Cancer in a mission hospital in South Africa. With emphasis on cancer of the cervix uteri, liver and urinary bladder

The Ethel Lucas Memorial Hospital serves three African tribes, Shangaans, Swazis and Sothos, in the Lowveld of the North‐Eastern Transvaal of the Republic of South Africa. Two hundred and eleven patients with cancer have been seen there during a 9‐year period. These cases are presented as a relative frequency study in comparison with other selected studies in Southern, Eastern and Western Africa. By these comparisons there is less cancer of the tongue, stomach, nose and sinuses and more cancer of the esophagus, liver, pancreas, cervix uteri and urinary bladder at Acornhoek than elsewhere with certain exceptions. No Burkitt's tumors have been recognized. Three cancers were frequent enough to warrant comparison of their relative frequencies in the three African tribes attending the hospital and to warrant speculation of possible causes. Cancer of the urinary bladder was the only cancer which occurred with a significantly increased frequency in Shangaans and Swazis when compared with its occurrence in Sothos. The evidence for schistosomiasis as a causative agent in cancer of the bladder is inconclusive.