Background:The exact relationship between gastroesophageal reflux disease (GERD) and esophageal squamous cell cancer (ESCC) is far from clarification.The aim of this study was to investigate the epidemiology of GERD in a region with high prevalence of ESCC in China.Methods:A population-based,cross-sectional study was conducted in a high ESCC prevalent area,Anyang,Henan,China.All subjects fulfilled questionnaires and underwent gastroendoscopy with routine esophageal biopsy.The subjects were divided into GERD subtypes (reflux esophagitis [RE] and non-erosive reflux disease [NERD]) and controls.Odds ratios (ORs) and 95％ confidence intervals (CIs) were calculated to examine risk factors for RE and NERD.Results:A total of 2844 subjects were finally enrolled.The prevalence of GERD (RE + NERD) was 17.3％.Among them,271 (9.53％) adults were diagnosed with RE.The prevalence of RE increased with age (7.09％ in 45-50 years,8.00％ in 51-60 years,and 9.53％ in 61-69 years,x2 =62.216,P ＜ 0.001).Sixty-seven (2.36％) subjects were diagnosed with the silent RE.A total of 221 (7.77％) subjects were diagnosed with NERD.Frequent liquid food consumption (OR [95％ CI]:1.502 [1.076-2.095]) was independent risk factor for RE as well as age,male gender,high body mass index (BMI),ever smoking.Age was independent risk factor for NERD.For silent RE,age,male gender,and frequent liquid food consumption were risk factors.Conclusions:In the population with high prevalence of ESCC,a high prevalence of GERD and inverted proportion of RE/NERD were presented.Age was an independent risk factor for GERD.The male gender,high BMI,smoking,and frequent liquid food consumption may be risk factors for RE but not for NERD.