Pan D, et al. - Researchers focused on the epidemiology of esophageal precancerous lesions (EPL) in rural Huai'an District in this cross-sectional epidemiological study utilizing the Early Diagnosis and Early Treatment Project of Esophageal Cancer database from 2011 to 2017. A completely distinct pattern was suggested, according to which only a minor role of alcohol use was suggested in EPL, and a significant association was shown by excessive tobacco use in rural Huai'an District, while the dominant factors could be eating habits and environmental exposure. This work may be promising to offer scientific evidence to support primary prevention of esophageal squamous cell carcinoma in this region.