The incidence rates of oesophageal cancer vary widely across different countries and regions of the world. The annual incidence reported in Linxian Province in central China is 140 per 100,000. This compares with an average rate for Western countries of 3 per 100,000. 2009 represented the first year there was a documented decrease in the incidence of oesophageal cancer in China, primarily in squamous cell carcinoma. Of the Western countries, Russia, Scotland, and the Scandinavian countries have some of the highest rates. Overall, the incidence of oesophageal cancer in Western countries is rising faster than that of any other malignancy.[1] In the US, the incidence of adenocarcinoma of the oesophagus in particular is increasing dramatically across all socioeconomic boundaries. It was estimated that in the US in 2017 there would be 16,940 new cases of and 15,690 deaths from oesophageal cancer.[2] Geographical disparities exist, even within the US. Although the causes for these disparities are not clear, the hypothesis is either a genetic predilection or an unusual exposure to certain environmental toxins. In the US, the 2 areas with the highest prevalence and highest mortality for this disease are the Charleston, SC and Baltimore, MD areas, including their respective adjacent bay counties. Worldwide, in 2005 it has been estimated that there were 497,700 new cases and 416,500 deaths from oesophageal cancer, and the prevalence is expected to increase by about 140% by 2025.[1]

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