Cancer of the esophagus has shown peculiar worldwide geographic clustering; it has also occurred in excess among individuals in lower socioeconomic census tracts of certain cities. These facts have prompted inquiry into its etiology. Emphasis has been given to environmental effects, particularly mechanical and/or irritating processes, dietary deficiency, and a variety of carcinogens. Immunological susceptibility has been considered, although only infrequently. Overall, primary genetic factors have received short shrift in epidemiological investigations of this disease. An hypothesis of stress related cancer in concert with genotypic susceptibility is presented.
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