Conclusions: In this region, the proportion of AC has significantly increased in both black and white men with a trend towards an increase in women. Median survival decreased with advancing stage at diagnosis. There was no change in median survival among the three cohorts. However, there were trends towards earlier stage at diagnosis and improved survival in AC. This may be due to surveillance of patients with Barrett’s esophagus. Our results imply that blacks with chronic GERD should also be offered Barrett’s surveillance.