How can you develop esophageal cancer?

Depends on the type: Squamous cell carcinoma of the esophagus for the most part is casued by smoking, consuming alcohol, nitrosamines, such as pickled foods and smoked meats. Adenocarcinoma is casued by acid reflux, which can lead to injury of the lining of the esophagus, causing barrett's metaplasia. Barrett's can lead to low grade, then high grade dysplasia, and finally esophageal adenocarcinoma.

Multiple: In the past, it was more commonly associated with smoking and drinking. Today, the most common reason is prolonged acid reflux leading to barretts esophagitis, which can be a pre-malignant condition if left untreated.