Epidemiology

Esophageal cancer is the 11th most common cancer worldwide and the seventh most common cause of death from cancer. More than 80% of esophageal cancer cases and deaths occur in developing countries, and approximately 80–90% are squamous cell carcinomas in the high-incidence regions. The incidence rates of esophageal cancer show wide variation internationally. It has been shown to be more common among men than women in general. Of note, it is approximately 3.5 times more common among males in Japan. Both incidence and mortality are on the rise in number since 1960 due to the aging of Japanese population, while age-adjusted mortality rates are decreasing in both male and female. Convincing risk factors for esophageal squamous carcinoma include tobacco smoking and alcohol consumption, while suggestive protective factors are fruit and vegetable intake. Likewise, intake of high temperature beverages and foods show high probability of increasing risk through heat damage in the esophagus. Approximately 88% of male esophageal cancer (52% for females) in Japan is thought to have been avoidable by lifestyle improvement such as refraining from smoking of tobacco and alcohol use, while maintaining sufficient fruit and vegetable intake.