Esophageal and gastric cancers are leading causes of cancer-related mortality worldwide, with a disproportionate burden in low and middle-income countries. In Afghanistan, population-based cancer data are scarce, and hospital-based studies remain essential for understanding local disease patterns. This study aimed to describe the demographic characteristics, histopathological patterns, and distribution of esophageal and gastric cancer at a major tertiary referral center in Kabul.

This retrospective hospital-based case series included all patients diagnosed with esophageal or gastric cancer at Jumhoriat Hospital, Kabul, between October 2023 and August 2024. Demographic, socioeconomic, behavioral, and histopathological data were extracted from medical records. Descriptive statistics were used to summarize findings, and the chi-square test assessed the association between sex and cancer type.

Out of 3,250 registered cancer cases, 917 patients were diagnosed with esophageal or gastric cancer. Esophageal cancer accounted for 708 cases (77.2%), while gastric cancer comprised 209 cases (22.8%). The highest proportion of cases occurred in the 55–64-year age group for both esophageal (28.2%) and gastric cancers (32.0%). Esophageal cancer showed a relatively balanced sex distribution (53.2% male), whereas gastric cancer was significantly more frequent among males (71.2%) (χ² = 20.75, p < 0.001). Squamous cell carcinoma was the predominant histological subtype of esophageal cancer (70%), while adenocarcinoma was the most common subtype of gastric cancer (81.3%). A high proportion of patients, particularly those with esophageal cancer (85.3%), belonged to a low economic status, and substance use (primarily opium derivatives) was frequently reported.

Esophageal cancer constitutes the majority of upper gastrointestinal cancer cases at this major referral center in Kabul, with both malignancies predominantly affecting individuals aged 55–64 years. The observed patterns align with reports from other low-resource settings and highlight the need for targeted prevention strategies, strengthened early detection, and investment in a population-based cancer registry in Afghanistan.