Abstract: Objective : To compare the age of onset and the survival rate for case of esophagealsquamous cell carcinoma with and without cancer family history of Upper Gastrointestinal Cancer. Methods : A total of 1792 cases with esophageal squamous cell carcinoma from a high risk region innorth China were treated surgically. Chi-square and Student's t-test were used to compare the charac-teristic distribution and the difference in age of onset between cases with positive family history of up-per gastrointestinal cancer (N=495) and those cases with negative one (N=1297). Survival curves wereplotted with Kaplan-Meier methods, and Wald Test in the Cox Proportional Hazard Model was used totest the significance of a prognostic factor adjusted for other factors between the two group cases. Re-Sults : Esophageal Squamous Cell Carcinoma cases with positive family history had onset age significantly younger than those without (51.9± 8.3 Vs 53.4± 8.3 P<0.00), but the former had relatively lowersurvival rates than the latter; the difference were significant for cases over 50 years old (the 3, 5, 10year survival rates for the two group were 55.2 Vs 60.2, 48.8 Vs 54.5, 44.5 Vs 49.4 respectively, (P_wald=0.03) and for UICC stage 0-Ⅰ cases (the 3-, 5-and 10-year survival rates for the 2 group were 87.5Vs 94.7, 87.5 vs 91.6, 87.5 vs 91.6, respectively, (P_wald =0.02). Within the positive family history group,cases under 50 years old had significantly higher survival rates than the over 50 years old (the 3,5,10year survival rates for the two group were 63.4 vs 55.3, 60.6 vs 48.9, 58.5 vs 44.6, respectively, (P_Wald =0.03), whereas within the negative family history group, cases under age of 50 had almost the same sur-vival rate as those over 50 (the 3-, 5-and 10-year survival rates for the two group were 62.3 vs 60.2,54.6 vs 54.5, 50.9 vs 49.4, respectively, (P_Wald =0.67), despite there was a 14.4-year difference betweenthe average age of the 2 group. Conclusion : The findings suggest that the cases with familialesophageal squamous cell carcinoma treated surgically may develop the cancer earlier, and may have apoorer prognosis compared to the sporadic cases from the high risk region. The association found be-tween younger onset-age and higher survival rate for the familial cases only may suggest some advan-tage of early discovery for the survival.