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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 8 in 10 oesophageal cancers (80%) develop in people aged 60 or over.

Being overweight or obese


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 (cancer of the foodpipe). It is linked to more than 1 in 4 oesophageal cancers in men and more than 1 in 10 in women. The more overweight you are the higher the risk.

Smoking or using tobacco


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. It is linked to two thirds of oesophageal cancers.

You also have an increased risk of oesophageal cancer if you

  • smoke a pipe
  • chew tobacco
  • use snuff
  • use betel quid (paan or pan)



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.



You should eat at least 5 portions of fresh fruit and vegetables every day.

Not eating enough fruit and vegetables may increase your risk of getting oesophageal cancer.

Barrett's oesophagus

Barrett's oesophagus increases your risk of oesophageal cancer, although the risk is still small.

Between 1 and 5 people out of 100 (1–5%) with Barrett’s oesophagus will develop oesophageal 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.

Medical conditions

Some other very rare conditions increase oesophageal cancer risk, including achalasia. This is a rare condition that means the valve between your oesophagus and stomach doesn't relax, allowing food and liquid to go back into the oesophagus.


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

  • breast cancer
  • lung cancer
  • oropharynx cancer
  • larynx cancer
  • Hodgkin lymphoma

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.

Reducing your risk

There are ways to reduce your risk of cancer.

Last reviewed: 
05 May 2016
  • 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

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