Cancer of the oesophagus has great diversity in geographical distribut
ion and incidence. The rate of oesophageal cancer has been increasing
in some areas and the reasons for this are not clear. This review outl
ines fascinating epidemiological aspects and the risk factors for squa
mous cell carcinoma of the oesophagus. While in the Western world the
effects of alcohol an tobacco are substantial preconditions, worldwide
other factors, such as diet, nutritional deficiencies, environmental
exposure and infectious agents (especially papillomavirus and fungi),
play a significant role. Chronic irritation of the oesophagus appears
to participate in the process of carcinogenesis, particularly in patie
nts with thermal and/or mechanical injury, achalasia , oesophageal div
erticulum, chronic lye stricture, radiation therapy, injection sclerot
herapy and gastric resection before the appearance of oesophageal tumo
ur. The association of Plummer-Vinson syndrome, coeliac disease, tylos
is and scleroderma with oesophageal cancer has also been reviewed.