Esophageal adenocarcinoma (EAC) was almost unknown a generation ago but is now more common than squamous cell carcinoma of the esophagus.

Tobacco and alcohol use are the major risk factors for squamous cell carcinoma of the esophagus, but are not risk factors for EAC.

Both Barrett’s esophagus (BE) and esophageal adenocarcinoma (EAC) are more common in men. The risk of progression from BE to EAC is also higher in men.

Most cases of EAC occur after age 60.

A study to determine the prevalence of BE in asymptomatic individuals identified BE in 7% of the population.

High-grade dysplasia is often associated with early invasive adenocarcinoma.

BE rarely regresses entirely

The annual risk of developing EAC continues indefinitely, at a constant rate regardless of the duration of BE.

Surveillance with endoscopy may help to detect early stage tumors, which have better survival.

Treatment for high-grade dysplasia is controversial because of the high morbidity and relatively high surgical mortality associated with esophagectomy. Only individuals in good health are candidates for esophagectomy. Alternative treatments, including endoscopic mucosal resection and photoablation, show promise.