What is oesophageal cancer?

Oesophageal cancer is a cancer that starts in the food pipe. The food pipe is also called the oesophagus or gullet.

Cancer is when abnormal cells start to divide and grow in an uncontrolled way. The cells can grow into surrounding tissues or organs and may spread to other areas of the body. 

The food pipe

The food pipe (oesophagus) is part of your digestive system. It is the tube that carries food from your mouth to your stomach. It lies behind the windpipe (trachea) and in front of the spine. 

At the top of the oesophagus there is a ring of muscle called the upper oesophageal sphincter. This sphincter opens the oesophagus when food or liquid comes toward it. It also stops food from going down the windpipe. 

The lower part of the oesophagus joins the stomach. This is called the gastro-oesophageal junction (GOJ). There is a ring of muscle called the cardiac sphincter at the GOJ. This controls food moving from the oesophagus into the stomach. Between meals, the cardiac sphincter closes. This stops stomach contents and acid moving backwards from the stomach into the oesophagus.

Where does oesophageal cancer start?

The wall of the oesophagus has several layers of tissue. These include the inner layer (mucosa), muscle, and connective tissue. Oesophageal cancer starts in the inner lining of the oesophagus and can spread outward through the other layers.

Cell type

There are 2 main types of cell lining the oesophagus:

• squamous cells
• glandular (adenomatous) cells

Cancer can start in either type of cell. So there are 2 main types of oesophageal cancer - squamous cell carcinoma and adenocarcinoma.

Parts of the oesophagus

Cancer can develop in any part of the oesophagus.

Upper and middle part

Cancers in the upper part and middle part tend to be squamous cell carcinomas. These develop from cells that make up the inner lining of your oesophagus. 

Lower part

Cancers in the lower part of the oesophagus tend to be a type called adenocarcinoma. These cancers start in gland cells.

The gastro oesophageal junction

The lower end of the oesophagus joins the stomach. The area where the oesophagus and stomach join is called the gastro oesophageal junction (GOJ). Cancers that start here are called gastro oesophageal junction cancers.

It can sometimes be difficult to tell the difference between oesophageal, stomach and GOJ cancers. But we know from research that GOJ cancers are a separate type of cancer. They can behave differently to cancers of the oesophagus and stomach. 

How common is it?

Around 9,300 people are diagnosed with oesophageal cancer in the UK each year. It’s the 14th most common cancer in adults.

Who gets it?

Oesophageal cancer is more common in men than women.

It's more common in older people. In the UK, on average each year around 40 out of 100 (around 40%) of new cases are in people aged 75 and over. It's very rare in people younger than 40.