Certain diseases and conditions may increase a person’s chances of developing esophageal cancer.
A person with long-standing gastroesophageal reflux disease (GERD) runs a high risk of getting the malignancy. GERD is a condition where acid manages to escape from the stomach and enter the esophagus. This may cause heartburn, whereby an individual feels a burning sensation coming from the middle of the chest.
Acid that escapes into the esophagus from the stomach may cause damage to the mucosa of esophagus, especially in the lower third. When squalors cells in the esophagus are replaced by abnormal glandular cells that are more resistant to such acid, a condition known as Barrett’s esophagus occurs. Individuals with Barrett’s esophagus are at a particularly high risk of developing esophageal cancer, especially the adenocarcinoma type. For this reason, patients have Barrett’s esophagus should be monitored closely by their doctors. It should be noted, however, that most people with Barrett’s esophagus do not actually develop esophageal cancer. It has been estimated by researchers that only 1% of those with Barrett’s esophagus will develop the disease.
The abnormal cells found in individuals with Barrett’s esophagus may cause the pre-cancerous condition known as dysplasia. A person with Barrett’s esophagus who develops dysplasia may have as much as 50 times the likelihood of developing adenocarcinoma of esophagus, compared to people who do not have dysplasia.
Achalasia is a condition where the lower esophageal sphincter is not able to relax properly. When this occurs, food and liquids cannot pass into the stomach. The condition is most probably caused by a defect of nerve cells in the lower esophagus. This defect prevents the nerve from relaxing, which in turn makes it difficult for an individual to swallow. Approximately 6% of achalasia patients develop esophageal cancer of the squamous cell type. Researchers have not yet determined with certainty why this occurs.
Another disease that increases the risk of esophageal cancer is tylosis. This is an inherited condition. It results in excessive growth of the top skin layers on the palms and the soles. Experts believe that this occurs due to a mutation of a gene on chromosome 17. This mutation could also be the cause of other cancers of the esophagus. Individuals with tylosis have a 40% risk of developing esophageal cancer in their life time. As such, they should undergo early and regular monitoring. An upper endoscopy is the normally recommended procedure for such monitoring.
Esophageal webs are also related to esophageal cancer. These are abnormal tissue protrusions into the esophagus, which can interfere with swallowing. They may be found sometimes in individuals with anemia. Esophageal webs may likewise be found in people who have abnormalities in certain organs such as the fingernails, the spleen, and the tongue. When these abnormalities are found in combination, it is often called the Plummer-Vinson syndrome. It is also referred to sometimes as the Paterson-Kelly syndrome. A tenth of patients with this syndrome develop esophageal cancer of the squamous cell type.
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Reviewed by:
Jiade J. Lu, M.D.
Diplomate, American Board of Radiology (Radiation Oncology)
Medical Director
The Cancer Information Network
Date Modified: 05/31/04
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