Plants associated with esophageal cancer cases in Curacao.

The island of Curacao in the Netherlands Antilles lies 60 miles north of northwestern Venezuela. The island is 38 miles long and 7 miles wide at its broadest point, 2tëmiles at the narrowest. The population is roughly 120,000; 75% are locally born negroid. Autopsy records for the period 1936-1960 showed esophageal cancer to be the most com mon malignant tumor for both men and women among these native people (5, 7). A comparison of the number of cases in that 24-year span with the 115 cases among this group in the 6 years 1960-1965 showed an unchanged crude incidence rate of 20.9 per 100,000(6). Local pathologists have considered and abandoned various environmental and food factors as contributory to this unusual health problem (7). At least one field remained unexplored: the possible ingestion of carcinogens through the use of plant "teas" for self-medication and refreshment. In 1965, under Grant ROI CA-07966 from the National Institutes of Health, I began to investigate the extent of this practice, the plants employed, and which ones occurred most frequently in the histories of esophageal cancer victims (8). The environmental conditions can be briefly summarized as follows: There is a large oil refinery in the midst of the heavily populated city of Willemstad, but the prevailing winds gener ally carry the fumes offshore in a southeasterly direction. At times when the refinery is said to be "burning off the bad oil,"