Cancer of the oesophagus in Soweto

Abstract

Oesophageal cancer is remarkably common in Transkei, a rural part of South Africa, but has not been thought to affect urban blacks nearly as often. The incidence of oesophageal cancer in Soweto, South Africa's largest urban black community, is assessed. The age-standardized incidence is 125/100 000 in men and 37/100 000 in women. Oesophageal cancer is now a disease as much of urban as of rural blacks, a fact which may be epidemiologically significant. The prognosis for oesophageal cancer in blacks is widely believed to be almost hopeless, regardless of treatment. The results of treatment in 265 patients over 3 years are presented - in 21% the disease was confined to the oesophagus and these patients were treated by oesophagectomy (30% 3-year survival rate); 23% had local spread and were treated by extra-oesophageal bypass (11% 1-year and 2% 2-year survival rate); and 51% had advanced disease (1% 1-year survival rate, no survivors at 2 years). Five per cent of the patients died before any treatment could be given.