1.2 Risk factors
Certain regions of the world have a higher incidence of oesophagogastric cancer. This variation of incidence by region is multifactorial and involves different environmental exposures and genetic diversity of the populations, most likely related to dietary factors.
Australia has a higher rate of adenocarcinoma of the oesophagus than SCC – this is reversed in Asian countries. These risk factors persist in more recent immigrants and should be factored into risk assessments.
There are very few people at high risk. However, people with the following risk factors are at increased risk:
| Oesophageal adenocarcinoma |
Oesophageal SCC | Gastric cancer |
| • Male gender
• Obesity • Gastro-oesophageal reflux • Barrett’s oesophagus • Tobacco smoking • Alcohol consumption • Increasing age |
• Heavy alcohol consumption
• Tobacco smoking • Increasing age • Caustic injury • Achalasia |
• Increasing age
• Helicobacter pylori (H. pylori) bacteria • Previous partial gastrectomy, especially more than 20 years ago, usually for benign ulcer disease • Tobacco smoking • Pernicious anaemia • Family history of gastric cancer (hereditary gastric cancer exists) |
Note: The most common risk factors are bolded.
