Cancer of the oesophagus in Africa. A summary and evaluation of the evidence for the frequency of occurrence, and a preliminary indication of the possible association with the consumption of alcoholic drinks made from maize.

The oesophagus is the most common site of tumour development in men in parts of eastern and southern Africa. In West Africa cancer of the oesophagus is practically unknown. In the areas where it is common, the frequency is not uniformly high but shows sharp gradients within short distances. Most of the present high frequencies seem to have developed from a negligible incidence 30 or forty years ago. In all areas the disease is more common in men than women but the sex ratio varies from less than 2: 1 to 12: 1. Alcohol has been shown to be implicated in the development of cancer of the oesophagus elsewhere in the world. Home-made beer and spirit are common in many parts of Africa but there is no geographical association between frequency of consumption and the occurrence of oesophageal cancer. Evidence exists which suggests that both the geographical and temporal distributions in Africa could reflect the use of maize as a major ingredient of alcoholic drinks.