Polyps and carcinoma of the large bowel in the South African Bantu

Abstract

The South African Bantu has an unusual pattern of disease of the large bowel. for all practical purposes he does not have Crohn's diseaseulcerative colitisor diverticulosis. Cancer of the large bowel is of extremely low frequencyand this series of 96 cases was never associated with adenomatous polyps. in 14,000 autopsiesno adenomatous polyps were found. During a 12-year period at the Baragwanath Hospital (2,000 beds)only 6 adenomatous polyps were submitted to Surgical Pathology. Low incidence of carcinoma of the large bowel is undoubtedly environmental rather than genetic. in direct contrast to the United Statesthe Bantu has an extremely bulky diet and increased frequency of defecation. Bacterial flora may also be important. Because of these factorswe should be concerned with prevention as well as detection of large bowel cancer.