When Heartburn Isn’t Harmless: Understanding the Link Between GERD and Esophageal Cancer

In recognition of Esophageal Cancer Awareness Month, experts are raising awareness about the risks associated with persistent heartburn and acid reflux. Dr. Costas Bizekis, a thoracic surgeon at NYU Langone Health, shared insights on how chronic GERD can lead to more serious conditions, including esophageal cancer.

How GERD Can Increase Esophageal Cancer Risk

Over time, persistent reflux can damage the lining of the esophagus, leading to inflammation, erosions, bleeding and discomfort when eating. If left unchecked, these repeated injuries can cause changes in the cells lining the esophagus that may eventually become cancerous. In the United States, GERD is one of the leading risk factors for developing esophageal cancer.

What Is Barrett’s Esophagus and Why It Matters

In some patients, long-standing reflux can lead to Barrett’s esophagus, a precancerous condition often identified during an endoscopy. This occurs when the lining of the esophagus changes due to ongoing acid exposure. While not cancer itself, Barrett’s esophagus can progress over time.

Dr. Bizekis explained that Barrett’s esophagus exists on a spectrum. Some patients have no dysplasia, or abnormal cell changes, while others may develop low-, intermediate- or high-grade dysplasia, with higher grades requiring closer monitoring and more aggressive treatment.

When Acid Reflux Symptoms Require More Than Medication

Although many patients manage GERD with medications and lifestyle changes, some continue to experience persistent symptoms. In those cases, more advanced treatment options may be considered. Dr. Bizekis noted that minimally invasive, often robotic, surgical procedures — such as fundoplication — can help reinforce the lower esophageal sphincter and reduce reflux, potentially allowing patients to stop medications and better control their symptoms.

Dr. Bizekis emphasized that ongoing heartburn should not be ignored. For patients with persistent reflux, speaking with a doctor and considering further evaluation, such as an endoscopy, can help detect early changes and reduce the risk of progression to esophageal cancer.

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