Esophageal cancer is a rare condition that is most prevalent in males over the age of 55 years. Research suggests that esophageal cancer diagnosis is most common among people aged 65–74 years.

Esophageal cancer is rare in the United States. Data from 2019 show that males and females have around a 0.5% risk of developing esophageal cancer during their lifetime. Males are approximately three times more likely than females to develop esophageal cancer.

The National Cancer Institute (NCI) estimates that esophageal cancer will be responsible for 2.6% of all cancer-related deaths in the United States in 2023.

Screening for the disease involves looking for related signs in people with no cancer symptoms. Individuals with a higher risk of developing esophageal cancer may undergo screening programs.

This article examines the prevalence of esophageal cancer at different ages. It also discusses screening guidelines and survival rates.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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Infographic by Bailey Mariner

The risk of esophageal cancer increases with age. According to the American Cancer Society, fewer than 15% of esophageal cancer diagnoses occur in people under 55 years.

The median age at diagnosis is 68 years, and diagnosis is most common among those aged 65–74 years.

Esophageal cancer in people aged 54 years and below is relatively rare. However, researchers state that diagnoses of esophageal adenocarcinoma are becoming increasingly prevalent in people under 50, increasing by nearly 3% each year between 1975 and 2015.

White people are more likely to develop esophageal cancer than individuals from other ethnic groups. Adenocarcinoma is most common in white people, while African Americans, Alaska natives, and Hispanics are more likely to develop squamous cell carcinoma (SCC).

Researchers do not fully understand what causes esophageal cancer, but some factors can increase a person’s risk.

Risk factors include:

  • Age: The risk of esophageal cancer increases with age.
  • Gender: Males are more likely than females to develop the condition. This may be due to increased tobacco and alcohol use among males.
  • Tobacco and alcohol: Cigarettes, cigars, pipes, and chewing tobacco are serious risk factors for esophageal cancer.
  • Gastroesophageal reflux disease (GERD): GERD happens when acid escapes from the stomach into the esophagus. It can irritate the esophagus lining and increase the risk of esophageal cancer.
  • Barrett’s esophagus: People experiencing acid reflux for long periods may develop Barrett’s esophagus. Having this condition increases a person’s risk of developing adenocarcinoma of the esophagus.
  • Physical inactivity: As with many cancers, regularly exercising can reduce a person’s risk of developing the condition.
  • Diet: Certain foods, such as processed meats, can increase the risk of esophageal cancer.
  • Achalasia: Esophageal achalasia is a motility condition that causes difficulty moving food into the stomach. Food can gather in the lower esophagus, irritating cells in this area.
  • Obesity: Obesity increases the risk of a person developing adenocarcinoma in their esophagus, as it can cause acid reflux.
  • Tylosis: This rare hereditary condition causes small growths to grow in the esophagus, increasing the risk of SCC of the esophagus.
  • Injury to the esophagus: People can sustain chemical burn scars on the esophagus from accidentally consuming lye, an ingredient in strong industrial and household cleaners. Scarring increases the risk of developing SCC.
  • Previous cancers: Having a history of lung, mouth, or throat cancer also increases the risk of developing SCC of the esophagus.
  • Human papillomavirus (HPV) infection: Having an HPV infection may increase the risk of developing esophageal cancer.

Learn more about esophageal cancer risk factors.

There are no routine screening tests for esophageal cancer in the United States. Doctors may suggest screening if a person has risk factors for the condition but does not have symptoms. They may use the following tests:

  • Esophagoscopy: A doctor inserts a thin tube into the esophagus. The tube features a light and lens at the end so the doctor can check the esophagus for abnormal areas.
  • Biopsy: A surgeon takes a sample of tissue from the esophagus. A pathologist then assesses the sample in a laboratory to determine whether it is cancerous.
  • Brush cytology: A doctor brushes cells from the esophagus lining for examination under a microscope.
  • Balloon cytology: A doctor collects cells from the esophagus by inflating a small balloon inside the esophagus before pulling it out. A pathologist then examines the cells on the balloon for abnormalities.
  • Chromoendoscopy: During esophagoscopy, a doctor sprays dye onto the esophagus lining. Heavily stained areas may indicate Barret’s esophagus.
  • Fluorescence spectroscopy: A doctor passes a light probe through an endoscope and shines the light on the esophagus lining. They then measure the light that the cells emit. Cancerous tissue emits less light than typical tissue.

Screening can allow doctors to detect esophageal cancer early, which may mean more effective treatment and a better outlook.

Learn how doctors test for esophageal cancer.

A 5-year relative survival rate indicates how likely people with a certain cancer are to be alive 5 years after diagnosis, compared with those without the disease.

According to the National Cancer Institute’s Surveillance, Epidemiology and End Results database, the 5-year survival rate for esophageal cancer is 21.7%. This means that people with esophageal cancer are 21.7% as likely to be alive 5 years after diagnosis as those without it.

However, these 5-year relative survival rates vary depending on the stage of the cancer at the point of diagnosis.

The three stages of esophageal cancer and their survival rates are:

  • Localized: This means that cancer is present only in the esophagus. This includes stages 1 and 2 but not stage 0. Localized esophageal cancer has a 5-year relative survival rate of 48.8%.
  • Regional: This means that cancer is present in nearby lymph nodes. Regional esophageal cancer has a 5-year relative survival rate of a 27.7%.
  • Distant: This means that cancer has spread to distant organs or lymph nodes. Distant esophageal cancer has a 5-year relative survival rate of 5.6%.

Learn more about life expectancy for esophageal cancer.

The risk of esophageal cancer increases with age and is most prevalent in males over 55 years. Esophageal cancer in people under 54 years is rare.

The main risk factors for esophageal cancer include increased age, being male, smoking, and certain lifestyle choices. People with Barret’s esophagus and GERD also have an increased risk.

There are no routine screenings for esophageal cancer in the United States, but doctors may recommend regular screening for people with several risk factors.