Esophageal Cancer in the Bantu of the Transkei Associated With Mineral Deficiency in Garden Plants2

Abstract
Inspections were made of 29 gardens on which Bantu with esophageal cancer had largely subsisted for 15 to 30 years before their deaths and 29 gardens in the middle of large tumor-free areas nearby. The cancer gardens were less productive than the tumor-free gardens, showed severer leaf signs which indicated molybdenum deficiency, and the leaves of the maize had “withered end” only in these gardens. Molybdenum treatment reduced the incidence of withered end to one quarter. This remarkably close association between esophageal cancer and poor plant production may point to a more direct cause and is being investigated. Results of diagnostic leaf “injections” done in cancer gardens suggested that deficiencies, not only of molybdenum but also of iron, copper, zinc, and other trace elements, were widespread. The increase in crop after treatment proved that molybdenum deficiency had reduced the metabolic efficiency of beans (Phaseolus) and cucurbits to a small fraction of normal and had rendered maize prone to attack by two fungi known to be toxic to animals. These deficiencies may lead to the formation of nitrosamines, some of which cause cancer of the esophagus selectively in rats. A systematic preliminary chemical screening of Bantu Foods from cancer gardens for these and related carcinogens will therefore be carried out. The Appendix describes the cultural habits of Bantu insofar as they may lead to the use of possibly carcinogenic foodstuffs. The staple foods cultivated are maize, pumpkins, beans, and potatoes, and the women eke out a bare subsistence by consuming a wide seasonal variety of weeds, e.g., dandelions (Taraxacum), milky thistles (Sonchus), black nightshade (Solanum nigrum), many of which are known to be poisonous. Signs of malnutrition are common, and in the frequent periods of food shortage the women may well be forced to make use of more and more unsuitable (possibly carcinogenic) plants.