Esophageal cancer is the 8th most commonly diagnosed cancer worldwide and the 6th in the ranking of mortality among all cancers. The lifetime risk is about 1 in 125 in men and 1 in 400 in women.
How lethal it is
Most esophageal cancers are diagnosed in their late stages, when cure is unlikely, and that late detection is what drives the numbers. The mortality-to-incidence ratio is as bad as 0.88, close to one death for every diagnosis, and the overall 5-year survival rate is about 20%.
Where and in whom it occurs
The two histological types occupy largely opposite geographies. Esophageal squamous cell carcinoma (ESCC) is the more common type worldwide and clusters in two belts of high prevalence: one stretching from the Caspian Sea to northern China, and one from Ethiopia to South Africa. Esophageal adenocarcinoma (EAC) is less common globally, but it is now the predominant type in Western countries such as the United States, the United Kingdom, Iceland and Australia.
Esophageal cancer is generally more common in men than in women, but the size of that difference depends on the region, and for ESCC it is much smaller in high-prevalence areas. In low-prevalence countries such as the United States, the male-to-female ratio is about 4:1, whereas in high-prevalence areas such as Iran and China the two sexes are affected almost equally.