Abstract: Incidence and Geographic Characteristics of Esophagus-gastric Junction AdenocarcinomaZhifeng CHEN, Zhiming DONGCorrespondence to: Zhifeng CHEN, E-mail: czf4591@163.comFourth Hospital of Hebei Medical University Cancer Institute, Shijiazhuang 050011, ChinaAbsract High-risk areas of esophageal cancer in China are mainly distributed in six geographic regions. They are theTaihang Moutains in Northern China; the Qinling Mountains in Shannxi and Henan provinces; the Dabie Moutains in Hubei,He'nan and Anhui provinces; the North of Sichuan; the Fujian and Guangdong provinces and the North of Jiangsu prov-ince. At the same time, there are also high-risk areas of esophageal cancer in the Xinjiang and Gansu in the Northwest ofChina. In 2000, WHO renamed cancer of the gastric cardia as esophageal gastric junction adenocarcinoma. Over the pastfew years, epidemiological studies showed that in the major geographic areas listed the incidence of gastric cardia canceris increasing. Death registration and clinical diagnosis data from the different regions were analyzed in this paper in orderto understand the trends and causes of gastric cardia cancer. In the Taihang Mountains of North China and in the northernparts of Sichuan and Jiangsu provinces, the incidence of gastric cancer in male patients ranked first in 6 of the 10 high-riskregions. The same trend appeared in Fujian and Guangdong, the Qingling Mountains in Shannxi and He'nan, and the north-western regions of China. In northwestern regions of Gansu province, results of endoscopic diagnosis during two time peri-ods (1977-1988 and 1989-2000) were compared. The detection rate of cardiac carcinoma of the gastric fundus increasedby 29.9% in these regions. Cardiac carcinoma accounted for 45.8% in the detection rate of gastric cancer in Wuwei city.Analysis of the affected regions in Uygur gastric cancer patients revealed that cardiac carcinoma amounted for 43.9%～45.3% of all cases with gastric cancer. Based on the current geographical epidemiological data, there is still a high risk ofcarcinoma of gastric cardia in China's traditional high-risk area of esophageal cancer. The phenomenon is more conspicu-ous in the mountain areas and the regions with blocked traffic. There are 2 main explanations behind the increased detec-tion: One is that gastric cardia is to be classified statistically as gastric carcinoma based on the ICD-8 coding, thus chang-ing the traditional registration method in China that classifies cardiac carcinoma as esophageal cancer. Another is the com-prehensive application of endoscopy to improve the differential diagnosis of esophageal cancer from gastric cardia can-cers. Smoking and drinking alcohol surely contribute to the occurence of gastric cardia cancer. But hereditary factors mayplay a major role in causing regional gastric cardia cancer.Keywords Esophagogastric junction adenocarcinoma; Region; Epidemiology