Re: is there any connection between esophageal cancer and a hiatal hernia?

Dear Student,

Yes, there is a connection. Gastroesophageal reflux disease (GERD) , which is a condition where stomach acid travels up into the esophagus and causes irritation, is known to be a risk factor for Barrett's esophagus, a condition where abnormal cells are found in the lining of the esophagus. Barrett's esophagus is a premalignant condition--that is, it can lead to cancer of the esophagus.

As the esophagus descends through the chest into the abdomen, it passes through a hiatus, or opening, in the diaphragm. When the muscles around this opening loosen, the stomach can slip upwards through the hiatus--this is called a hiatal hernia. Hiatal hernias cause GERD, and so one would expect that they would be associated with esophageal cancer. In fact, studies have shown that hiatal hernias are associated with an increased risk of cancer of the esophagus (1,2).

Thanks for your question!

- Stephen C. Lattanzi, M.D.

References

1. Wu AH et al. Hiatal hernia, reflux symptoms, body size, and risk of esophageal and gastric adenocarcinoma. Cancer 2003 Sep 1; 98(5): 940-8.

2. Avidan B et al. Hiatal hernia size, Barrett's length, and severity of acid reflux are all risk factors for esophageal adenocarcinoma. Am J Gastroenterol 2002 Aug; 97(8): 1930-6.