Esophageal squamous cell carcinoma (ESCC) is the eighth most common
cancer by incidence worldwide. Although the
cancer is located at a readily recognizable and accessible site in the body, it is the sixth most common cause of
cancer death. The 1- and 5-year survival rates in China are 50% and 15%, respectively. Furthermore, the
cancer has distinct geographic and etiological risk factors in different locations around the world. Since ESCC is highly prevalent in the Chaoshan (Southeastern) region of China, this report will focus on a review of risk factors for the
cancer in this area. From the review, it is clear that some important and traditional factors are involved, e.g. environmental
mutagens,
genetic predisposition. However, unique factors, e.g. the drinking of very hot
tea, may play an important role. This review highlights the role of complex risk factors (environmental, genetic and cultural) which contribute to the multistage development of
cancer: localized injury,
inflammation, mitogenesis, mutagenesis,
carcinogenesis and eventually mortality. The latter is contributed by unnecessary delay in seeking medical care which may be culturally related. The review emphasizes the need to identify causal mechanisms for the complex carcinogenic process which can provide opportunity for prevention and treatment of this potentially curable
cancer.