A growing body of literature is beginning to elucidate the role of the microbiome in esophageal cancer. Oral health factors such as tooth loss and periodontal disease are associated with both esophageal microbiome changes and esophageal cancer risk. In esophageal squamous cell cancer, the periodontal pathogens Fusobacterium nucleatum and Porphyromonas gingivalis have been shown to have pro-neoplastic effects and are associated with worse clinical outcomes. Although distinct shifts in esophageal microbiome composition have been described, the role of bacteria in the pathogenesis of esophageal adenocarcinoma remains comparatively understudied. Bacteria represent potential prognostic and therapeutic biomarkers, as well as modifiable targets in esophageal neoplasia.
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