Introduction: Esophageal cancers occur at very high frequency in certain parts of China, Iran, South Africa, Uruguay, France, and Italy and in some regions of India.The highest incidence of this cancer in India has been reported from Assam in the North-East region where it is the second leading cancer in men and third leading cancer in women.A familial aggregation of esophagial cancer has been reported in Assam region of North East India along with high consumption of tobacco paste and tobacco water, suggesting that environmental carcinogens in addition to geographic and genetic factors play major etiologic role.