Esophageal carcinoma diagnosis. Dr. Anton Titov, MD. What are the symptoms of esophageal carcinoma? Dr. Jari Rasanen, MD. And what are the typical patient demographics at diagnosis? The age, particular risk factors, because we know that esophageal carcinoma is diagnosed at late stages frequently. That's the problem. Usually the patients will get the symptoms at a very late stage of the esophageal cancer. Common symptoms are difficulties in swallowing your food. Some pain problems can be there. But very often when you get the symptoms, it is rather late stage of disease already. Dr. Jari Rasanen, MD. And therefore, if a patient has some chronic inflammation in his esophageal mucosa, he or she should be followed up with gastroscopies. Then you could find possible esophageal cancer in the early stages. There are some countries with particular risk factors for esophageal carcinoma, where esophageal carcinoma happens more often. Is it hot drinks, particular alcohol, or smoking or anything else that is a risk for esophageal cancer? There is a significant difference between the types of esophageal cancer in Western and Eastern countries. In Western countries, esophageal cancer is related to gastric reflux disease. Gastric reflux, on the other hand, is related to obesity. So, basically obesity and reflux disease are the most important risk factors in Western countries. On the other hand, in the Eastern countries, the type of esophageal cancer is more often squamous cell carcinoma. Esophageal cancer risk is more related to hot beverages, tobacco smoking, and alcohol consumption. There are certainly some genetic differences between western and eastern countries, which can also explain the epidemiological differences. Does the location of his esophageal cancer differ from eastern and western countries depending on the histological type of esophageal cancer? Yes, it does, because, like, squamous cell carcinoma, basically can be found everywhere in the esophagus, but it is more common in the middle and upper part of the esophagus. On the other hand, adenocarcinoma, which is more common In Western countries, it's almost always in the distal part of the esophagus.