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HOFFMAN in 1915 stated confidently that " when every reasonable allowance is made for the want of accuracy and completeness in the available returns for the African Continent, it would seem safe to assume that cancer is of a relatively very low degree of frequency in African countries. even among the white population of European origin and that among the native population, as a general rule, maliginant disease is extremely rare ". A steady flow of information from Africa, particularly in the last two decades, has shown that cancer in Africa is far from rare, although very different from the pattern seen in Europe and North America. A study of the cancer pattern of Southern Uganda, using the records of the Kampala hospital from 1897-1956 by Davies et al. (1964), indicated that the type and site pattern of cancer had not changed substantially over the years. The enthusiasm to record cancer patterns in Africa has been stimulated by the discovery of unusual situations, the investigation of which may add considerably to our knowledge of neoplasia. Early surveys were relative frequency studies of hospital or laboratory biopsy material which enabled comparison with other African or developing countries to be made. These studies contained many biases of collection and comparison with surveys from countries with more sophisticated vital statistics was excluded. Many objections to relative frequency ratio studies in Africa have been made; the reluctance of the public to use available medical facilities, illustrated by the preponderance of male patients in African hospitals, the varying medical facilities which are not themselves related absolutely to population density, the influence that the enthusiasm of medical staff in under-doctored areas can play in the detection of a specific disease and, above all, the natural preponderance of cancers readily available to the surgical knife in a poorly equipped peripheral hospital. However, none of these biases explained the impressive percentage of some tumours in early reports from Africa primary cancer of the liver in Portuguese East Africa, Prates (1943), the African lymphoma, Burkitt (1958) and naso-pharyngeal cancer in Kenya, Clifford (1961). There are now reliable rate surveys from Southern Africa, Nigeria, Portuguese East Africa and Uganda from which we cani assess the overall incidence of cancer and of specific sites against the background of developed countries. Edington and Maclean (1965) in a recent study in Ibadan comparing a relative ratio frequency survey with a rate study of …

Cancer incidence in Kenya 1957-63.