal weight may push acid into the esophagus, which increases your risk of developing esophageal cancer. […] Infection with certain types of human papillomavirus, or HPV, a common sexually transmitted disease, can increase your chance of developing squamous cell cancer. […] People with achalasia have an increased long-term risk of developing esophageal cancer.
#15 What Causes Esophageal Cancer, Is It Hereditary & Risk Factors
https://www.cancercenter.com/cancer-types/esophageal-cancer/risk-factors
Gastroesophageal reflux disease (GERD)Stomach acid that seeps up into the esophagus is a strong risk factor for adenocarcinoma of the esophagus. […] Extra weight or obesityThis also appears to be a factor for adenocarcinoma of the esophagus, most likely because it increases the risk of esophageal reflux. […] A diet high in processed meatsSome evidence suggests that this kind of diet, with foods such as hot dogs, bacon or preserved lunch meats, may increase the risk of esophageal cancers. […] Some unavoidable risk factors for developing esophageal cancer include: AgeThe risk increases with age (esophageal cancer is rare in patients younger than 55). […] GenderMen are three to four times more likely to be diagnosed with this cancer than women. […] RaceWhite men are at higher risk for adenocarcinoma. Black men are at higher risk for squamous cell cancer.
#16 Etiology and Prevention of Esophageal Cancer
https://pmc.ncbi.nlm.nih.gov/articles/PMC5040887/
In many economically less-developed areas, such as Linxian in Northern China and Golestan in Northeastern Iran, dietary factors, including dietary carcinogens and insufficiencies of micronutrients, were found to be even more important risk factors than smoking and drinking. […] Consumption of beverages and food at high temperatures, which causes thermal damage to the esophageal epithelium, has been documented to increase the risk of ESCC. […] The etiology of GCA is strongly associated with gastroesophageal reflux. […] The major etiological factor in EAC is gastroesophageal reflux manifested as gastroesophageal reflux disease. […] The current clinical strategy involves regular endoscopic examinations and biopsy pathology. […] The trends toward declining incidence rates of ESCC, combined with the rapidly rising rates of EAC and GCA during the past several decades, strongly suggest that lifestyle and other environmental factors are the major etiological factors for esophageal and gastric cancers.
#17 Risk factors for esophageal cancer | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/esophageal/risks
Having overweight or obesity increases the risk of adenocarcinoma of the esophagus. […] People who drink very hot coffee, tea, mat and other beverages (hotter than 65C) have a higher risk of developing esophageal cancer, particularly squamous cell carcinoma. […] Tylosis is a rare inherited disease that increases the risk of developing esophageal cancer. […] Researchers think that achalasia increases the risk for SCC of the esophagus because the food trapped in the esophagus can cause chronic irritation. […] About 10% of people with Plummer-Vinson syndrome will develop SCC of the esophagus. Researchers think that this syndrome increases the risk for SCC of the esophagus because it causes nutritional problems, and the food trapped in the webs can cause chronic irritation. […] The esophagus can be damaged by exposure to chemicals. […] People who had cancer that started in the upper airway, such as oral, pharyngeal or laryngeal (voice box) cancer, are at risk for SCC of the esophagus. […] People who were exposed to ionizing radiation have a higher risk of developing esophageal cancer, mainly SCC of the esophagus.
#17 Risk factors for esophageal cancer | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/esophageal/risks
A risk factor is something that increases the risk of developing cancer. It could be a behaviour, substance or condition. Most cancers are the result of many risk factors. But sometimes esophageal cancer develops in people who dont have any of the risk factors described below. […] The most common types of esophageal cancer are adenocarcinoma and squamous cell carcinoma (SCC). Some risk factors are common to both types of esophageal cancer, but other risk factors are linked with only adenocarcinoma or SCC. […] Low socioeconomic status increases the risk of esophageal cancer, especially SCC. […] Barretts esophagus is the most common precancerous condition of the esophagus. It isnt cancer, but it can sometimes become esophageal cancer if it isnt treated. Some of the risk factors for esophageal cancer may also cause Barretts esophagus.
#18 Causes of oesophageal cancer | Macmillan Cancer Support
https://www.macmillan.org.uk/cancer-information-and-support/oesophageal-cancer/causes-and-risk-factors-of-oesophageal-cancer
Being overweight may increase your risk of developing oesophageal cancer. […] Oesophageal cancer is more common in men than women. […] Like most cancers, the risk of oesophageal cancer increases as you get older. […] Smoking increases the risk of oesophageal cancer. […] Research has also shown that chewing smokeless tobacco, such as betel quid, paan or gutkha, increases the risk of developing oesophageal cancer. […] Drinking a lot of alcohol over a long period of time increases your risk of developing oesophageal cancer. […] A diet that is high in pickled vegetables may increase your risk of developing oesophageal cancer. […] Previous radiotherapy to the chest, such as to treat lung or breast cancer, may increase your risk of developing oesophageal cancer. […] The following rare conditions can increase the risk of oesophageal cancer: Achalasia in this condition, the valve between the oesophagus and stomach does not relax properly, so food builds up in the lower oesophagus. […] Tylosis patients with this inherited skin condition are also at high risk of developing oesophageal cancer.
#19 Oesophageal cancer | World Cancer Research Fund
https://www.wcrf.org/preventing-cancer/cancer-types/oesophageal-cancer/
Infection with human papilloma virus (HPV) increases the risk of the squamous cell carcinoma type of oesophageal cancer. […] Oesophageal cancer affects twice as many men as women. This is likely because of smoking, alcohol and exposure to other risk factors rather than gender in and of itself. […] Older people are more at risk of developing oesophageal cancer. You are unlikely to develop oesophageal cancer if you are under 40. […] Our Expert Panel of scientists has also looked at other things that may be linked with the risk of oesophageal cancer. The evidence for the risk factors listed below is limited, and we do not recommend that you change your behaviour only on the basis of these risk factors. There is some evidence that: vegetables may decrease the risk of oesophageal cancer. […] fruit may decrease the risk of oesophageal squamous cell carcinoma. […] being physically active may decrease the risk of oesophageal cancer. […] processed meat may increase the risk of oesophageal squamous cell carcinoma.
#20 Esophageal Cancer – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK459267/
Esophageal adenocarcinoma in the US often arises from Barrett metaplasia, with risk factors including smoking, high body mass index, gastroesophageal reflux disease (GERD), and a diet low in fruits and vegetables. Alcohol intake is not associated with adenocarcinoma. Some studies have linked Barrett esophagus to epidermal growth factor polymorphisms as well as conditions that increase esophageal acid exposure, including Zollinger-Ellison syndrome, scleroderma, lower esophageal sphincter relaxing drugs, and bariatric procedures. Familial Barrett esophagus may be associated with rare autosomal inherited dominant susceptible alleles. Protective factors against Barrett esophagus and esophageal adenocarcinoma include a high-fiber diet, antioxidants, fruits and vegetables, folate, vitamin C, proton-pump inhibitors, and NSAIDs. However, none have been confirmed as preventative interventions.
#21 Esophageal Cancer – Symptoms, Causes, Complications & Prevention PACE Hospitals – Best Hospitals in Hitech City, Hyderabad, India | Near Madhapur, Kukatpally, KPHB, Kondapur, Gachibowli, Jubilee Hills, Banjara HillsPACE Hospitals Contact
https://www.pacehospital.com/esophageal-cancer-symptoms-causes-complications-and-prevention
Human papillomavirus […] Human papillomavirus (HPV) infection has been correlated with an increased incidence of squamous cell cancers of the upper oesophagus. […] Polycyclic aromatic hydrocarbons […] Polycyclic aromatic hydrocarbons have been carcinogens (cancer causing agents) for a long time which result from the incomplete combustion of organic substances. […] N-Nitroso compounds […] N-nitroso compounds (NNCs) are strong carcinogens inducing oesophageal cancer, and stomach cancers. […] Acetaldehyde […] Acetaldehyde exposure can be through various ways most notably by drinking alcohol. […] Fumonisins […] Toxins from a fungus that grows mostly on corn (Fusarium verticillioides). […] Gastroesophageal acid reflux […] Symptomatic gastroesophageal acid reflux disease (GERD) illness is one of the most important recognised risk factors for oesophageal cancer.
#22 Risks and causes of oesophageal cancer | Cancer Research UK
https://www.cancerresearchuk.org/about-cancer/oesophageal-cancer/causes-risks
Drinking alcohol increases your risk of squamous cell oesophageal cancer. The more you drink, the higher your risk of developing cancer. […] Barrett’s oesophagus increases your risk of oesophageal cancer, although the risk is still small. […] Gastro oesophageal reflux disease (GORD) increases your risk of developing oesophageal adenocarcinoma. The longer or more often you have symptoms, the higher your risk. […] Having achalasia can increase your risk of oesophageal cancer.
#23 Current Status and Future Prospects for Esophageal Cancer
https://www.mdpi.com/2072-6694/15/3/765
Mycotoxins are naturally occurring secondary metabolites of several toxigenic fungi which can grow on different foods. […] Symptomatic GERD is the strongest known risk factor for EAC and its precursor lesion Barrettâs esophagus. […] Studies on BMI and EC have consistently shown contrasting risk association patterns for ESCC and EAC subtypes. […] A meta-analysis of nine studies showed that patients with gastric atrophy have almost a two-fold increased risk for ESCC and no risk for EAC. […] Different indicators of poor oral health and oral hygiene, including tooth loss, an index of the sum of decayed, missing, and filled teeth (DMFT), and less frequent or no tooth brushing, have been linked to increased ESCC risk in high-risk regions. […] Although the studies on microbiome and EC are at their early stages, they indicate a potential role for the oral and esophageal microbiome in the risk of ESCC and EAC.
#24 Azthena logo with the word Azthena
https://www.news-medical.net/health/Causes-of-esophageal-cancer.aspx
The risk of adenocarcinoma among patients with Barrett metaplasia has been estimated to be 30-60 times higher than in general population. […] Achalasia is a disorder where the lower esophageal sphincter or muscle ring that partitions the stomach from esophagus remains tight and does not relax. […] Other risk factors include: Age – Those between the ages of 45 and 70 have the highest risk of esophageal cancer […] Poor diet that is low on fruits and vegetables and certain vitamins and minerals like vitamins A, C, B1 or zinc may also raise risk of esophageal cancers. […] Chemical pollutants exposure may also raise risk of esophageal cancer. […] Human papillomavirus (HPV) infection May be one of the risk factors. […] Having a risk factor doesn’t mean that a person will develop cancer of the esophagus. There are many who have one or more of these risk factors but do not develop esophageal cancer.
#25 North West Cancer Research | Oesophageal Cancer
https://nwcr.org/cancer-types/oesophageal-cancer/
Oesophageal cancer is often caused through obesity, with 1 in 4 men and 1 in 10 women diagnosed with the disease having their diagnosis linked to obesity. […] Smoking, excessive drinking and a diet lacking in fruit and vegetables are also preventable causes. […] However, age is also a major factor, whilst between 1 and 5 percent of people with Baretts oesophagus will develop the cancer.
#26 Esophageal Cancer – Symptoms, Causes, Complications & Prevention PACE Hospitals – Best Hospitals in Hitech City, Hyderabad, India | Near Madhapur, Kukatpally, KPHB, Kondapur, Gachibowli, Jubilee Hills, Banjara HillsPACE Hospitals Contact
https://www.pacehospital.com/esophageal-cancer-symptoms-causes-complications-and-prevention
Obesity […] Overweight (body mass index from 25 to < 30 Kg/m2) and obesity (body mass index of 30 Kg/m2 or higher) are associated with oesophageal cancer. [...] Hiatal Hernia [...] By increasing gastric acid reflux, hiatal hernia may raise oesophageal cancer risk. [...] Achalasia Cardia [...] Achalasia is an oesophageal motility condition marked by aperistalsis (devoid of peristaltic movement) in the distal esophagus and lack of lower oesophageal sphincter relaxation. [...] Gastric atrophy [...] Patients with gastric atrophy (thinning of the inner lining, gastric glands and mucosa of the stomach wall) are 3 times more likely to contract oesophageal cancer. [...] Poor oral hygiene and tooth loss: Poor oral health could potentially be a risk factor for oesophageal cancer. [...] Occupational exposure [...] Although not considered an occupational cancer, the risk of oesophageal cancer is 2-16 times higher with occupational exposure to asbestos. [...] Low socioeconomic status [...] Oesophageal cancer has long been known as a disease of the poor and the socially disadvantaged.
#27 Esophageal Cancer Risk Factors | Esophagus Cancer Risk | American Cancer Society
https://www.cancer.org/cancer/types/esophagus-cancer/causes-risks-prevention/risk-factors.html
People with excess weight or obesity have a higher chance of getting adenocarcinoma of the esophagus. […] Certain substances in the diet may increase esophageal cancer risk. […] People who engage in regular physical activity may have a lower risk of adenocarcinoma of the esophagus. […] People with achalasia have a risk of esophageal cancer that is many times normal. […] People with this condition also develop small growths (papillomas) in the esophagus and have a very high risk of getting squamous cell cancer of the esophagus. […] About 1 in 10 people with this syndrome eventually develop squamous cell cancer of the esophagus or cancer in the lower part of the throat (hypopharynx). […] People with these strictures have an increased risk of squamous cell esophageal cancer, which often occurs many years (even decades) later.
#28 Esophageal Cancer: Causes and Risk Factors
https://www.verywellhealth.com/esophageal-cancer-causes-and-risk-factors-514027
Genetics probably play a greater role in squamous cell carcinoma than adenocarcinoma, especially with regard to certain gene abnormalities that have been tied to the disease. […] One genetic syndrome, tylosis, is associated with a very high risk of esophageal squamous cell carcinoma. […] 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. […] Barrett’s esophagus is 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. […] Achalasia is associated with a high risk of esophageal cancer, with cancer often occurring 15 to 20 years after the diagnosis. […] Smoking is linked to the development of adenocarcinoma of the esophagus, but less so than squamous cell cancers. […] Some medications are associated with either an increased or decreased risk of adenocarcinoma of the esophagus.
#29 Esophageal Cancer: Symptoms, Causes & Treatment
https://my.clevelandclinic.org/health/diseases/6137-esophageal-cancer
Human papillomavirus (HPV): HPV is a common virus that can cause tissue changes in your vocal cords and mouth and on your hands, feet and genitals. […] History of cancer: People whove had cancer of the neck or head have a greater risk for esophageal cancer. […] Other disorders: Esophageal cancer is linked to some rare and/or inherited conditions. One is achalasia, an uncommon disease that makes it hard for you to swallow. Another disorder is tylosis, a rare, inherited disorder in which excess skin grows on the palms of your hands and the soles of your feet. […] Occupational exposure to certain chemicals: People exposed to dry cleaning solvents over a long time are at higher risk of developing esophageal cancer.
#30 Esophageal Cancer Risk Factors | Esophagus Cancer Risk | American Cancer Society
https://www.cancer.org/cancer/types/esophagus-cancer/causes-risks-prevention/risk-factors.html
People who have had certain other cancers, such as lung cancer, mouth cancer, and throat cancer have a high risk of getting squamous cell carcinoma of the esophagus as well. […] Signs of HPV infection have been found in up to one-third of esophagus cancers from people in parts of Asia and South Africa. But signs of HPV infection have not been found in esophagus cancers from people in the other areas, including the US. HPV is a rare cause of esophageal cancer.
#31 Family history of esophageal cancer increases the risk of esophageal squamous cell carcinoma | Scientific Reports
https://www.nature.com/articles/srep16038
A population-based case-control was performed to explore familial aggregation of esophageal squamous cell carcinoma (ESCC). […] We observed a close to doubled risk of ESCC associated with a positive family history of esophageal cancer among first degree relatives (odds ratio [OR]=1.85, 95% confidence interval [CI]: 1.42-2.41), after adjusting age, sex, family size and other confounders. […] The excess risks of ESCC increased with the increasing of first-degree relatives affected by esophageal cancer (p<0.001). [...] In particular, those individuals whose both parents with esophageal cancer had an 8-fold excess risk of ESCC (95%CI: 1.74-36.32). [...] Our results suggest family history of esophageal cancer significantly increases the risk for ESCC. [...] The first-degree relatives of the cases were more often reported to have been affected by esophageal cancer than those relatives of the controls (34.7% vs. 21.9%), which renders an OR of 1.85(95%CI: 1.42-2.41).
#32 Oesophageal Cancer | Causes, Symptoms & Treatments | Cancer Council
https://www.cancer.org.au/cancer-information/types-of-cancer/oesophageal-cancer
Oesophageal cancer is not common. Men are much more likely than women to be diagnosed with this cancer. […] Risk factors for oesophageal cancer include: smoking tobacco, alcohol consumption, diet low in fresh fruit and vegetables, obesity, exposure to certain chemical fumes, family history of gastrointestinal disorders, having an inherited genetic condition such as Cowden syndrome or Peutz-Jeghers syndrome (PJS), certain medical conditions such as Barrett’s oesophagus or gastro-intestinal reflux disease. […] Lifestyle factors such as poor nutrition and being overweight or obese, smoking tobacco and high alcohol consumption significantly increase the risk of oesophageal cancer.
#33 Causes of Esophagus Cancer | What Causes Esophageal Cancer? | American Cancer Society
https://www.cancer.org/cancer/types/esophagus-cancer/causes-risks-prevention/what-causes.html
We do not yet know exactly what causes most esophageal cancers. However, there are certain risk factors that make getting esophageal cancer more likely. […] Scientists believe that some risk factors, such as the use of tobacco or alcohol, may cause esophageal cancer by damaging the DNA in cells that line the inside of the esophagus. Long-term irritation of the lining of the esophagus, as happens with reflux, Barretts esophagus, achalasia, Plummer-Vinson syndrome, or scarring from swallowing lye, may also lead to DNA damage. […] Cancers can be caused by DNA mutations (changes) that turn on oncogenes or turn off tumor suppressor genes. This leads to cells growing out of control. Changes in many different genes are usually needed to cause esophageal cancer. […] The DNA of esophageal cancer cells often shows changes in many different genes. However, its not clear if there are specific gene changes that can be found in all (or most) esophageal cancers. […] A very small number of esophageal cancers are caused by inherited gene mutations. […] Certain risk factors, such as tobacco and alcohol use, probably play a role in causing these acquired mutations, but so far its not known what causes most of them.
#34 An Overview of Oesophageal Cancer – symptoms, treatment and alternative therapies | CANCERactive
https://www.canceractive.com/article/oesophagael-cancer-symptoms-treatment-and-therapies
Hereditary factors make some people more likely to develop polyps in their stomach, which may increase risk. […] Certain health disorders like pernicious anaemia, gastritis and other irritable stomach problems are often blamed. But the real issue is „Is there something underlying these various causes?” […] Bacteria from your mouth and from your stomach but not necessarily from your gut have been linked to this cancer. […] Research shows HPV is found at higher levels than normal in people with oesophageal squamous cell cancer (ESCC). […] Helicobacter pylori has lived in the bodies of humans for hundreds of thousands of years. […] When it comes to H. pylori and oesophageal cancer, many experts thought the two were linked. But now epidemiology studies suggest the opposite might be true. […] Antibiotics and drugs like Ramipril can also lower levels of Firmicutes in the body.
#35 Current Status and Future Prospects for Esophageal Cancer
https://www.mdpi.com/2072-6694/15/3/765
The IARC Monograph program has classified alcohol consumption as a cause of EC. […] While the IARC Monograph program has classified opium consumption as carcinogenic to humans, the evaluation in 2020 indicated that there was limited evidence on whether opium use can cause EC. […] In 2016, the IARC monograph program classified drinking very hot beverages, defined as â¥65 Â°C, as âprobably carcinogenic to humansâ (known as Group 2A). […] While incidence rates of ESCC are higher in low- and middle-income countries and the converse holds for EAC, in within-country analyses, low SES is associated with a 1.5 to 2-fold increased risk of both ESCC and EAC subtypes. […] The IARC monograph program has classified household combustion of biomass fuel as probably carcinogenic to humans. […] Drinking un-piped (untreated) water from different sources, including wells, cisterns, and rivers, has been linked to around a two-fold increase in ESCC risk in different regions.
#36 Esophageal cancer Information | Mount Sinai – New York
https://www.mountsinai.org/health-library/diseases-conditions/esophageal-cancer
Esophageal cancer is not common in the United States. It occurs most often in men over age 50 years. […] Squamous cell esophageal cancer is linked to smoking and drinking too much alcohol. […] Adenocarcinoma is the more common type of esophageal cancer. Having Barrett esophagus increases the risk for this type of cancer. Acid reflux disease (gastroesophageal reflux disease, or GERD) can develop into Barrett esophagus. Other risk factors include smoking, being male, or being obese. […] To reduce your risk of cancer of the esophagus: Do not smoke. Limit or do not drink alcoholic beverages. Get checked by your doctor if you have severe GERD. Get regular checkups if you have Barrett esophagus.
#37 Oesophageal Cancer | Symptoms, Diagnosis and Treatment
https://patient.info/cancer/oesophageal-cancer-leaflet
Oesophageal cancer is cancer of the gullet (oesophagus). […] The exact cause of cancerous cells is unclear. It is thought that something damages or alters certain genes in the cell. This makes the cell abnormal and multiply out of control. […] Many people develop cancer of the gullet (oesophagus) for no apparent reason. However, certain risk factors increase the chance that oesophageal cancer may develop. These include: […] Ageing. It is more common in older people. Most cases are in people over the age of 55. […] Being male. It is more common in men. […] Diet. A high-fat diet is thought to increase the risk and eating a lot of fruit and green vegetables is thought to reduce the risk. […] Obesity. Being obese can increase the risk. […] Where you live. Oesophageal cancer is much more common in China and certain other Far Eastern countries than in Europe.
#38 What Causes Esophageal Cancer, Is It Hereditary & Risk Factors
https://www.cancercenter.com/cancer-types/esophageal-cancer/risk-factors
Barretts esophagusThis disease is caused by long-term esophageal reflux. […] AchalasiaThis disease causes the opening of the esophagus into the stomach to malfunction. […] Plummer-Vinson syndromeThis disease causes obstructive webs to grow in the upper esophagus, leading to trapping of food. […] With esophageal cancer, several gene mutations have been identified that occur in all cells and may be passed down through families. […] These mutations cause only a small number of esophageal cancers, but the risk isnt avoidable. […] While its not possible to completely prevent esophageal cancer, there are ways to greatly reduce the risk. […] Avoid all forms of tobacco use (cigarettes, pipes, cigars, vapes, chewing tobacco). […] Avoid alcohol or use alcohol in moderation. […] Research shows that taking medications called nonsteroidal anti-inflammatory drugs (NSAIDs, including aspirin and ibuprofen) may reduce the risk of developing both squamous cell carcinoma and adenocarcinoma of the esophagus, according to the NCI.
#39 Esophageal Cancer: Symptoms, Causes, Diagnosis, Treatment
https://www.webmd.com/cancer/esophageal-cancer
You may be able to lower your risk of esophageal cancer by: Avoiding tobacco, Not drinking alcohol, or drinking less, Eating more fruits and vegetables, Maintaining a weight that’s healthy for you, Seeking treatment for reflux and heartburn, Avoiding solvents in the workplace, Avoiding HPV infection, by getting vaccinated if your doctor recommends it, Following your doctor’s advice for screening if you have Barrett’s esophagus.
#40 Establishing risk factors for oesophageal cancer to inform prevention | World Cancer Research Fund
https://www.wcrf.org/research-policy/our-research/grants-database/establishing-risk-factors-for-oesophageal-cancer-to-inform-prevention/
Is your risk of oesophageal cancer determined by what you eat and drink and how this differs by gender, geography, body weight, your alcohol intake and whether you smoke? […] Its estimated that about 70% of the oesophagus cancers could be prevented by improving lifestyle including nutrition and body size. […] According to the latest review of scientific evidence only smoking, alcohol consumption and obesity are known to cause one or both types of oesophagus cancer. […] This suggests that body fatness and diet might affect the risk of oesophagus cancer differently for men and women. […] The effect of food and drink on oesophageal cancer risk in east Africa […] This research funded by WKOF is looking at whether strong alcohol, heat damage from hot food and drinks, and a restricted diet increase oesophageal cancer risk. […] Piet van den Brandts research concluded that eating a Mediterranean diet may reduce the risk of lung, postmenopausal breast, oesophagus (squamous cell carcinoma in men), and stomach cancers.
#41 Risk factors for esophageal cancer | Canadian Cancer Society
https://cancer.ca/en/cancer-information/cancer-types/esophageal/risks
There is convincing evidence that the following factors increase your risk for esophageal cancer. […] Using any kind of tobacco has been linked to the development of esophageal cancer. Tobacco use combined with drinking alcohol increases the risk of developing esophageal cancer more than either risk factor alone. […] Smoking cigarettes causes both squamous cell carcinoma (SCC) and adenocarcinoma of the esophagus, but people who smoke are more likely to develop SCC. […] Drinking alcohol increases your risk for SCC of the esophagus. Drinking alcohol combined with using tobacco increases the risk of esophageal cancer more than either risk alone. […] Betel quid contains cancer-causing substances that increase the risk of developing SCC of the esophagus. […] Gastroesophageal reflux disease (GERD) increases the risk of Barretts esophagus, which increases the risk of developing adenocarcinoma of the esophagus.
#42 Esophageal Cancer: Practice Essentials, Background, Anatomy
https://emedicine.medscape.com/article/277930-overview
The risk factors and etiologic associations for SCC of the esophagus include the following: Smoking and alcohol use, Diet, Certain infections, Tylosis. […] The principal risk factors and etiologic associations for esophageal adenocarcinoma include the following: GERD, Obesity and metabolic syndrome. […] GERD is the most common predisposing factor for adenocarcinoma of the esophagus. Adenocarcinoma may represent the last event of a sequence that starts with irritation caused by the reflux of acid and bile and progresses to specialized intestinal (Barrett) metaplasia, low-grade dysplasia, high-grade dysplasia, and finally adenocarcinoma.
#43 Oesophageal Cancer | Symptoms, Diagnosis and Treatment
https://patient.info/cancer/oesophageal-cancer-leaflet
Smoking. […] Heavy drinking – especially spirits. […] Long-standing acid reflux from the stomach (gastro-oesophageal reflux disease (GORD)). […] Barrett’s oesophagus. This is a condition at the lower end of the oesophagus where the cells which line the oesophagus have become changed. […] Oesophageal cancer is not inherited so does not run in families. However, a family history of hiatal hernia appears to be a risk factor in developing oesophageal adenocarcinoma.
#44 Krebs – Oesophageal cancer
https://www.krebsdaten.de/Krebs/EN/Content/Cancer_sites/Oesophageal_cancer/oesophageal_cancer_node.html
Other important risk factors are excess weight and smoking. […] A motility disorder of the oesophagus and the sphincter muscle between the oesophagus and the stomach (achalasia) significantly increases the risk of both squamous cell carcinoma and adenocarcinoma. […] Familial clustering of oesophageal cancer has also been documented.