The exact causes of cancer of the esophagus are not known. However, studies show that any of the following factors can increase the risk of developing esophageal cancer:

• Age. Esophageal cancer is more likely to occur as people get older; most people who develop esophageal cancer are over age 60.

• Sex. Cancer of the esophagus is more common in men than in women.

• Tobacco Use. Smoking cigarettes or using smokeless tobacco is one of the major risk factors for esophageal cancer.

• Alcohol Use. Chronic and/or heavy use of alcohol is another major risk factor for esophageal cancer. People who use both alcohol and tobacco have an especially high risk of esophageal cancer. Scientists believe that these substances increase each other's harmful effects.

• Barrett's Esophagus. Long-term irritation can increase the risk of esophageal cancer. Tissues at the bottom of the esophagus can become irritated if stomach acid frequently "backs up" into the esophagus -- a problem called gastric reflux. Over time, cells in the irritated part of the esophagus may change and begin to resemble the cells that line the stomach. This condition, known as Barrett esophagus, is a premalignant condition that may develop into adenocarcinoma of the esophagus.

• Other Types of Irritation. Other causes of significant irritation or damage to the lining of the esophagus, such as swallowing lye or other caustic substances, can increase the risk of developing esophageal cancer.

• Medical History. Patients who have had other head and neck cancers have an increased chance of developing a second cancer in the head and neck area, including esophageal cancer.

Having any of these risk factors increases the likelihood that a person will develop esophageal cancer. Still, most people with one or even several of these factors do not get the disease. And most people who do get esophageal cancer have none of the known risk factors.

Identifying factors that increase a person's chances of developing esophageal cancer is the first step toward preventing the disease. We already know that the best ways to prevent this type of cancer are to quit (or never start) smoking cigarettes or using smokeless tobacco and to drink alcohol only in moderation. Researchers continue to study the causes of esophageal cancer and to search for other ways to prevent it. For example, they are exploring the possibility that increasing one's intake of fruits and vegetables, especially raw ones, may reduce the risk of this disease.

Researchers are also studying ways to reduce the risk of esophageal cancer for people with Barrett's esophagus.

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