Cancer of the Oesophagus in Africa

Abstract

An association with alcohol consumption has been established elsewhere in the world but the mere quantity of alcohol consumed is insufficient to explain global

A retrospective study of the cancer patterns among hospital in-patients in Botswana 1960-72

“…The frequency in females is much lower (0.4%) but it is increased to 1.4% by the inclusion of the unsubstantiated cases. The sex ratio therefore lies somewhere between 6: 1 and 20: 1 and is more like the situation observed in Johannesburg, Bulawayo or Southern Malawi than that in the Transkei, where it is common in both males and females (Cook, 1972). There is some indication of geographical variation in the frequency of tumours of the oesophagus in males (see Table III).…”

“…The latter region is adjacent to the south-west of Rhodesia, Francistown being only 150 miles from Bulawayo where the frequency of cancer of the oesophagus was found to be 16.2% of all male tumours (UICC, 1970). The change of frequency within Botswana is of interest in view of the dramatic gradients in frequency for this site reported from other parts of Africa and other parts of the world (Cook and Burkitt, 1971;Cook, 1972;Mahboubi et al, 1973).…”

“…Table IV gives, for males and females, the absolute numbers of tumours of specified sites occurring in each age group. Table V (Cook and Burkitt, 1971;Cook, 1972). It is, however, much more common than in West Africa, where it is still virtually unknown (Denues and Munz, 1967;Edington and Maclean, 1965).…”

Factors associated with oesophageal cancer in Soweto, South Africa

“…In some parts of the country it is now the most common cancer in black men (Rose, 1973). Figures from hospitals in Johannesburg which have served the black population show an increase from 2% of all tumours in men in the 1930s, to 11% in the early 1950s and 28% in the early 1960s (Cook, 1971). In Soweto, which is adjacent to Johannesburg and where most of the black population are resident, standard annual incidence rates during 1980-1982 for males and females were 26 and 6 per 100,000 (standardised to world population) respectively (Walker et al, 1984).…”

“…However a population survey conducted in areas of high and low incidence in the Transkei suggests that a combined effect of smoking pipe tobacco and of drinking may be of importance there (McGlashan et al, 1982). Cook (1971) collated information on the occurrence of cancer of the oesophagus throughout Africa and found evidence for a geographical and temporal association with the consumption of beer made from maize. In South Africa there had been a change from using mostly sorghum for beer-making to using mostly maize with sorghum retained only as the fermenting agent.…”