What is the most common type of esophageal cancer in the United States?

Adenocarcinoma is the most common type of esophageal cancer in the United States, particularly associated with the distal esophagus and the gastroesophageal junction. This type of cancer has seen an increase in prevalence over the past few decades, primarily attributed to the rising rates of obesity and gastroesophageal reflux disease (GERD), both of which can lead to Barrett's esophagus, a precancerous condition where the normal squamous epithelium is replaced by columnar epithelium due to chronic injury.

In contrast, squamous cell carcinoma, while historically the predominant type globally, is now less common in the U.S., especially in comparison to adenocarcinoma. The occurrence of small cell carcinoma and large cell carcinoma is quite rare in the esophagus, as these are more commonly associated with other anatomic locations, such as the lung. Thus, the increasing rates of adenocarcinoma in the context of particular risk factors underscore its prominence as the most common form of esophageal cancer in the United States today.