The normal esophagus is lined by stratified squamous nonkeratinizing epithelium. Squamous cell carcinoma arises from this epithelial layer in apparent response to chronic toxic irritation. Alcohol, tobacco, and certain nitrogen compounds have been identified as carcinogenic irritants. Alcohol and tobacco use are the principal modifiable risk factors for esophageal squamous cell carcinoma. According to the American Cancer Society, the combination of long -term alcohol ingestion and tobacco use is the most substantial risk factor. Infection with human papillomavirus, particularly subtypes 16 and 18, has been implicated in the pathogenesis of esophageal squamous cell carcinoma.
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