Table 4. Summary of similarities and differences between Japan and China in epidemiology of esophageal cancer.
| Japan | China | |
| Similarities | ||
| Histologic type | ESCC: predominant histologic type | |
| Incidence and mortality: men vs women | Higher rates in men than in women | |
| Risk factors | Two established risk factors: cigarette smoking and alcohol drinking | |
| Differences | ||
| Health burden | Relatively low vs other major cancers | High, especially in rural areas |
| Pattern of incidence/mortality according to geographic area | Not noted | Wide variations between rural and urban areas |
| Risk factor profiles according to geographic area | Not noted | Probably different |
| Strength of associations concerning major risk factors: cigarette smoking and alcohol drinking |
Strong | Relatively weak, especially in high-incidence rural areas |
| Association with gastric cardia adenocarcinoma | Not noted | Reported in recent GWAS Studies |
| Loci associated with susceptibility to ESCC in GWAS | PLCE1 and C20orf54 | ADH1B and ALDH2 |
| Prevention strategy | Smoking cessation and avoidance of excessive drinking, especially in individuals with certain susceptibility risk variants, such as ALDH 2*1 genotypes. | Diet, alcohol consumption, and cigarette smoking are essential components. In rural areas, must improve nutritional status, drinking water quality, food preservation, and cooking practices. |
ESCC: esophageal squamous cell carcinoma; GWAS: genome-wide association study; PLCE1: phospholipase C epsilon 1; C20orf54: chromosome 20 open reading frame 54; ADH1B: alcohol dehydrogenase; ALDH2: acetaldehyde dehydrogenase.