Increasing frequency of esophageal cancer among black male veterans

Between the years of 1975 and 1979, the frequency of diagnosis of esophageal cancer has doubled at the Baltimore VA Medical Center due to a rapid increase of esophageal cancer among black males. This increase was not related to increased yearly hospital admission rates, percentage of black patients admitted yearly, or increased use of the hospital for chronic disease processes. Detailed chart review and comparison with consecutive medical admissions as controls revealed heavy alcohol use and urbanization to be risk factors experienced more frequently by black than white male veterans. A serious question needs to be quickly answered: Does the rise of esophageal cancer at the Baltimore VAMC reflect a rise among black males only in Baltimore or does it reflect a rise nationwide among black males with a history of previous employment in the armed forces?