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About the Authors:
Sonja P. Dawsey
Affiliation: Nutritional Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, Maryland, United States of America
Stanley Tonui
Affiliation: Tenwek Hospital, Bomet, Kenya
Robert K. Parker
Affiliation: Department of Surgery, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States of America
John W. Fitzwater
Affiliation: Department of Surgery, Texas Tech University School of Medicine, Health Sciences Center, Lubbock, Texas, United States of America
Sanford M. Dawsey
Affiliation: Nutritional Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, Maryland, United States of America
Russell E. White
Affiliations Tenwek Hospital, Bomet, Kenya, Department of Surgery, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States of America
Christian C. Abnet
* E-mail: [email protected]
Affiliation: Nutritional Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Bethesda, Maryland, United States of America
Introduction
Worldwide, esophageal cancer (EC) ranks eighth in cancer incidence and sixth in cancer mortality [1]. There are two primary cell types of EC, esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC); together these two types account for >95% of all cases of EC. In recent years, EAC rates have increased in most Western industrialized countries, and it has become the predominant form of EC in these populations; however, in other areas of the world, ESCC still predominates. About 80% of ECs occur in developing countries, and in these countries, nearly all of these cancers are ESCC [1].
The incidence of EC varies widely, and certain areas such as northern China [1], northeastern Iran [2], and South Africa [3] have very high rates of this disease, with age-standardized incidence rates from 50 to over 100 cases per 100,000 population per year. In contrast, most Western countries have much lower incidence rates of EC, from 4 to 10 cases per 100,000 population per year [4], [5].
Western Kenya also appears to have high rates of esophageal cancer. It has proven difficult to establish reliable cancer or death registries in this area, but case series reports from Tenwek Hospital, a tertiary care center in southwestern Rift Valley Province, and Moi Teaching and Referral Hospital, a tertiary care center in...