What causes oesophageal cancer?

The oesophagus carries food from the mouth to the stomach. Repeated injury and inflammation can cause cells in its lining to change over time. Barrett's oesophagus, often associated with long-standing acid reflux, can alter the lining and is linked with a higher likelihood of some oesophageal cancers. Tobacco exposure, alcohol use, excess body weight, and difficulty swallowing may also be relevant contributors, depending on the cancer type. These factors do not make cancer certain, and some people develop it without a clear explanation.

Arrange a medical review for persistent heartburn, food sticking, painful swallowing, unexplained weight loss, vomiting, or ongoing chest discomfort. A clinician may review reflux symptoms, medicines, tobacco and alcohol exposure, and any history of Barrett's oesophagus. Testing can include an upper endoscopy, during which tissue samples may be taken if an area looks abnormal.

Seek urgent help if food is stuck and you cannot swallow liquids, or if vomiting contains blood, stools are black, or you have severe chest pain, breathing difficulty, or faintness. Prompt review is also warranted when swallowing steadily becomes harder, because obstruction and dehydration can develop.

Could reflux or Barrett's oesophagus explain my symptoms? Do I need an endoscopy or biopsy? Which changes in swallowing should lead me to seek urgent help? What steps could reduce irritation of the oesophagus?