Esophageal cancer risk factors

Increased risk
There are a number of risk factors for esophageal cancer. Some subtypes of cancer are linked to particular risk factors:
 * Age. Most patients are over 60, and the median in US patients is 67.
 * Gender. It is more common in men.
 * Tobacco smoking and heavy alcohol use increase the risk, and together appear to increase the risk more than these two individually.
 * Swallowing lye or other caustic substances.
 * Particular dietary substances, such as nitrosamine.
 * A medical history of other head and neck cancers increases the chance of developing a second cancer in the head and neck area, including esophageal cancer.
 * Plummer-Vinson syndrome (anemia and esophageal webbing)
 * Tylosis and Howel-Evans syndrome (hereditary thickening of the skin of the palms and soles).
 * Radiation therapy for other conditions in the mediastinum.
 * Celiac disease predisposes towards squamous cell carcinoma.
 * Gastroesophageal reflux disease (GERD) and its resultant Barrett's esophagus increase esophageal cancer risk due to the chronic irritation of the mucosal lining (adenocarcinoma is more common in this condition, while all other risk factors predispose more for squamous cell carcinoma). Giving that obesity predisposes to reflux, there appears to be an increased risk of adenocarinoma in obesity.
 * According to one Italian study of "diet surveys completed by 5,500 Italians" — a study which has raised debates questioning its claims among cancer researchers cited in news reports about it — eating pizza more than once a week appears "to be a favorable indicator of risk for digestive tract neoplasms in this population."
 * Recent epidemiologic studies have found that obesity (measured as BMI) is another strong risk factor for esophageal adenocarcinoma.

Decreased risk

 * Risk appears to be less in patients using aspirin or related drugs (NSAIDs).
 * The role of Helicobacter pylori in progression to esophageal adenocarcinoma is still uncertain, but, on the basis of population data, it may carry a protective effect.  It is postulated that H. pylori prevents chronic gastritis, which is a risk factor for reflux, which in turn is a risk factor for esophageal adenocarcinoma.
 * According to the National Cancer Institute, "diets high in cruciferous (cabbage, broccoli, cauliflower) and green and yellow vegetables and fruits are associated with a decreased risk of esophageal cancer."