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A survey has been carried out covering the years [1964][1965][1966] to obtain the cancer incidence for Africans and Indians of the metropolitan area of Durban, Natal.Tables of comparison of the standardized cancer morbidity rates between Durban Africans, Durban Indians, Durban Hindus, Durban Moslems, Johannesburg Africans (1954) and English resident in England (four regions) are given.All rates used in this paper are standardized against the African Standard Population (Doll et al., 1966).The overall cancer incidence in Durban Africans of both sexes and Durban Indian females is as high as for most westernized countries. Indian males have a low overall cancer incidence which is not readily explained.The commonest male African cancers are at the sites of oesophagus, lung and liver; oesophageal and lung cancer rates show a tendency to rise.The commonest female cancer in both Africans and Indians is cancer of the cervix uteri. In addition, Indian females appear to be prone to cancers of the whole alimentary tract. This tendency is even more pronounced among Moslem women, who also are much more subject to breast cancers than Hindu women.

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Summary.-A study of the smoking and drinking habits of 196 oesophageal cancer cases and 1064 control patients was made. All subjects were African males aged 35 years or more, drawn from a mainly urbanized population.It was found that tobacco smoking was prevalent and that pipe tobacco (used in pipes or in hand rolled cigarettes) was used more frequently than has been found in westernized countries. The drinking of alcohol was also a prevalent habit. Tribal affiliations were examined and all three of these factors showed differences between cases and controls. Further analysis of smoking and drinking together showed that only smoking had a positive association with oesophageal cancer, and this was also true after tribal adjustment had been made. A comparable analysis of data on Durban African males yielded similar findings. It was concluded that tobacco smoking was a powerful oesophageal insult but the authors were not able to show that alcohol was important in the development of oesophageal cancer in these people. Cigarette tobacco does not appear to be a significant oesophageal insult but pipe tobacco does, and the use of both these types of tobacco together may have a synergistic effect. Tribal affiliation has bearing on the smoking pattern.THE RISE in incidence of oesophageal cancer in southern Africa over the last 40 years has been well documented (Burrell, 1957(Burrell, , 1962Higginson and Oettle, 1960;Skinner, 1967;Oettle, 1967) and a current high incidence in African males has been found in Durban (Schonland and Bradshaw, 1968) and Johannesburg (Robertson, Harington and Bradshaw, 1971).Tobacco and alcohol consumption have been considered as possible aetiological agents by many workers (Clemmesen, 1965) and it is these two habits, taken separately and together, which have been investigated in this study.

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