There are two main types of esophageal cancer: squamous cell cancer and adenocarcinoma of the esophagus.
Squamous cell occurs most commonly in African Americans as well as people who smoke cigarettes and drink alcohol excessively. This type of cancer is not increasing in frequency.
The other cancer, adenocarcinoma of the esophagus, occurs most commonly in Caucasians as well as people with gastroesophageal reflux disease (GERD). This cancer is increasing in frequency.
The most common symptom of GERD is heartburn, a condition that 20 percent of American adults experience at least twice a week. Although these individuals are at increased risk of developing esophageal cancer, the vast majority of them will never develop it. But in a few patients with GERD (estimated at 10-15%), a change in the esophageal lining develops, a condition called Barrett’s esophagus. Doctors believe most cases of adenocarcinoma of the esophagus begin in the Barrett’s tissue. Barrett’s esophagus is a condition in which the esophageal lining changes.
Your doctor will first perform an upper endoscopy to diagnose Barrett’s esophageal.
Dysphasia, a pre-cancerous change in the tissue, can develop in any Barrett’s tissue. Barrett’s tissue is visible during endoscopy, although a diagnosis by endoscopic appearance alone is not sufficient. The definitive diagnosis of Barrett’s esophagus requires biopsy confirmation.
Barrett’s esophagus is twice as common in men as women. It tends to occur in middle-aged Caucasian men who have had heartburn for many years. There’s no agreement among experts on who should be screened. Even in patients with heartburn, Barrett’s esophagus is uncommon and esophageal cancer is very rare. One recommendation is to screen patients older than 50 who have had significant heartburn or required regular use of medications to control heartburn for several years. If that first screening is negative for Barrett’s tissue, there is no need to repeat it.