What is oesophageal cancer?
Oesophageal cancer is a malignant tumour found in the tissues of the oesophagus. The cancer starts in the mucosa and as the tumour grows deeper into the oesophageal wall the risk that it might spread to other parts of the body increases.
This cancer can be found anywhere in the oesophagus. In western countries such as Australia oesophageal cancer is most commonly found in the lower section of the oesophagus and where the oesophagus meets the stomach (gastro-oesophageal junction).
Topics on this page:
- The oesophagus and digestive system
- Types of oesophageal cancer
- What are the risk factors?
- Who gets oesophageal cancer?
The oesophagus and digestive system
The oesophagus is part of the upper gastrointestinal (GI) tract and the digestive system. It is a long tube that delivers food, fluids and saliva from the mouth and throat to the stomach.
The different layers of tissue (known as the wall) in the oesophagus include:
- mucosa – the moist innermost layer, which helps move food in the oesophagus
- submucosa – supports the mucosa and gives it blood to survive and take away any of the nutrients
- muscle layer (muscularis) – pushes food down the oesophagus
- outer layer (serosa) – It does not exist around the oesophagus.
Types of oesophageal cancer
Oesophageal cancer can occur in different types of cells that exist in the oesophagus. The main types include:
- Squamous cell carcinoma – begins in the cells lining the oesophagus (mucosa), which are called squamous cells. This type of cancer is more common in the middle and upper part of the oesophagus and is more common in Asia, although it is still diagnosed in Australia.
- Adenocarcinoma – begins in the glandular tissue of the mucosa, which is found in the lower part of the oesophagus.
If oesophageal cancer is not found and treated early, it can grow through the wall into nearby structures. Oesophageal cancers can also spread into the lymphatic system to nearby lymph nodes and through the bloodstream to other parts of the body, most commonly the liver. It can also invade the windpipe, lungs and the lining around the heart.
What are the risk factors?
The exact causes of oesophageal cancers are unknown, but some factors may increase your risk.
Having one or more of these risk factors does not mean you will develop oesophageal cancer. See your doctor if you are concerned about your risk factors or any symptoms you are experiencing.
Common risk factors include:
- high alcohol consumption
- a diet low in fresh fruit and vegetables
- medical conditions, including gastro-oesophageal reflux disease (GORD) and Barrett’s oesophagus
- a personal or family history of gastro-oesophageal disorders, such as hernia, polyps, ulceration or oesophagitis
- eating smoked, salted, pickled or poorly-refrigerated food
- exposure to certain chemical fumes, fertilisers or dry-cleaning agents
- frequently drinking very hot liquids.
GORD and Barrett’s oesophagus
Gastro-oesophageal reflux (GORD) and Barrett’s oesophagus are risk factors for oesophageal cancer.
People who have repeated episodes of reflux (heartburn) may be diagnosed with GORD. This is when stomach acid backs up into the oesophagus.
Over time, the walls of the oesophagus become damaged, causing inflammation or loss of tissue (oesophagitis).
In some people this may cause the cells lining the oesophagus to be replaced by a different type of cell. This is called Barrett’s disease.
Who gets oesophageal cancer?
Over 1300 people are diagnosed with oesophageal cancer in Australia each year. This is an uncommon cancer, making up 1.4% of cancer cases in men and 0.8% of cancer cases in women. However the incidence of adenocarcinoma of the oesophagus in Australia is increasing.
Oesophageal cancer is more common in men – 65% of people diagnosed with oesophegeal cancer are male.
Around 80% of cases of oesophageal cancers are diagnosed in people aged 60 years and older. The average age that people are diagnosed with cancers of the oesophagus is around 71.