To explore the potential reasons for the decreasing trend in ESCC detection between 2003 and 2018, we used a dataset of 3605 subjects for whom all eight variables were available (ie, age, usual alcohol intake, alcoholic beverage most frequently consumed, cigarette smoking, BMI, chronic atrophic gastritis, ALDH2 genotype, and ADH1B genotype). This evidence concerns the gene ALDH2 and chronic atrophic gastritis.