Both types of esophageal
Cancer more commonly affect men older than 60 years, but risk factors
for adenocarcinoma are different from those of squamous cell carcinoma.
Adenocarcinoma of the esophagus is most commonly seen within a segment of
Barrett esophagus, chronic peptic sores in the lower esophagus. This is an
acquired condition characterized by precancerous cells that replace the normal
cellular lining of the lowest portion of the esophagus. The condition occurs as
a complication of chronic reflux of gastric contents (GERD) into the lower
Squamous cell carcinoma occurs more commonly in people who heavily use tobacco
and alcohol or who have previously swallowed some caustic substance, for example
also more common in people who have been diagnosed with squamous cell cancer of
the head and neck.
Men are up to 5 times more likely than women to be diagnosed with esophageal
Among men, African Americans have the highest rate, more than 2.7 times greater
than the rate for non-Hispanic white men.
Incidence rates generally increase with age in all racial and ethnic groups.
Cancer of the esophagus is a common cancer in developing countries of
the world, where most tumors are squamous cell
Important risk factors in developing countries include the following:
In the developed world, adenocarcinoma is becoming almost as common as squamous
Reducing use of tobacco and alcohol can reduce the frequency of squamous cell
carcinoma of the esophagus. At least 90% of cases of this
Cancer in North America may be attributable to alcohol and tobacco.
Adenocarcinoma of the esophagus is a frequent complication in Barrett esophagus,
which may be found in up to 20% of people with symptoms of gastroesophageal
People with frequent symptoms of reflux (heartburn or regurgitation) should
undergo screening with endoscopy.
People with Barrett esophagus should have regular endoscopic tests to detect
precancerous changes of the esophageal lining.
They also require tight control of the symptoms of gastroesophageal reflux,
which may include dietary and lifestyle changes as well as
and possible surgery, to prevent progression of Barrett esophagus.
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