A spatial and temporal analysis of four cancers in African gold miners from Southern Africa.

The pattern of cancer in African gold miners over the 8-year period 1964-71, comprising 2,926,461 man-years of employment was studied. Of the 1344 cancers found, primary liver cancer accounted for 52-8%, oesophageal cancer 12-1%, cancer of the respiratory system 5-4% and cancer of the bladder 4-8%. Analysis of the spatial distribution of these four cancers, both on subcontinental and local scale, showed distinct gradients of occurrence between areas of significantly higher and lower incidence than expected. In the case of primary liver cancer in Mozambique and oesophageal cancer in the Transkei, the spatial distribution reflects closely that found in the general resident population of each territory. The crude incidence rate of primary liver cancer in gold miners from Mozambique dropped sharply over the period of the survey.