Esophageal adenocarcinoma: Risk factors

The incidence of esophageal adenocarcinoma (EAC) has dramatically increased in the last three decades, both in the United States and also in Western European countries. Gastroesophageal reflux disease (GERD) and Barrett's esophagus (BE) have been implicated as major risk factors. A growing body of literature indicates central obesity, independent of body mass index, to be associated with increased risk of developing EAC. Tobacco use has been reported as a possible risk factor for EAC, although studies have failed to show a consistent relationship between alcohol intake and development of esophageal adenocarcinoma. Infection with Helicobacter pylori and use of non-steroidal anti-inflammatory drugs have been shown to reduce the risk of EAC, while low intake of fruits and vegetables seem to increase the risk. The steep incline in incidence coupled with high mortality demand increased efforts to evaluate the pathophysiology and risk factors to help reduce the burden of EAC.