Descriptive Epidemiology

Worldwide, esophageal cancer is the eighth most common cancer and the sixth most common cause of cancer death, accounting for approximately 450 000 new cases and a similar number of deaths in 2002. More than 70% of esophageal cancer is squamous cell carcinoma, and approximately 20% is adenocarcinoma. Squamous cell carcinoma arises from dysplasia in the middle and lower third of the esophagus epithelial lining, whereas adenocarci-noma usually develops in the glandular tissue in the distal esophagus. The incidence of esophageal cancer varies tremendously with geographic location and populations throughout the world, with a maximum ratio of 500 to 1. In central and Southeast Asia, the Far East, and the Middle East, squamous cell carcinoma is the predominant form of esopha-geal cancer, whereas in the United States and Europe, adenocarcinoma of the esophagus has been rapidly increasing since 1970s, particularly in Caucasian men, to approach or surpass the rate of squa-mous cell carcinoma. In the United States, African Americans have an approximately 2-fold increased risk for esophageal cancer compared to Caucasians, possibly because of an unhealthy lifestyle.

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