Let's start the conversation with gastroesophageal reflux disease. It's a very common problem. Gastroesophageal Reflux is a risk factor for esophageal carcinoma. Dr. Anton Titov, MD. How does GERD lead to esophageal cancer? Does anti-reflux surgery reduce or completely remove the cancer risk? Gastroesophageal reflux disease is a very common problem. Dr. Jari Rasanen, MD. Everywhere in the world, it's counted that almost 20% of all population is suffering from some form of gastric reflux at least every week. Luckily, the reflux very seldom leads to esophageal cancer. Still, the main problem with esophageal reflux disease is that it's causing chronic inflammation in the esophagus's mucosa, which leads to cancer formation. The exact mechanism behind this process is unknown. Dr. Jari Rasanen, MD. But we have studied that one of the mechanisms can be this. Because of chronic inflammation, there will be the formation of free oxygen radicals, which is called oxidative stress in the mucosa. This can cause damage to DNA. In turn this leads to esophageal cancer.