Summary

• Incidence is increasing across the Western world.
• Men are twice as likely as women to develop the disease.
• The 2 main histological types are squamous cell carcinoma and adenocarcinoma. In the US, adenocarcinomas now account for 80% of cases overall.
• Low socioeconomic status, smoking, excessive alcohol use, GORD, Barrett's oesophagus, and obesity are some of the main risk factors.
• Tumours are often locally advanced at the time of diagnosis. Accurate staging is important for prognosis and treatment planning.
• Early stage cancers in surgical candidates are best treated by oesophagectomy.
• For locally advanced disease, combined modality therapy is considered the current standard. This involves surgery, chemotherapy, and radiotherapy.
• High-risk patients should be treated with a combination of chemotherapy and radiotherapy for best results, but local recurrence rates remain high.