The incidence of oesophageal cancer in the Netherlands has doubled in the period 1978-1996 (from 2.2 to 4.8 per 100.000 person-years) and at the end of this period the incidence of adenocarcinomas equalled the incidence of squamous cell carcinomas1• The main risk factors for squamous cell carcinomas are alcohol and tobacco. Adenocarcinomas of the oesophagus are associated with obesity2 , symptoms of gastric reflux3 and to specialised columnar (Barrett's) epithelia4 • In recent years several genetic events that occur within the oesophageal mucosa leading to oesophageal adenocarcinoma have been discovered5·". However an overall understanding of the rising incidence remains incomplete.