Esophageal Cancer: The Real Culprits

Chronic heartburn does not increase chance of esophageal cancer

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Patients are more likely to develop esophageal cancer as a result of obesity or smoking rather than acid reflux disease, according to a study done at the University of Michigan.

Contrary to popular belief, acid reflux disease, better known as heartburn, is not much of a risk factor for esophageal cancer for most people, according to new research.

"Smoking and obesity cause more esophageal cancer than acid reflux."

"It's a rare cancer," said study author Dr. Joel H. Rubenstein, an assistant professor in the University of Michigan department of internal medicine.

"About 1 in 4 people have symptoms of GERD [acid reflux disease] and that's a lot of people," he said. "But 25 percent of people aren't going to get this cancer. No way."

GERD is characterized by the frequent rise of stomach acid into the esophagus.

Rubenstein said he was concerned that as medical technology advances, enthusiasm for screening for esophageal cancer will increase, though there is no evidence that widespread screening has a benefit. About 8,000 cases of esophageal cancer are diagnosed in the United States each year, he said.

In Rubenstein's opinion, screening for esophageal cancer should not be performed routinely in men younger than 50 or in women because of the very low incidences of the cancer, regardless of the frequency of GERD symptoms.

Although Rubenstein said white males have a risk of developing esophageal cancer that's about four to five times higher than the risk for black males, the odds are still comparatively low. Men at any age are three times more likely to get colon cancer than esophageal cancer, according to the research.

Men over 60 who suffer from weekly GERD "might warrant screening," the authors concluded, but only if it were known to be accurate, safe and inexpensive.

In Depth

  • Using computer models based on data from a national cancer registry and other published research about acid reflux disease, the study found only 5,920 cases of esophageal cancer among whites younger than 80 years old, with or without acid reflux disease, in the U.S. population in 2005.
  • White men over 60 years old with regular acid reflux symptoms accounted for 36 percent of these cases. Women accounted for only 12 percent of the cases, regardless of age and whether or not they had acid reflux disease.
  • People with no acid reflux symptoms accounted for 34 percent of the cases, the authors said. Men under 60 accounted for 33 percent of the cases.
  • For women, the risk for the cancer was negligible, about the same as that of men for developing breast cancer, or less than 1 percent, the researchers said.
  • Anyone with acid reflux disease who develops more serious symptoms that don't respond to medication, such as a problem swallowing, unexplained weight loss, or vomiting, should see a doctor, as those symptoms could be signs of esophageal cancer, he noted.

The study was published this month in the American Journal of Gastroenterology.

Reviewed by: 
Review Date: 
December 20, 2010
Last Updated:
April 20, 2011