Recent epidemiologic trends in cancer of the esophagus

In developed countries there is a decreasing incidence of oesophageal cancers in males. In France, a strong difference is still observed between northern and southern areas, incidence being twice in the former. Incidence is slightly increasing in females. For the past 20 years, the rate of adenocarcinoma of the lower third is growing, especially in North America. This trend is emerging in France, but remains at a lesser degree. Carcinomas of the lower oesophagus present clinical and epidemiological similarities with those of the cardia. This change could be explained by the increasing prevalence of gastro-oesophageal reflux. Alcohol and tobacco remain the main risk factors of squamous cell carcinoma. Aniseed aperitif, warm spirits and beer carry the highest risk. For tobacco, the risk is correlated to the duration of consumption and decreases after quitting.