What are the two most common types of esophageal cancer?

The two most common types are squamous cell carcinoma and adenocarcinoma. NCI's summary for clinicians says it plainly: "two histological types account for most malignant esophageal neoplasms: adenocarcinoma and squamous cell carcinoma." Each is named for the cell that turned cancerous. They behave like two different diseases that happen to share an address.

The esophagus itself is "the hollow, muscular tube that moves food and liquid from the throat to the stomach."

Two cell types, two ends of the tube

Squamous cell carcinoma "forms in the thin, flat cells lining the inside of the esophagus." NCI notes it is "most often found in the upper and middle part of the esophagus, but can occur anywhere along the esophagus." Squamous cells are flat and overlapping, like roof tiles. They are the esophagus's natural lining, built to take the scrape of swallowed food.

Adenocarcinoma "begins in glandular cells," the kind that make fluids such as mucus. It "usually forms in the lower part of the esophagus, near the stomach."

That location gap is no accident. Glandular cells do not belong in the esophagus at all. They show up at the bottom end when stomach acid washes upward for years and the lining rebuilds itself into something more stomach-like. That change has a name: Barrett esophagus. It is the soil this cancer grows in.

The risk factors split too

For squamous cell carcinoma, NCI names tobacco use and alcohol use as the primary risk factors.

For adenocarcinoma, NCI says risk factors "are less clear." It does identify Barrett esophagus as raising risk, and states that "symptomatic gastroesophageal reflux is a risk factor for esophageal adenocarcinoma." The risk climbs with "frequency, severity, and duration of reflux symptoms." Heartburn once in a while is not the concern. Years of it is.

Which type is most common has flipped

This is where older information often misleads. Squamous cell carcinoma used to dominate. NCI reports that "the incidence of adenocarcinoma has risen dramatically in the last few decades and is now more prevalent than squamous cell carcinoma in the United States." Adenocarcinomas now "account for at least 50% of malignant lesions." Meanwhile "approximately 30% of esophageal cancers in the United States are squamous cell carcinomas."

The picture is different in other parts of the world. That is why sources disagree, depending on where they were written.

This cancer is uncommon but serious. The American Cancer Society's estimates for 2026 are 22,530 new cases and 16,290 deaths in the United States.

What to do with this

The symptom that matters most involves swallowing. NCI lists "painful or difficult swallowing" and weight loss as the main signs. It also lists pain behind the breastbone, hoarseness and cough, indigestion and heartburn, and a lump under the skin.

Food catching or sticking on the way down is not something to work around by chewing longer or switching to soft meals. It earns an appointment. NCI does note these signs "may be caused by esophageal cancer or by other conditions," so this is a reason to get checked, not a reason to panic.

The other useful step sits upstream. If you have had frequent reflux for years, say so in detail: how often, for how long, and how bad. That is precisely the information NCI ties to risk, and it is what a doctor needs in order to weigh an endoscopy to look for Barrett esophagus.