Linzhou, Yangcheng, Shexian and Yangzhong counties are considered to be high-risk areas for esophageal carcinoma using traditional standards. However, based on the incidence of malignant tumors and death statistics from 1998～2002 in Chinese cities and counties[1], the incidence of esophageal carcinoma in these counties was not the most prominent. In these areas, the incidence of gastric cancer ranked first. So what are the differences between the above-mentioned areas and Changle in Fujina and Linqu in Shandong Province? The authors have combined the defined norms for cardiac cancer, published by the WHO in 2000, with the epidemiological changes in high-risk areas of esophageal carcinoma[2]. We propose to discuss the importance of cardiac cancer morbidity and death registration in tumor monitoring sites all over China, and to provide new views related to this topic of interest.