Aetiology

Aetiology of oesophageal cancer is multifactorial. It is thought to be caused by an interaction between environmental risk exposures, nucleotide polymorphisms of inflammatory and tumour growth promoting pathways (1).

Risk factors for oesophageal adenocarcinoma:

• two main risk factors
  • gastro-oesophageal reflux
  • obesity
• other risk factors
  • Barrett’s oesophagus
  • tobacco use
  • history of thoracic radiation
  • diet low in vegetables and fruits
  • increased age
  • male sex
  • medications that relax the lower oesophageal sphincter
  • familial history (rare)

Risk factors for oesophageal squamous cell carcinoma:

• two main risk factors
  • tobacco smoking
  • high alcohol consumption
• other risk factors
  • mutations of enzymes that metabolise alcohol
  • achalasia
  • caustic injury
  • history of thoracic radiation
  • low socioeconomic status
  • poor oral hygiene
  • nutritional defi ciencies
  • non-epidermolytic palmoplantar keratoderma (1,2)

Reference:

• (1) Lagergren J, Lagergren P. Oesophageal cancer. BMJ. 2010;341:c6280.
• (2) Pennathur A et al. Oesophageal carcinoma. Lancet. 2013;381(9864):400-12.