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What is Heartburn’s Link to Cancer?

Risk increases with severity and frequency of heartburn

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Esophageal cancer is a relatively rare cancer which traditionally has been challenging to treat. Esophageal cancers are either squamous cell carcinomas or adenocarcinomas.  These two types differ in their risk factors, where they appear in the esophagus and in their treatment options.

Squamous cell carcinomas are the most common form of esophageal cancer worldwide but have become less frequent in the U.S. These tumors are traditionally associated with alcohol abuse and heavy smoking. 

More recently, though, adenocarcinoma has become the predominant form of this disease. This cancer is typically found at the end of the esophagus where it joins the stomach. The major risk factor for adenocarcinoma is gastroesophageal reflux disease, or acid reflux

The risks of Barrett’s esophagus

The risk for the development of adenocarcinoma increases with both the severity and frequency of heartburn symptoms. Chronic heartburn may damage the lining of the esophagus. Over time, the lining of the esophagus actually changes in response to reflux, a condition referred to as Barrett’s esophagus. Most patients with chronic heartburn develop Barrett’s esophagus prior to developing esophageal adenocarcinoma. 

Other risk factors for the development of adenocarcinoma include obesity and to some extent smoking. 

Most people who have chronic heartburn will never develop Barrett’s esophagus and most patients with Barrett’s esophagus will never develop esophageal adenocarcinoma. The fact is that heartburn is common — and esophageal cancer is rare. 

When to see your doctor

Still, talk to your physician if you have frequent heartburn symptoms or constantly need to take over-the-counter antacids. Other symptoms of esophageal cancer include difficulty swallowing or pain with swallowing. 

It’s important to note that many of these risk factors for esophageal cancer can be controlled. Quitting smoking, increasing your physical activity, and watching what and how much you eat are reasonable steps that you can take to potentially reduce your risk of developing this disease.

Tags: acid reflux, adenocarcinomas, alcohol abuse, antacids, esophageal cancer, gastroesophageal reflux disease, heartburn, smoking, swallowing disorders
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Michael McNamara, MD, is Associate Staff at Cleveland Clinic’s main campus in Solid Tumor Oncology.

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