Which precursor condition is most commonly associated with adenocarcinoma of the esophagus?

Adenocarcinoma of the esophagus is most commonly associated with Barrett's esophagus, a condition where the normal squamous cells lining the esophagus are replaced by columnar cells due to chronic irritation, often from gastroesophageal reflux disease (GERD). Barrett's esophagus is considered a precancerous condition; it is a key risk factor for the development of esophageal adenocarcinoma because the metaplastic changes that occur in this condition increase the likelihood of malignant transformation over time.

The transition from normal esophageal epithelium to Barrett's epithelium is driven by the chronic exposure to acidic gastric contents, typical of GERD. Patients with Barrett's esophagus often undergo regular surveillance for dysplasia, as the presence of dysplastic changes indicates a higher risk for developing adenocarcinoma. This relationship underlines the importance of identifying Barrett's esophagus and managing GERD appropriately to mitigate the risk of cancer. Thus, Barrett's esophagus stands out as the precursor condition most closely linked to the development of esophageal adenocarcinoma.