Age standardized incidence rates for esophageal cancer (EC) in East Africa have been previously reported as high as 47.2 per 100,000, compared to the worldwide incidence of 9.0 per 100,000. Sharp geographic gradients in the incidence of EC suggest a dominant role for environmental carcinogens in etiology. We are seeking sought to explore possible etiologic risk factors for the high incidence of EC in Tanzania. We are conducting a case-control study to explore potential etiologic effects of diet, lifestyle, and environment. Newly diagnosed EC cases are recruited at Muhimbili National Hospital and Ocean Road Cancer Institute. Hospital controls are identified from inpatients with non-malignant conditions and matched 1:1 for gender and age ±10 years. The study team conducts in-person interviews with cases and controls in Swahili to evaluate self-reported behaviors. A genome-wide analysis study (GWAS) using DNA extracted from saliva specimens obtained from cases and controls is planned.