The cause of esophageal cancer varies depending on the type of cancer. Risk factors for squamous cell cancer are smoking and excessive alcohol consumption.
The risk of developing squamous cell esophageal cancer is approximately 150 times higher in those who consume 120 g or more of alcohol and 2 packs or more of cigarettes per day than those who do not use these substances.
Very hot eating and drinking habits, human papilloma virus (HPV) infection, achalasia (a benign esophageal disease with difficulty in swallowing), radiotherapy, Plummer-Vinson syndrome (narrowing of the upper end of the esophagus in iron deficiency anemia and causing difficulty in swallowing) Other factors suggested to be facilitating the development of esophageal cancer can be listed as; damage to the esophagus due to drinking caustic substances such as cedar or bleach, gluten allergy, vitamin A, riboflavin and zinc deficiency, excess nitrosamine in the diet.
Esophageal cancer risk factors are less well understood. Barrett’s esophagus, a complication of gastroesophageal reflux disease, is the best known risk factor for esophageal adenocarcinoma.
The condition known as Barrett’s esophagus or Barrett’s metaplasia is a serious and silent complication of gastroesophageal reflux disease. In this disease, the tissue lining the inner surface of the esophagus is replaced by the tissue lining the inner surface of the stomach or intestines.
In general, the incidence of Barrett’s metaplasia in people who underwent gastroscopy for complaints other than reflux is 0.5-1%, while this rate rises to 5-15% in those who undergo endoscopy due to reflux. In patients who develop stenosis in the esophagus, this rate may increase up to 50%.
Although Barrett’s esophagus can be seen at any age, its incidence increases after the age of 40. It is more common in western society and white race. The importance of Barrett’s esophagus is that it is a disease that can transform into cancer.
The incidence of cancer in the esophagus in patients with Barrett’s esophagus is around 0.5% per year, which means that the risk of developing esophageal cancer in patients with Barrett’s esophagus is 30 to 50 times higher than in the general population.
For this reason, patients with Barrett’s esophagus should be followed up by performing gastroscopy at regular intervals and taking tissue samples, and patients with early signs of cancer transformation should be treated with surgical treatment.
Does gastroesophageal reflux disease lead to esophageal cancer? Although studies show that the incidence of esophageal cancer increases slightly in the presence of gastroesophageal reflux disease, this increase is not so evident in moderate and mild reflux cases.
(0.002% in those without reflux complaints, 0.003%-0.018% in those with mild and moderate reflux, 0.035% in those with severe reflux).
Our current knowledge shows that there is a slight but insignificant increase in the incidence of esophageal cancer in reflux disease. This risk is significantly lower than the probability of developing serious complications (0.5-1.5%) that can be seen in surgical treatment.