Abstract: To analyze the incidence trends of esophageal and gastric cancer in Cixian based on tumor registry data from 1988 to 2007. Methods: The esophageal and gastric cancer incidence in Cixian from 1988 to 2007 was obtained from the C15.0-C15.9 and C16.0-C16.9 databases. The annual percent change ( APC ) was calculated using the y = α + βχ + ε linear model. Results: The overall incidence of esophageal cancer displayed a downward trend. The APC of the total incidence in men and women combined was -1.15% ( P = 0.002 ). In women, APC = -1.47% ( P = 0.001 ), and in men, APC = -0.94% ( P = 0.119 ). The trend in the incidence of gastric cancer increased. The overall gastric cancer APC in both sexes was 1.3%, with 1.5% for men, and 1.3% for women, all of which are statistically significant ( P = 0.083 ). For the sub-site, cardiac cancer exhibited the highest significant increase, accounting for 40.0% of all gastric cancer cases. The APC of the total incidence in men and women was 8.07%, with 6.51% for women, and 8.07% for men. All statistical calculations were significantly different ( P < 0.001 ). The incidence showed a downward trend when the anatomic site was associated with esophageal and cardiac cancer, but the difference was not statistically significant. Conclusion: For the past 20 years, the incidence of gastric cardia cancer in Cixian has been increasing, whereas that for esophageal cancer has been declining. The increase in the incidence of gastric cancer is closely related to the ICD  coding rules.