February 12, 2026
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February 12, 2026

Early Signs of Oesophageal Cancer: What to Look Out For

Cancer Awareness Months
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Cancer
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Reviewed By:
Dr Michael Williams
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Early Signs of Oesophageal Cancer: What to Look Out For

Contents

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Oesophageal cancer is one of the more aggressive cancers – but when caught early, outcomes can improve significantly. Because symptoms often appear late, awareness of early warning signs is critical. February is Oesophageal Cancer Awareness Month, making it the perfect time to learn what to watch out for and when to take action. This article explores the early signs, risk factors, and the importance of proactive screening.

Oesophageal cancer accounts for 7,900 deaths a year across the UK, largely due to late diagnosis. Yet, encouragingly, around 59 per cent of cases are preventable through lifestyle changes like quitting smoking, reducing alcohol, and managing reflux. Early awareness of risks can make a real difference by increasing treatment options, which in turn can preserve quality of life and survivability7.  

Understanding the early signs and symptoms could greatly improve outcomes.

Why Early Detection Matters in Oesophageal Cancer

Oesophageal cancer, or cancer of the gullet, is the 14th most common cancer in the UK, with around 9,400 new diagnoses each year1. It is considered one of the less survivable cancers because the early signs are often subtle or mistaken for other conditions. Along with the lack of a UK-wide screening programme, the often undetected symptoms lead to late diagnosis and limited treatment options2. 

Early Signs of Oesophageal Cancer to Watch For

There are several early signs to be aware of that can easily be mistaken for something harmless, like indigestion. 

Difficulty swallowing (Dysphagia)

  • The most common symptom of oesophageal cancer3. 
  • Starts with difficulty swallowing solid foods, then soft food, then liquids as the tumour narrows the gullet4. 
  • Can develop into choking, coughing, or vomiting as the disease progresses4. 

Persistent heartburn or acid reflux

  • Heartburn and indigestion are among the earliest warning signs5. 
  • Long-term reflux can cause changes to the lining of the oesophagus, leading to Barrett’s oesophagus. This is where cells act abnormally and may develop into growths3. 
  • If antacids no longer help or symptoms worsen, especially if you have multiple risk factors, contact your GP for advice5. 

Hoarseness, chronic cough, or sore throat

  • These often appear in advanced disease when the tumour presses on nerves or irritates the airways3.
  • They can occasionally appear early, especially if the cancer starts near the voice or windpipe. 
  • These may progress to vomiting blood from bleeding tumours or ulcers4. 

Unexplained weight loss

  • Often an overlooked symptom, especially in older adults4. 
  • This can result from discomfort when eating due to tumour growth and irritation4. 
  • Lower tumours may press on the stomach, leading to feeling full sooner4. 

Tiredness and blood changes

  • Anaemia may develop from iron deficiency due to mild bleeding in the gullet6. 
  • Fatigue is very common and may be caused by anaemia6. 
  • High platelet count or too many clotting cells can lead to unwanted blood clot formation6. 

Although these symptoms on their own may not be cancer, new or persistent symptoms should be discussed with your GP, even just for peace of mind5. 

Who’s Most at Risk?

Known risk factors

Most cases of oesophageal cancer stem from multiple environmental and lifestyle factors. These risk factors can stack; for example, persistent reflux and smoking may compound, increasing overall risk1,8,9. Risk factors include:

  • Men
  • Over 75s
  • Smoking or using other tobacco products
  • Heavy drinking
  • Obesity
  • Poor diet
  • Chronic acid reflux
  • Barrett’s oesophagus
  • Radiotherapy for other cancers can slightly increase the risk 
  • Achlasia, which is a rare condition that affects the nerves and muscles of the oesophagus and makes it difficult to swallow

By making small changes to reduce risk factors like quitting smoking, managing weight, and seeking treatment for chronic reflux, you can help reduce the overall risk of oesophageal cancer. 59 per cent of oesophageal cancer is preventable7. 

Genetic predispositions

Family history can increase the risk of oesophageal cancer.  In about 1 in 15 cases, cancer runs in families, often through Barrett’s oesophagus10,11. Having two immediate relatives with a history of oesophageal or stomach cancer can also significantly increase your risk12.

Several rare genetic conditions can increase the risk of oesophageal cancers, including:

  • Tylosis: a faulty gene (RHBDF2) causes thickening of the skin on the hands and feet and has a 40-90% lifetime risk of oesophageal cancer13. 
  • Fanconi anaemia: several gene mutations can lead to changes in certain pathways that can increase the risk of several cancer types14. 

If several close family members have oesophageal or upper gut cancer, talk to your GP for advice, as there are no routine tests available for most people. 

When to Seek Help and What Happens Next

If new symptoms persist for over 3 weeks, then contact your GP for advice. The GP may refer you to a specialist who may perform an endoscopy or some imaging for investigation5. 

An endoscopy, which is where a small camera is used to look at the lining of your oesophagus to identify any abnormalities, may be used for further investigation. This procedure is safe, quick, and can often be done on the same day3. 

Early diagnosis allows for the best quality of care, more treatment options, and preserves quality of life and survivability. People with an early diagnosis can have a 50 per cent 5-year survival rate15, compared to a late-stage diagnosis, which is less than 20 per cent8. 

Conclusion

Oesophageal cancer is tough to spot early due to its subtle signs like difficulty swallowing, persistent heartburn, unexplained weight loss, hoarseness, or tiredness from blood changes. Recognising these can lead to early diagnosis, better chances of survival, more treatment options, and preserved quality of life. 

With around 9,400 UK cases yearly and no nationwide screening, seeking GP advice for new symptoms lasting over 3 weeks is extremely important. Especially if you have multiple risk factors. 

February’s Oesophageal Cancer Awareness Month is your prompt to share this information, trust your instincts, and take charge of your health today. 

Ezra offers several imaging services that can screen for early warning signs of multiple cancers, as well as 500+ non-cancerous conditions. For more information, contact Ezra today.

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References 

1. Guts UK. Oesophageal Cancer Awareness Month. Guts UK. Accessed February 9, 2026. https://gutscharity.org.uk/awareness/awareness-dates/oesophageal-cancer-awareness-month/ 

2. Less Survivable Cancers Taskforce. Less Survivable Cancers Awareness Week. Less Survivable Cancers Taskforce. Accessed January 21, 2026. https://lesssurvivablecancers.org.uk/awarenessweek/ 

3. Macmillan Cancer Support. Oesophageal cancer - Macmillan Cancer Support. Accessed February 10, 2026. https://www.macmillan.org.uk/cancer-information-and-support/oesophageal-cancer 

4. Cancer Research UK. Symptoms of oesophageal cancer. Accessed February 10, 2026. https://www.cancerresearchuk.org/about-cancer/oesophageal-cancer/symptoms 

5. NHS. Symptoms of oesophageal cancer. nhs.uk. July 5, 2023. Accessed January 21, 2026. https://www.nhs.uk/conditions/oesophageal-cancer/symptoms/ 

6. Venugopalan Pathiyil D, Henry RA, Joseph J, Oomen AT, Janardhanan Kakkra J. Severe Iron Deficiency Anemia Leading to Thrombocytosis With Arterial and Venous Thrombosis. Cureus. 13(9):e17893. doi:10.7759/cureus.17893 

7. Cancer Research UK. Oesophageal cancer statistics | Cancer Research UK. Accessed February 10, 2026. https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/oesophageal-cancer 

8. Huang FL, Yu SJ. Esophageal cancer: Risk factors, genetic association, and treatment. Asian J Surg. 2018;41(3):210-215. doi:10.1016/j.asjsur.2016.10.005 

9. Cancer Research UK. Risks and causes of oesophageal cancer. Accessed February 10, 2026. https://www.cancerresearchuk.org/about-cancer/oesophageal-cancer/causes-risks 

10. Chen T, Cheng H, Chen X, et al. Family history of esophageal cancer increases the risk of esophageal squamous cell carcinoma. Sci Rep. 2015;5:16038. doi:10.1038/srep16038 

11. Romero Y. Familial Association in Barrett Esophagus. Gastroenterol Hepatol. 2007;3(5):346-348. 

12. Choi YJ, Kim N. Gastric cancer and family history. Korean J Intern Med. 2016;31(6):1042-1053. doi:10.3904/kjim.2016.147 

13. Blaydon DC, Etheridge SL, Risk JM, et al. RHBDF2 mutations are associated with tylosis, a familial esophageal cancer syndrome. Am J Hum Genet. 2012;90(2):340-346. doi:10.1016/j.ajhg.2011.12.008 

14. Chen H, Zhang S, Wu Z. Fanconi anemia pathway defects in inherited and sporadic cancers. Transl Pediatr. 2014;3(4):300-304. doi:10.3978/j.issn.2224-4336.2014.07.05 

15. Bird-Lieberman EL, Fitzgerald RC. Early diagnosis of oesophageal cancer. Br J Cancer. 2009;101(1):1-6. doi:10.1038/sj.bjc.6605126