The Epidemiology of Esophageal Adenocarcinoma

Gastroenterology. 2018 Jan;154(2):390-405. doi: 10.1053/j.gastro.2017.07.046. Epub 2017 Aug 3.


The incidence of esophageal adenocarcinoma (EAC) has increased in many Western countries and is higher in men than women. Some risk factors for EAC have been identified-mainly gastroesophageal reflux disease, Barrett's esophagus, obesity, and tobacco smoking. It is not clear whether interventions to address these factors can reduce risk of EAC, although some evidence exists for smoking cessation. Although consumption of alcohol is not associated with EAC risk, other exposures, such as physical activity, nutrition, and medication use, require further study. Genetic variants have been associated with risk for EAC, but their overall contribution is low. Studies are needed to investigate associations between risk factors and the molecular subtypes of EAC. The prognosis for patients with EAC has slightly improved, but remains poor-screening and surveillance trials of high-risk individuals are needed.

Keywords: Epidemiology; Esophageal Cancer; Genetic Risk; Lifestyle.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adenocarcinoma / epidemiology*
  • Adenocarcinoma / etiology*
  • Adenocarcinoma / prevention & control
  • Adenocarcinoma / therapy
  • Alcohol Drinking / adverse effects
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Barrett Esophagus / epidemiology*
  • Barrett Esophagus / genetics
  • Carcinogens / toxicity
  • Chemoradiotherapy, Adjuvant
  • Diet / adverse effects
  • Esophageal Neoplasms / epidemiology*
  • Esophageal Neoplasms / etiology*
  • Esophageal Neoplasms / prevention & control
  • Esophageal Neoplasms / therapy
  • Esophagectomy
  • Gastroesophageal Reflux / epidemiology*
  • Gastrointestinal Microbiome
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects
  • Incidence
  • Male
  • Neoadjuvant Therapy
  • Obesity / epidemiology*
  • Prognosis
  • Proton Pump Inhibitors / therapeutic use
  • Risk Factors
  • Sedentary Behavior
  • Sex Factors
  • Tobacco Smoking / adverse effects


  • Anti-Inflammatory Agents, Non-Steroidal
  • Carcinogens
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Proton Pump Inhibitors

Supplementary concepts

  • Adenocarcinoma Of Esophagus