Esophageal squamous cell carcinoma (ESCC) accounts for about 90% of the 456,000 incident esophageal cancers each year. Regions of high incidence include Eastern to Central Asia, along the Rift Valley in East Africa, and into South Africa. There are many causes of ESCC, which vary among regions. Early studies in France associated smoking cigarettes and heavy alcohol consumption with high rates of ESCC, but these factors cannot explain the high incidence in other regions. We discuss other risk factors for ESCC, including polycyclic aromatic hydrocarbons from a variety of sources, high-temperature foods, diet, and oral health and the microbiome—all require further research. A growing list of defined genomic regions affects susceptibility, but large genome-wide association studies have been conducted with ethnic Chinese subjects only; more studies are called for in the rest of Asia and Africa. ESCC has been understudied, but growing infrastructure in more high-incidence countries will allow rapid progress in our understanding.

每年发生的 456,000 例食管癌中，食管鳞状细胞癌 (ESCC) 约占 90%。高发地区包括东亚到中亚、东非裂谷沿线以及南非。食管鳞癌的病因有很多，不同地区的病因也不同。法国的早期研究将吸烟和大量饮酒与食管鳞癌的高发病率联系起来，但这些因素无法解释其他地区的高发病率。我们讨论了食管鳞癌的其他危险因素，包括各种来源的多环芳烃、高温食物、饮食、口腔健康和微生物组——所有这些都需要进一步研究。越来越多的确定的基因组区域会影响易感性，但大型全基因组关联研究仅针对华裔受试者进行；需要在亚洲和非洲其他地区进行更多研究。 ESCC 尚未得到充分研究，但高发国家基础设施的不断发展将使我们的理解迅速取得进展。