Oesophageal mucosa in a population at risk of oesophageal cancer: post-mortem studies.

We performed post-mortem studies of oesophageal mucosa from 513 consecutive autopsies of cases who died from unnatural causes or from diseases not related to the oesophagus. Of these, 170 cases were rural blacks from endemic high-risk areas, 98 were urban blacks at high risk, 158 were coloureds at moderate risk and 87 whites at low risk for oesophageal carcinoma. Oesophagi were studied macroscopically and histologically to determine malignant and precursor lesions. A prevalence of 1.0 to 1.8% of squamous carcinoma and 7 to 7.5% of mucosal dysplasia was detected in cases older than 30 years from high-risk urban and rural population groups. These results are in accord with our previous cytological and endoscopical screening studies. No significant differences in the prevalence of oesophagitis, glycogenic acanthosis and atrophy were found in the groups studied. A study of oesophageal melanocytes showed a 3% prevalence, unrelated to dysplastic and malignant lesions, and suggested that these cells were of little if any practical significance as precursor lesions.