Risk factors and survival from colorectal cancer in black patients in Soweto, South Africa.

In Africa, while colorectal cancer is very uncommon in the black population, it is rising in urban dwellers. A series of 42 patients treated at Baragwanath Hospital, Soweto, were compared with 92 controls. Average age of patients was relatively low 55 years. 73 per cent presented late with far advanced disease at Stages C and D. No familial component was apparent. Patient's years of schooling and social class were non-revealing compared with data on controls. Dietarily, the same applied to fat intake (relatively low) and fibre intake (considerably decreased). Median survival time was short, 7.5 months.

Survival of black patients with gastric cancer in Soweto, Johannesburg, South Africa.

In a series of 39 black gastric cancer patients, treated at Baragwanath Hospital, Soweto, Johannesburg, the time of 50 per cent mortality was 3.5 months, half that of white patients. Patients' median age was lower than that of white patients, 58 versus 70 yr. Male/female ratio was 1.3:1. Black patients presented late; no patients' lesions were at clinical stages I and II, compared with 5-15 per cent reported for white patients. Weight loss, abdominal pain and vomiting were predominant features. Frequencies of smoking and of alcohol consumption in male and female patients appeared much the same as those prevailing in the general population. No marked differences between patients and controls were apparent in socioeconomic state, educational level, general dietary intake, nor in ownership of a refrigerator.

Appendicectomy incidence in black and white children aged 0 to 14 years with a discussion on the disease's causation.

Annual incidence of appendicectomy in urban black and white children of 0-14 yr. for 1985-1987 were estimated from hospital data obtained in Potchefstroom and Bloemfontein, also for black children at Baragwanath Hospital, Johannesburg. Rates per 10,000 children remain low for blacks, varying from 0.5, to 1.9: but were high for whites, 21.5 to 39.5. The latter are within the range of rates published in the West. As to diet, for blacks, mean daily fibre has fallen over several years to 10-14 g, similar to that of whites. Because of progressive fibre depletion, a marked rise in appendicectomies in blacks would be expected. The dietary fibre and the hygiene hypotheses afford only partial explanations for the disease's occurrence. Neither explains puzzling epidemiological differences including the recent fall in whites, nor throws light on the nature of precipitating factors.