Esophageal cancer is a leading cause of cancer death around the world. Although esophageal cancer survival rates are low, even with treatment, catching it in its early stages can improve overall life expectancy.

Esophageal cancer is the fifth most common gastrointestinal cancer in the United States. In 2023, an estimated 21,560 people received a diagnosis, the majority of which are men.

There are two main subtypes of esophageal cancer — esophageal adenocarcinoma and esophageal squamous cell carcinoma. The majority of esophageal cancer diagnoses in the U.S. are adenocarcinoma.

Due to its lack of symptoms early on, doctors often diagnose esophageal cancer in its advanced stages. They tend to associate it with a poor prognosis and overall lower quality of life.

This article looks at esophageal cancer life expectancy and the factors that affect survival rates.

A man's neck showing that he has esophageal cancer. -1Share on Pinterest
Cavan Images/Getty Images

The American Cancer Society (ACS) uses a 5-year relative survival rate to assess the outlook for any given cancer.

A 5-year relative survival rate compares people with the same type and stage of cancer to the overall population.

For example, if the rate is 20%, it means people with that stage and type of cancer are 20% as likely as those without cancer to live for 5 years after their diagnosis.

These statistics only provide a loose idea of what a person’s outlook will be. To get an accurate and in-depth view of their outlook, a person should talk with a healthcare professional.

The table below outlines the survival rates for esophageal cancer.

Stage Stage description 5-year relative survival rate
Localized Cancer is only present in the esophagus.47%
Regional Cancer has spread from the esophagus to nearby lymph nodes or tissues.
DistantCancer has spread to lymph nodes or organs that are further away from the esophagus.
All stages combinedThe average of the previous stages combined. 21%

One of the main reasons esophageal cancer has poor survival rates is that symptoms rarely appear in the early stages when survival rates are best.

Diagnosis tends to occur in the advanced stages when swallowing becomes difficult and the individual notices significant weight and muscle mass loss.

By this time, esophageal cancer may have already progressed past stage 3 and become “unresectable,” or spread too far for complete surgical removal.

The speed of metastasis, or how quickly cancer spreads to other areas of the body, is also a factor in esophageal cancer life expectancy.

A 2018 study published in the journal Frontiers in Oncology indicates esophageal cancer can affect distant sites within 6 months despite aggressive treatment, and median survival after distant metastasis is 5 months.

What about age and gender factors?

Age and gender may impact an individual’s risk of developing esophageal cancer. However, experts have not proven that these factors significantly influence survival rates after diagnosis.

A 2022 nationwide and population-based cohort study published in the journal Annals of Surgical Oncology found men had a slightly lower survival rate compared to women, as did people diagnosed with the squamous cell carcinoma form of esophageal cancer.

Another 2022 study, published in the journal Scientific Reports, found no statistical difference in survival rates between men and women.

Research from 2021 published in the journal Annals of Surgical Oncology found an association between older age and minimally higher mortality rates overall, but people over the age of 75 years had an independent risk for short-term mortality from esophageal cancer.

A smaller study on age, published in the journal Shanghai Chest in 2019, showed the opposite end of the spectrum, with a link found between being under the age of 45 years and superior survival rates in advanced esophageal cancer.

What about lifestyle factors?

A number of lifestyle factors — such as smoking, alcohol consumption, poor diet, and excess weight — may increase the risk of developing esophageal cancer.

However, this does not necessarily mean that these behaviors impact the mortality rate.

Of the lifestyle factors known to affect esophageal cancer risk, experts have found that smoking has an independent effect on mortality rates.

A 2019 retrospective study in the journal Experimental and Therapeutic Medicine found an association between cigarette smoking and an increased risk of death during esophageal cancer treatment.

The more years someone smoked, the higher their risk.

In its early stages, esophageal cancer may have no noticeable symptoms.

Late signs tend to stem from the area of the esophagus, which extends from the back of the throat down to the stomach.

Late stage symptoms can include:

The prognosis for esophageal cancer is poor overall, but early detection can improve outcomes.

If a surgeon can resect the cancer by completely removing it, a person may have higher survival rates. Postoperative complications can be serious, however, and quality of life is not always improved.

Care from a multidisciplinary team can help manage challenges related to feeding tubes, proper calorie intake, and physical frailty.

Nurses, dieticians, and rehabilitation specialists can help maintain a person’s quality of life with or without surgery.

A cancer diagnosis can feel overwhelming, but learning more about the condition can help.

The following are frequently asked questions about esophageal cancer life expectancy.

Can you live a long life after esophageal cancer?

Experts do not associate esophageal cancer with long-term survival.

It may be possible for some people to live longer than average after diagnosis, especially if doctors find cancer early and the person is younger in age.

What are the chances of surviving esophagus cancer?

The 5-year survival rate for esophageal cancer is only 20%, but that does not mean survival beyond 5 years is impossible.

Life expectancy will depend on when experts diagnose cancer, its underlying causes, and the patient’s age.

It is not possible to predict an individual’s chances of surviving esophageal cancer. For most individuals, it is a fatal condition.

Esophageal cancer life expectancy is short compared to many other cancers.

It is a type of gastrointestinal cancer that spreads rapidly, and doctors rarely detect it in its early stages when survival rates are highest.

Advanced age, being male, and smoking may also minimally increase esophageal cancer mortality rates.