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Cancer Explained
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Esophageal Cancer Risk Factors

A plain-language explanation of what raises the risk of esophageal cancer, including tobacco, alcohol, and chronic acid reflux. Based on the National Cancer Institute.

NCI source

Last reviewed: 2026-07-07

The short answer

Esophageal cancer risk is higher for people who smoke or use tobacco, drink heavily, or have long-term acid reflux and Barrett's esophagus. Obesity and older age also raise risk. The main risk factors differ between the two types of esophageal cancer.

  • Tobacco use and heavy alcohol use raise the risk of esophageal cancer.

  • Long-term acid reflux and Barrett's esophagus raise the risk of adenocarcinoma.

  • Obesity is linked to a higher risk of adenocarcinoma.

  • Risk rises with age, and men are affected more often than women.

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The full explanation.

The simple version

A risk factor is anything that raises the chance of developing a disease. Esophageal cancer has several known risk factors, some tied to habits like smoking and drinking, and some tied to long-term acid reflux. Having risk factors does not mean you will get cancer.

Habits that raise risk

Tobacco use and heavy alcohol use both raise the risk of esophageal cancer, especially the squamous cell type. Using tobacco and alcohol together raises risk more than either one alone.

Tobacco and heavy alcohol use are major, changeable risk factors.

Reflux, Barrett's, and weight

Long-term acid reflux can lead to Barrett's esophagus, which raises the risk of adenocarcinoma. Obesity is also linked to adenocarcinoma, partly because it can worsen reflux. Managing reflux and weight may help lower this risk.

Factors you cannot change

Risk rises with age, and men develop esophageal cancer more often than women. The main risk factors differ between the two types: squamous cell carcinoma is linked more to tobacco and alcohol, while adenocarcinoma is linked more to reflux, Barrett's esophagus, and obesity.

Words to know

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Common questions

What are the main risk factors?

The main risk factors include tobacco use, heavy alcohol use, long-term acid reflux with Barrett's esophagus, obesity, and older age. Men are affected more often than women.

How do tobacco and alcohol affect risk?

Both tobacco and heavy alcohol use raise the risk of esophageal cancer, especially the squamous cell type. Using both together raises risk more than either alone.

How does acid reflux raise risk?

Long-term acid reflux can lead to Barrett's esophagus, a change in the lower esophagus lining that raises the risk of adenocarcinoma.

Does weight matter?

Yes. Obesity is linked to a higher risk of esophageal adenocarcinoma, partly because it can worsen acid reflux.

Can I lower my risk?

You cannot change your age or sex, but not using tobacco, limiting alcohol, managing acid reflux, and keeping a healthy weight may help lower risk.

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Quick quiz

Test your knowledge

0 of 4 answered

  1. Q1.Which habits raise esophageal cancer risk?
  2. Q2.What does long-term acid reflux raise the risk of?
  3. Q3.Which is linked to esophageal adenocarcinoma?
  4. Q4.Can risk be lowered?

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Related learning map

How this explanation connects to 11 other things you can explore — related topics, terms, questions, practice, and its NCI source.

Esophageal Cancer Risk Factors