When you get a diagnosis of cancer, it's natural to wonder what may have caused the disease. Doctors can seldom explain why one person develops esophageal cancer and another doesn't. However, we do know that people with certain risk factors are more likely than others to develop esophageal cancer. A risk factor is something that may increase the chance of getting a disease.

Studies have found the following risk factors for esophageal cancer:

• Age 65 or older: Age is the main risk factor for esophageal cancer. The chance of getting this disease goes up as you get older. In the United States, most people are 65 years of age or older when they are diagnosed with esophageal cancer.
  
  
• Being male: In the United States, men are more than three times as likely as women to develop esophageal cancer.
  
  
• Smoking: People who smoke are more likely than people who don't smoke to develop esophageal cancer.
  
  
• Heavy drinking: People who have more than 3 alcoholic drinks each day are more likely than people who don't drink to develop squamous cell carcinoma of the esophagus. Heavy drinkers who smoke are at a much higher risk than heavy drinkers who don't smoke. In other words, these two factors act together to increase the risk even more.
  
  
• Diet: Studies suggest that having a diet that's low in fruits and vegetables may increase the risk of esophageal cancer. However, results from diet studies don't always agree, and more research is needed to better understand how diet affects the risk of developing esophageal cancer.
  
  
• Obesity: Being obese increases the risk of adenocarcinoma of the esophagus.
  
  
• Acid reflux: Acid reflux is the abnormal backward flow of stomach acid into the esophagus. Reflux is very common. A symptom of reflux is heartburn, but some people don't have symptoms. The stomach acid can damage the tissue of the esophagus. After many years of reflux, this tissue damage may lead to adenocarcinoma of the esophagus in some people.
  
  
• Barrett esophagus: Acid reflux may damage the esophagus and over time cause a condition known as Barrett esophagus. The cells in the lower part of the esophagus are abnormal. Most people who have Barrett esophagus don't know it. The presence of Barrett esophagus increases the risk of adenocarcinoma of the esophagus. It's a greater risk factor than acid reflux alone.

Many other possible risk factors (such as smokeless tobacco) have been studied. Researchers continue to study these possible risk factors.

Having a risk factor doesn't mean that a person will develop cancer of the esophagus. Most people who have risk factors never develop esophageal cancer.

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