Over a five year period (1978-1982), 520 new cases (males = 492, females = 28) of esophageal carcinoma (OC) have been registered in the department of Calvados in Normandy (589,000 inhabitants). Data were collected from Hospital records, pathological institutes and physicians. Mean age was 62.1 years in males, 70.1 years in females (p less than 10(3]. A higher incidence was observed among farmers and workers in rural areas. A previous or synchronous cancer (mostly oro-pharyngeal) was associated in 86 patients (16.5 p. 100). Fourty-nine p. 100 of OC were located in the middle third of the esophagus. Histologic type was squamous cell in 91 p. 100, adenocarcinoma in 3 p. 100, and undifferentiated carcinoma in 6 p. 100. Esophageal resection was performed in 63, radiation therapy in 294, palliative surgical procedure in 91, and symptomatic treatment in the others. The overall 1-year survival rate was 31 p. 100 and the 5-year survival rate was 3 p. 100. Excluding patients with associated cancer, the survival rates were 40.5 p. 100 and 7.6 p. 100, respectively. In France, the department of Calvados has the highest incidence of OC. The standardised incidence rate in males (31.6/100,000) in Calvados is exceeded only in four countries in the world. Decreasing incidence (4.6 p. 100 each year) has been observed during the past six years (p less than 0.05).