IN the 10-year period under review 168 cases of malignant disease of the small intestine were reported to the Birmingham Regional Cancer Registry. These do not represent all the cases occurring in the Birmingham Region in that time, since at the beginning of the period only the reaching hospitals and a few of the regional hospitals were reporting their cases. Towards the end of the time, however, practically all cases from the whole region were being reported. The cases reviewed, however, form an unselected series for evaluation and the follow-up was almost 98 per cent complete.
A review of all the cases of carcinoma of the stomach reported to the same Registry for the same period has already been published (Brookes, Waterhouse, and Powell, 1965). Reviews of malignant diseases of other organs in the gastro-intestinal tract are under preparation. I n the 10-year period 5441 cases of carcinoma of the stomach were reported, 8968 cases of carcinoma of the colon and rectum, 1264 cases of carcinoma of the pancreas, 550 cases of carcinoma of the liver, gall-bladder, and bile-ducts, and 1054 cases of carcinoma of the oesophagus. These compared with 168 cases of malignant disease of all types in the small intestine, and of these only 55 were carcinoma.
Types of Lesion.-In addition to the 55 cases of carcinoma there were 56 cases of sarcoma, 32 cases of carcinoid tumour, and 25 cases in which there was no definite histological diagnosis. This pattern has been pointed out in other series, and Pagtalunan, Mayo, and Dockerty (1964), reporting the series of 327 cases seen at the Mayo Clinic over a 25-year period, found 129 cases of carcinoma, 108 of sarcoma, and 68 of carcinoid. Table Z compares the series from the Mayo Clinic with our series and shows a striking similarity. The above authors point out the difficulty