To determine the incidence and mortality rates of esophageal cancer in central-western Brazil: Goiania, Brasilia, Cuiaba, and Campo Grande, incidence data for Cuiaba (2000-2005) and Brasilia (1999-2002) were obtained from the National Cancer Institute, and data from Goiania (1995-2008) from the Population-Based Cancer Registry of Goiania. Mortality data for the cities of central-western Brazil were obtained for the period 1980-2008 from the Ministry of Health. Age-standardized incidence and mortality rates were calculated using the world population of Segi. Mortality trends were assessed with the Joinpoint Regression Program and a P value less than 0.05 was defined as significant. The highest incidence of esophageal cancer among men was in Cuiaba ' (16.0/100 000); the lowest was in Goiania (6.5/100 000). Among women, the incidence rates were similar in Brasilia and Cuiaba, but in Goiania, the incidence declined. There was a significant increase in mortality among men in Cuiaba (2.4%, P = 0.03) and Campo Grande (1.2%, P=0.05), and in women (1.6%, P = 0.04) in Goiania. Mortality by age group increased significantly in Campo Grande by 1.9% for men aged at least 50 years and in Goiania by 2.7% among women aged at least 50 years; the mortality decreased in Goiania by 2.2% for women aged less than 50 years. The incidence of esophageal cancer in Brasilia and Cuiaba was similar to that of southern Brazil in some periods. There was an increase in mortality trends for men in Cuiaba and Campo Grande, and for women in Goiania. European Journal of Cancer Prevention 22: 235-243 (C) 2013 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.