During a 15-year survey (1955–69) of esophageal cancer among the Bantu of the Transkei, 5095 cases were reported to the registry from a population of 1.7 million. Of these, 3281 were confirmed by doctors. The survey was divided into 3 five-year study periods. Tabulations for the first and last periods were presented and showed an incidence rate for all cases at 35 per 100,000 for males and 17–19 per 100,000 for females for the whole area (African standard). Variation in incidence was marked among the 26 districts, ranging from 116 for males and 50 for females in the Butterworth area to 3 and 2, respectively, in Bizana during the first study period (1955–59). In the third period the pattern of variation between the districts followed that of the first period, and high- and low-incidence areas tended to remain as such. There was, however, a slight decrease in reported cases from the high incidence areas and an increase in the low incidence areas. More cases were confirmed in the second period, and the male to female ratio remained 2:1.