Who is most at risk for esophageal cancer?
Esophageal cancer is considered one of the most fatal problems that our digestive system may experience.
Because of thin muscular wall and adjacent to vital organs like lung and chest, the esophageal cancer spreads throughout the body in the early stages and make the treatment even harder.
Considering these characteristics of esophageal cancer, finding the one who is most at risk for esophageal cancer and check them frequently for the early stages of cancer, is the best way to find and treat this deadly cancer as soon as possible.
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What you will read next:
Esophageal cancer general considerations
Who is most at risk for esophageal cancer?
Gastric acid reflux and cancer
Achalasia and esophageal cancer
Vinson's Plummer Syndrome
Genital wart virus (HPV) and esophageal cancer
Esophageal cancer general considerations
like other parts of our body that may get different type of cancer, esophageal cancer also has various types with their own special risk factors and treatments.
For example, adenocarcinoma type has different causes than squamous cell carcinoma type (SCC), but we will address all risks for esophageal cancer generally.
Despite different types, all esophageal cancer’s manifestations resemble to each other and one cannot differentiate various types of esophageal cancers solely by their signs and symptoms.
The followings are main problems that esophageal cancer may cause:
- Any difficulty in swallowing, especially when taking big bite of meat or bread
- Bite in the throat
- Painful swallowing, especially if persistent.
- Changes in voice and speaking abilities
Who is most at risk for esophageal cancer?
In this article, the predisposing factors for esophageal cancer will be discussed in detail.
Risk factors are the same factors that if a person has one or more of them, he or she is more likely to develop esophageal cancer than a person who does not have a risk factor.
These risk factors include the following:
Age is a determining factor in increasing the risk of esophageal cancer, as only a small number of people with esophageal cancer are less than fifty-five years old.
Men are more likely than women to develop esophageal cancer
- Gastric acid reflux into the esophagus
The lower part of the esophagus, where it reaches stomach, is called lower esophageal sphincter or LES.
LES is responsible for maintaining enough muscle constriction in order to prevent stomach acid to enter esophagus.
When this function is impaired and the stomach acid enter esophagus, this condition is called gastro esophagus reflux disease or briefly GERD.
Esophagus in people with GERD is constantly exposed to direct contact with gastric acid and as time passes it will experience some kind of cellular changes called aplasia that is precursor for cancer.
Changes in cells of the lower esophagus over time can develop into a type of esophageal cancer called esophageal Adenocarcinoma.
People with GERD are slightly more likely to develop cancer than healthy people. People who have more GERD symptoms are more likely to develop cancer.
Symptoms of gastric reflux:
Symptoms of gastroesophageal reflux disease include the following:
- Heartburn
- Sputum and secretions that is felt in the throat that constantly make a person clear the throat
- Chronic cough
- Sore throat
Of course, it must be emphasized that every single one with GERD will not get esophageal cancer, but they will only have a higher chance of developing it.
In people who have had reflux for a long time, an especial complication called "Mary Bart" occurs.
Barrett's esophagus is a condition in which normal cells in the lower esophagus are replaced by abnormal cells that actually look like cells in the stomach and intestines.
These cells are more resistant than esophageal cells to the constant stimulation of stomach acid.
Over time, these cells become more and more abnormal, eventually leading to esophageal adenocarcinoma.
People with Barrett's esophagus have a higher risk of developing esophageal cancer
- Lack of physical activity:
Scheduled and regular physical activity will reduce the risk of developing esophageal cancers, so people who are more active during the day are less likely to develop esophageal cancer.
Perhaps the reason that obese people are more at risk for esophageal cancer is that prevalence of GERD is higher among overweight people.
Unhealthy diet is more common in overweight people and also obese people are less active than normal.
Drinking alcohol increases the risk of one of esophageal cancer types called Esophageal squamous cell or SCC
Tobacco users in any form, including cigarettes, pipes, chewing tobacco, etc., have a high risk of developing esophageal cancer of both types; esophageal adenocarcinoma and SCC.
It is interesting to know that people who smoke at least one pack of cigarettes a day will be twice as likely as non-smokers in the community to develop esophageal cancer.
If these people also stop smoking, their risk of developing esophageal adenocarcinoma will not be reduced, but smoke cessation will reduce their risk of developing SCC.
Obviously, the risk of developing esophageal cancers will be directly related to the duration of tobacco use
There is problem at the junction of esophagus with stomach where special muscle called lower esophagus sphincter or LES lies.
LES responsible for blockage of stomach acid from getting into esophagus. It becomes relax with every single swallowing and when swallowing process finishes become contracted.
In achalasia LES relaxation is impaired therefore food retains in the esophagus and would not enter stomach.
The muscles of the lower esophagus are contracted in people with achalasia, and the so-called gastric entrance narrows and swallowed food stays in the end of the esophagus for a long time.
Cells at the end of the esophagus undergo changes due to their direct and prolonged contact with food, which sometimes leads to esophageal cancer.
- Vinson's Plummer Syndrome
People with this syndrome have rings in the lower part of their esophagus that make it difficult to swallow when eating large pieces of meat and bread, in addition to difficulty swallowing (dysphagia); they also have iron deficiency anemia.
These people are more likely to develop esophageal cancer than the general population
It is an inherited and rare disease in which people are at high risk for esophageal cancer and should be checked regularly with early initiation of esophageal endoscopy.
People with Tylosis have extra thickening of skin at the palms and soles of the feet.
The risk of esophageal cancer among these group will reach up to 60 percent.
- Chemical damage to the esophagus:
Industrial substances, such as alkaline compounds in the soap industry, can cause abnormal changes in the esophagus.
In addition, people who for any reason mistakenly eat alkaline cleansing compounds such as bleach experience structural changes and narrowing of the esophagus.
One-third of people who have esophageal cancer in the Asia and Africa have the herpes papilloma virus or HPV. It is true that this virus is responsible for majority of warts around private parts but they also can cause other problems like esophagus cancer.
In developed American and European countries, the virus causes very few esophageal cancers.