Esophageal Cancer Prevention (PDQ®): Prevention - Patient Information [NCI]

What Is Prevention?

Cancer prevention is action taken to lower the chance of getting cancer. By preventing cancer, the number of new cases of cancer in a group or population is lowered. Hopefully, this will lower the number of deaths caused by cancer.

To prevent new cancers from starting, scientists look at risk factors and protective factors. Anything that increases your chance of developing cancer is called a cancer risk factor; anything that decreases your chance of developing cancer is called a cancer protective factor.

Some risk factors for cancer can be avoided, but many cannot. For example, both smoking and inheriting certain genes are risk factors for some types of cancer, but only smoking can be avoided. Regular exercise and a healthy diet may be protective factors for some types of cancer. Avoiding risk factors and increasing protective factors may lower your risk but it does not mean that you will not get cancer.

Different ways to prevent cancer are being studied.

General Information About Esophageal Cancer

Esophageal cancer is a disease in which malignant (cancer) cells form in the tissues of the esophagus.

The esophagus is the hollow, muscular tube that moves food and liquid from the throat to the stomach. The wall of the esophagus is made up of several tissue layers, including mucous membrane (inner lining), muscle, and connective tissue. Esophageal cancer starts in the inner lining of the esophagus and spreads outward through the other layers as it grows.
The esophagus and stomach are part of the upper gastrointestinal (digestive) system.

The two most common types of esophageal cancer are named for the type of cells that become cancerous:

• Squamous cell carcinoma: This type of cancer forms in the thin, flat cells lining the inside of the esophagus. This cancer is most often found in the upper and middle part of the esophagus but can occur anywhere along the esophagus. This is also called epidermoid carcinoma.
• Adenocarcinoma: This type of cancer begins in glandular cells. Glandular cells in the lining of the esophagus produce and release fluids such as mucus. Adenocarcinoma usually starts in the lower part of the esophagus, near the stomach.

See the following PDQ summaries for more information about esophageal cancer:

• Esophageal Cancer Screening
• Esophageal Cancer Treatment

Esophageal cancer is found more often in men.

Rates of esophageal cancer cases and deaths have decreased slightly over recent years. Men are about four times more likely than women to develop esophageal cancer, and the chance of people developing it increases with age. White men are more likely to develop esophageal cancer and have higher death rates from it than Black men across all age groups. Before age 69 years, Black women are more likely to develop esophageal cancer and have higher death rates from it than White women. After age 69 years, the likelihood of developing esophageal cancer and dying of it are higher among White women than Black women.

In the United States, rates of adenocarcinoma of the esophagus rose rapidly through the 1990s, overtaking rates of squamous cell carcinoma. Although the rates of squamous cell carcinoma are declining overall, they remain much higher among Black men than White men, while adenocarcinoma rates are higher among White men.

Esophageal Cancer Prevention

Avoiding risk factors and increasing protective factors may help prevent cancer.

Avoiding cancer risk factors may help prevent certain cancers. Risk factors include smoking, having overweight, and not getting enough exercise. Increasing protective factors such as quitting smoking and exercising may also help prevent some cancers. Talk to your doctor or other health care professional about how you might lower your risk of cancer.

The risk factors and protective factors for squamous cell carcinoma of the esophagus and adenocarcinoma of the esophagus are not the same.

The following risk factors increase the risk of squamous cell carcinoma of the esophagus:

Smoking and alcohol use

Studies have shown that the risk of squamous cell carcinoma of the esophagus is increased in people who smoke or drink a lot.

The following protective factors may decrease the risk of squamous cell carcinoma of the esophagus:

Avoiding tobacco and alcohol use

Studies have shown that the risk of squamous cell carcinoma of the esophagus is lower in people who do not use tobacco and alcohol.

Chemoprevention with nonsteroidal anti-inflammatory drugs

Chemoprevention is the use of drugs, vitamins, or other agents to try to reduce the risk of cancer. Nonsteroidal anti-inflammatory drugs (NSAIDs) include aspirin and other drugs that reduce swelling and pain.

Some studies have shown that the use of NSAIDs may lower the risk of squamous cell carcinoma of the esophagus. However, the use of NSAIDs increases the risk of heart attack, heart failure, stroke, bleeding in the stomach and intestines, and kidney damage.

The following risk factors increase the risk of adenocarcinoma of the esophagus:

Gastric reflux

Adenocarcinoma of the esophagus is strongly linked to gastroesophageal reflux disease (GERD), especially when the GERD lasts a long time and severe symptoms occur daily. GERD is a condition in which the contents of the stomach, including stomach acid, flow up into the lower part of the esophagus. This irritates the inside of the esophagus, and over time, may affect the cells lining the lower part of the esophagus. This condition is called Barrett esophagus. Over time, the affected cells are replaced with abnormal cells, which may later become adenocarcinoma of the esophagus. Obesity in combination with GERD may further increase the risk of adenocarcinoma of the esophagus.

The use of medicines that relax the lower sphincter muscle of the esophagus may increase the likelihood of developing GERD. When the lower sphincter muscle is relaxed, stomach acid may flow up into the lower part of the esophagus.

It is not known if surgery or other medical treatment to stop gastric reflux lowers the risk of adenocarcinoma of the esophagus. Clinical trials are being done to see if surgery or medical treatments can prevent Barrett esophagus.

The following protective factors may decrease the risk of adenocarcinoma of the esophagus.

Chemoprevention with nonsteroidal anti-inflammatory drugs

Chemoprevention is the use of drugs, vitamins, or other agents to try to reduce the risk of cancer. Nonsteroidal anti-inflammatory drugs (NSAIDs) include aspirin and other drugs that reduce swelling and pain.

Some studies have shown that the use of NSAIDs may lower the risk of adenocarcinoma of the esophagus. However, the use of NSAIDs increases the risk of heart attack, heart failure, stroke, bleeding in the stomach and intestines, and kidney damage.

Radiofrequency ablation of the esophagus

Patients with Barrett esophagus who have abnormal cells in the lower esophagus may be treated with radiofrequency ablation. This procedure uses radio waves to heat and destroy abnormal cells, which may become cancer. Risks of using radiofrequency ablation include narrowing of the esophagus and bleeding in the esophagus, stomach, or intestines.

One study of patients who have Barrett esophagus and abnormal cells in the esophagus compared patients who received radiofrequency ablation with patients who did not. Patients who received radiofrequency ablation were less likely to be diagnosed with esophageal cancer. More study is needed in order to know whether radiofrequency ablation decreases the risk of adenocarcinoma of the esophagus in patients with these conditions.

Cancer prevention clinical trials are used to study ways to prevent cancer.

Cancer prevention clinical trials are used to study ways to lower the risk of certain types of cancer. Some cancer prevention trials are conducted with healthy people who have not had cancer but who have an increased risk for cancer. Other prevention trials are conducted with people who have had cancer and are trying to prevent another cancer of the same type or to lower their chance of developing a new type of cancer. Other trials are done with healthy volunteers who are not known to have any risk factors for cancer.

The purpose of some cancer prevention clinical trials is to find out whether actions people take can prevent cancer. These may include eating fruits and vegetables, exercising, quitting smoking, or taking certain medicines, vitamins, minerals, or food supplements.

New ways to prevent esophageal cancer are being studied in clinical trials.

Information about clinical trials supported by NCI can be found on NCI's clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.

About This PDQ Summary

About PDQ

Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.

PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government's center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.

Purpose of This Summary

This PDQ cancer information summary has current information about esophageal cancer prevention. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.

Reviewers and Updates

Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.

The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Screening and Prevention Editorial Board.

Clinical Trial Information

A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

Clinical trials can be found online at NCI's website. For more information, call the Cancer Information Service (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).

Permission to Use This Summary

PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as "NCI's PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary]."

The best way to cite this PDQ summary is:

PDQ® Screening and Prevention Editorial Board. PDQ Esophageal Cancer Prevention. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: https://www.cancer.gov/types/esophageal/patient/esophageal-prevention-pdq. Accessed <MM/DD/YYYY>. [PMID: 26389280]

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Disclaimer

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Last Revised: 2024-05-24

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If you want to know more about cancer and how it is treated, or if you wish to know about clinical trials for your type of cancer, you can call the NCI's Cancer Information Service at 1-800-422-6237, toll free. A trained information specialist can talk with you and answer your questions.

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