The lower Third of the Esophagus is observed free of Malignancy. There are 2 types of cancer - squamous cell carcinoma and adenocarcinoma. In the United States, squamous cell carcinoma is much more common in blacks than whites. Chronic alcohol and tobacco use are strongly associated with an increased risk of squamous cell carcinoma. Adenocarcinoma is more common in whites, and is increasing dramatically in incidence. The vast majority of adenocarcinomas develop as a complication of Barrett's metaplasia ,which is a complication of chronic gastro esophageal reflux. Thus most adenocarcinomas arise in the lower third of the esophagus.
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