Esophageal Cancer Prevention (PDQ®)

As a National Cancer Institute (NCI)-designated Comprehensive Cancer Center, a core part of our mission is to educate patients and the community about cancer. The following summary is trusted information from the 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, including:

  • Changing lifestyle or eating habits.
  • Avoiding things known to cause cancer.
  • Taking medicines to treat a precancerous condition or to keep cancer from starting.

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 layers of tissue, including mucous membrane, muscle, and connective tissue. Esophageal cancer starts in the inside lining of the esophagus and spreads outward through the other layers as it grows.The stomach and esophagus are part of the upper digestive system.

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

  • Squamous cell carcinoma: Cancer that begins in squamous cells, the thin, flat cells lining 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: Cancer that begins in glandular (secretory) cells. Glandular cells in the lining of the esophagus produce and release fluids such as mucus. Adenocarcinomas usually start in the lower part of the esophagus, near the stomach.

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

Esophageal cancer is found more often in men.

Men are about three times more likely than women to develop esophageal cancer. The chance of developing esophageal cancer increases with age. Squamous cell carcinoma of the esophagus is more common in blacks than in whites.

In the United States, the rates of adenocarcinoma of the esophagus have increased in the last 20 years. It is now more common than squamous cell carcinoma of the esophagus. The rates of squamous cell carcinoma of the esophagus are decreasing.

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, being overweight, and not getting enough exercise. Increasing protective factors such as quitting smoking, eating a healthy diet, 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 following risk factors may increase the risk of esophageal cancer:

Tobacco and alcohol use

Squamous cell carcinoma of the esophagus is strongly linked with all types of tobacco and alcohol use. Stopping smoking can help lower the risk of this type of cancer.

Gastric reflux and Barrett esophagus

Adenocarcinoma of the esophagus is strongly linked to gastroesophageal reflux disease (GERD). GERD is a condition in which the contents of the stomach back into the lower part of the esophagus. GERD may irritate the esophagus and, over time, cause Barrett esophagus. Barrett esophagus is a condition that affects the cells lining the lower part of the esophagus. These cells change or are replaced with abnormal cells, which can lead to adenocarcinoma 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 esophageal cancer:

Avoiding tobacco and alcohol use

Many studies have shown that the risk of esophageal cancer is lower in people who do not use tobacco and alcohol.

Diet

A diet high in green and yellow fruits and vegetables and cruciferous vegetables (such as cabbage, broccoli, and cauliflower) may lower the risk of squamous cell carcinoma of the esophagus.

Nonsteroidal anti-inflammatory drugs

Some studies have shown that the use of nonsteroidal anti-inflammatory drugs (NSAIDs) may lower the risk of esophageal cancer. NSAIDS include aspirin and other drugs that reduce swelling and pain. Use of NSAIDs, however, increases the risk of heart attack, heart failure, stroke, bleeding in the stomach and intestines, and kidney damage.

Radiofrequency ablation

Radiofrequency ablation is being studied in clinical trials for certain patients with Barrett esophagus. This procedure uses radio waves to heat and destroy abnormal cells, which may become cancer.

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.

Clinical trials are taking place in many parts of the country. Information about clinical trials can be found in the Clinical Trials section of the NCI Web site. Check NCI's list of cancer clinical trials for esophageal cancer prevention trials that are now accepting patients.



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