Risk Factors for Esophageal Cancer

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Last updated and reviewed on: August 13, 2026

Risk Factors for Esophageal Cancer

Anything that increases your chance of developing cancer is called a risk factor. Having one or more risk factors does not mean you will develop esophageal cancer. Some people who develop esophageal cancer have few or no known risk factors. Risk factors also differ between adenocarcinoma and squamous cell carcinoma.

THE BASICS: Major risk factors for esophageal adenocarcinoma include chronic GERD, Barrett's esophagus, excess body weight, tobacco use, older age, and being male. Major risk factors for squamous cell carcinoma include tobacco and heavy alcohol use. Certain medical and inherited conditions can also increase risk.

GERD and chronic acid reflux

GERD occurs when stomach acid repeatedly flows backward into the esophagus. Long-term GERD increases the risk of adenocarcinoma because repeated acid exposure can damage cells in the lower esophagus. Most people with GERD do not develop esophageal cancer.

Barrett's esophagus

Barrett's esophagus occurs when chronic reflux causes the cells lining the lower esophagus to change. Barrett's esophagus increases the risk of adenocarcinoma, particularly if abnormal precancerous cells called dysplasia develop.

Tobacco use

Smoking and other tobacco exposure increase the risk of esophageal cancer, particularly squamous cell carcinoma. The risk generally decreases after someone quits smoking.

Heavy alcohol use

Heavy alcohol consumption significantly increases the risk of squamous cell carcinoma. Using tobacco and drinking heavily together can increase risk even further.

Excess body weight

Being overweight or having obesity increases the risk of esophageal adenocarcinoma. One possible reason is that excess abdominal weight can increase pressure on the stomach and contribute to chronic reflux.

Age

The risk of esophageal cancer increases with age. Most cases occur in people older than 55.

Sex

Esophageal cancer occurs much more often in men than women.

Achalasia

Achalasia is a disorder in which the lower esophageal sphincter does not relax normally. Food and liquids can remain in the esophagus longer than they should, causing irritation over many years. People with achalasia have an increased risk of squamous cell carcinoma.

Previous injury to the esophagus

Severe injury and scarring of the esophagus, including injury caused by swallowing caustic substances, can increase cancer risk many years later.

Certain inherited conditions

Rare inherited conditions can increase the risk of esophageal cancer. One example is tylosis, an inherited disorder associated with a high risk of squamous cell carcinoma.

History of certain cancers

People who have had cancers of the mouth, throat, or lungs may have an increased risk of squamous cell carcinoma of the esophagus. These cancers share several risk factors, particularly tobacco and alcohol exposure.

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