Epidemiology
- Adenocarcinoma: most common type of esophageal cancer in the US (67%)
- Squamous cell carcinoma (SCC): most common type of esophageal cancer worldwide (90%)
Etiology
Adenocarcinoma
- Exogenous risk factors
- Smoking (twofold risk)
- Obesity
- Endogenous risk factors
- Male sex
- Older age (50–60 years)
- Gastroesophageal reflux
- Barrett esophagus
- Localization: mostly in the lower third of the esophagus
Tip
The most important risk factors for esophageal adenocarcinoma are gastroesophageal reflux and associated Barrett esophagus.
Squamous cell carcinoma (SCC)
- Exogenous risk factors
- Alcohol consumption
- Smoking (ninefold risk)
- Diet low in fruits and vegetables
- Hot beverages
- Nitrosamines exposure (e.g., cured meat, fish, bacon)
- Endogenous risk factors
- Plummer-Vinson syndrome
- Achalasia
- Localization: mostly in the upper two-thirds of the esophagus
Tip
The primary risk factors for squamous cell esophageal cancer are alcohol consumption, smoking, and dietary factors (e.g., diet low in fruits and vegetables).