Risk Factors For Gastroesophageal Junction (GEJ) Cancer

Learn the controllable and uncontrollable risk factors for cancer of the gastroesophageal junction.

Medically reviewed in January 2022

Gastroesophageal junction adenocarcinoma is a rare type of cancer that begins in the gastroesophageal junction, or GEJ. The GEJ is the part of the body that connects the lower part of the esophagus (called the distal esophagus) to the upper part of the stomach (called the proximal stomach).

Because the GEJ is located between two major digestive organs, the esophagus and the stomach, there has been some debate whether the disease should be classified as an esophageal cancer or a stomach cancer. Though healthcare experts still disagree on this subject, research suggests that GEJ cancers behave more like cancers of the esophagus, and are staged and treated like esophageal cancers.

Controllable risk factors
The exact cause of GEJ cancer is unknown, though there are a number of factors that can increase a person’s risk of having GEJ cancer. As with many other health conditions, certain habits and lifestyle factors can increase risk. These include smoking, or using any type of tobacco product, including chewing tobacco, being obese, consuming alcohol in excess and a diet high in red meat and processed meat.

Quitting tobacco (if you use tobacco products), maintaining a healthy weight, limiting alcohol consumption and eating a healthy diet high in fruits, vegetables, whole grains and lean proteins can help reduce your risk of GEJ and esophageal cancers, as well as many other diseases.

Uncontrollable risk factors
There are also a number of risk factors that are beyond a person’s control, including gender, age and certain other health conditions. GEJ cancer is more common in men than in women. It is more common as people age, and most people who develop this type of cancer are over the age of 55.

GERD and other health conditions
A number of other health conditions, particularly those that impact with the functioning of the esophagus, also increase the risk of GEJ cancer (as well as esophageal cancer). These include:

  • GERD, or gastroesophageal reflux disease, a condition where stomach acid rises out of the stomach and into the esophagus.
  • Barrett’s esophagus, a precancerous condition which can happen as a result of GERD. With Barrett’s esophagus, persistent acid reflux damages causes permanent changes to the lining of the esophagus.
  • Achalasia. At the bottom of the esophagus is a sphincter, a ring of muscle that opens and closes to allow food to pass through, while keeping the contents of the stomach from rising back up. In people with achalasia, this esophageal sphincter doesn’t function properly.

While having one of these conditions increases the risk of developing GEJ only by a small percent, persistent heartburn or reflux should not be ignored, as it can lead to numerous other complications, including esophagitis, ulcers and strictures.

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