ABSTRACT

Oesophageal carcinoma is one of the most lethal carcinomas. It has a median survival of 10 months at diagnosis, and a cure rate of less than 5%; much better outcomes have been reported in Japanese studies. Worldwide, the majority are squamous carcinomas, which are about four times more common than adenocarcinomas. Within, and between, countries the incidence of squamous carcinoma varies dramatically, suggesting strong environmental factors in causation. Adenocarcinoma of the oesophagus is largely a disease of developed countries; the incidence of it has risen rapidly over the last 20 years (faster than for any other tumour). Adenocarcinomas tend to spread to the lymph nodes early and are more poorly differentiated at presentation than squamous carcinomas.