Risks and causes

Your risk of developing oesophageal cancer depends on many things including your age, lifestyle and other medical conditions.

Anything that can increase your risk of cancer is called a risk factor. Those that lower the risk are called protective factors.

Having one or more risk factors doesn’t mean that you will definitely get oesophageal cancer.


Cancer of the oesophagus is more common in older people. Around 40 out of 100 oesophageal cancers (around 40%) develop in people aged 75 and over.

Being overweight or obese

Photograph about Bodyweight

Obesity means being very overweight with a body mass index (BMI) of 30 or higher.

Try to maintain a healthy weight by being active and eating a healthy diet.

Being overweight or obese increases your risk of getting oesophageal cancer. More than 25 out of 100 oesophageal cancers (more than 25%) in the UK are caused by being overweight or obese. The more overweight you are the higher your risk.

Smoking or using tobacco

Photograph of Smoking

Your risk increases the longer you smoke. It's never too late to give up but the sooner you stop, the better.

Smoking increases your risk of the 2 main types of oesophageal cancer – squamous cell cancer and adenocarcinoma. Around 35 out of 100 oesophageal cancer cases (around 35%) in the UK are caused by smoking.

Smoking and drinking together further increases the risk of some oesophageal cancers more than either by itself.

You also have an increased risk of oesophageal cancer if you

  • chew tobacco
  • chew areca nut
  • use snuff
  • use betel quid (paan or pan)


Photograph of Alcohol

Your risk increases if you drink more than 14 units of alcohol a week. The less you drink, the lower your risk of developing cancer.

Drinking alcohol increases your risk of squamous cell oesophageal cancer.

Your risk is higher if you drink and smoke but your risk reduces after you stop smoking or drinking.

Barrett's oesophagus

Barrett's oesophagus increases your risk of oesophageal cancer, although the risk is still small. Many people with Barrett’s oesophagus do not develop cancer.

Barrett's oesophagus is a condition where the cells lining your oesophagus have become abnormal. This can happen due to long term acid indigestion (acid reflux). Not everyone with Barrett's oesophagus has reflux.

Between 3 and 13 people out of 100 (between 3 and 13%) with Barrett’s oesophagus in the UK will develop oesophageal adenocarcinoma in their lifetime. And each year, less than 1 in 100 people with Barrett’s (less than 1%) develop oesophageal adenocarcinoma. Your risk of developing oesophageal cancer is higher if you have more severe cell changes (high grade dysplasia). 

Your risk is also affected by how long the area of Barrett’s is. People with longer areas of Barrett’s have a higher risk than people with shorter areas.

Medical conditions

Gastro - oesophageal reflux disease (GORD) increases your risk of developing oesophageal adenocarcinoma. The longer you’ve had symptoms, the higher your risk.

GORD is a common condition where stomach acid flows back into the oesophagus from the stomach. This is called acid reflux. Symptoms include chronic heartburn and indigestion.


Radiotherapy for other cancers slightly increases your risk of oesophageal cancer, including:

  • breast cancer
  • lung cancer
  • oropharyngeal cancer
  • laryngeal cancer

Your risk of getting oesophageal cancer is still small. You would be at a higher risk from your existing cancer if you didn't have the radiotherapy your doctor recommends.

Very hot drinks

Your risk of developing oesophageal cancer is increased if you drink tea, coffee or other drinks at hot temperatures.

Reducing your risk

There are ways to reduce your risk of cancer.

  • Gastroesophageal reflux in relation to adenocarcinomas of the esophagus: a pooled analysis from the Barrett's and Esophageal Adenocarcinoma Consortium (BEACON)
    MB Cook, DA Corley, LJ Murray and others
    PLoS One 2014 Jul;9(7):e103508

  • A prospective study of tobacco, alcohol, and the risk of esophageal and gastric cancer subtypes
    ND Freedman, CC Abnet, MF Leitzmann, T Mouw, AF Subar, AR Hollenbeck, A Schatzkin
    Am J Epidemiol. 2007 Jun 15;165(12):1424–33

  • The cancer burden in the United Kingdom in 2007 due to radiotherapy
    J Maddams, DM Parkin, SC Darby
    Int J Cancer 2011;129(12):288–593

  • Second primary cancers after adjuvant radiotherapy in early breast cancer patients: a national population based study under the Danish Breast Cancer Cooperative Group (DBCG)
    Roychoudhuri, T Grantzau, L Mellemkjær, J Overgaard
    Radiother Oncol 2013;106(1):42–9

  • The fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010
    DM Parkin, L Boyd, LC Walker
    Br J Cancer 2011;105(S2):S77–S81

  • Meta-analysis: the association of oesophageal adenocarcinoma with symptoms of gastro-oesophageal reflux
    AP Thrift, JR Kramer, Z Qureshi, PA Richardson, HB El-Serag
    Am J Gastroenterol 2013;108(6):91–522

  • The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. Please contact patientinformation@cancer.org.uk with details of the particular issue you are interested in if you need additional references for this information.

Last reviewed: 
29 Nov 2019

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