Reflux, smoking, alcohol - Prevention of esophageal carcinomas must address these factors

In western industrialized countries, esophageal cancer is a rare entity. While smoking and alcohol are the major risk factors for squamous cell carcinoma, the most important etiological factor for adenocarcinoma is Barrett's esophagus caused by gastro-esophageal reflux. Over the past few decades there has been a dramatic increase in the incidence of adenocarcinoma. The prognosis for both types of esophageal cancer is poor, with a 5-year survival rate of <10%. Only early stages have a good prognosis. While prevention of squamous cell carcinoma is limited to avoiding drinking and smoking, prevention of adenocarcinoma requires endoscopic surveillance of Barrett's esophagus and the treatment of any dysplasia arising in it.