Although its etiology is unknown, esophageal cancer occurs predominantly in people with a history of alcohol and tobacco use. Individuals who have achalasia, strictures, or hiatal hernias are also at increased risk. In parts of the world where it is most common (Japan, Russia, China, the Middle East, and South Africa), the disease has been linked to nitrosamines and other contaminants in the soil. It has also been found to have a higher incidence in individuals whose diets are chronically deficient in fresh fruits, vegetables, vitamins, and proteins. Other risk factors include: obesity, gastroesophageal reflux disease (GERD), lye ingestion, occupational exposure (per-chloroethylene), and esophageal webs.

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