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American Journal of Epidemiology Vol. 130, No. 2: 237-247
Copyright © 1989 by The Johns Hopkins University School of Hygiene and Public Health


research-article

MONTHLY INJECTABLE STEROID CONTRACEPTIVES AND CERVICAL CARCINOMA

DAVID B. THOMAS1,, RAMIRO MOLINA2, HECTOR RODRIGUEZ CUEVAS3, ROBERTA M. RAY1, GUSTAVE RIOTTON4, ALFREDO DABANCENS2, SOCORRO BENAVIDES3, LUIS MARTINEZ2, ORIANA SALAS2, JOSE A. PALLET3 and JORGE LOPEZ2

1Program in Epidemiology, Fred Hutchinson Cancer Research Center Seattle, WA
2Faculty of Medicine, University of Chile Casilla 70014-7, Santiago, Chile
3Hospital General de Mexico SSA Balmis 7 Pasteur, Mexico 7, Distnto Federal, Mexico
4Centre de Cytologie et du depistage du Cancer 51 boulevard de la Cluse, 1211 Geneva 4, Switzerland

Reprint requests to Dr. David B. Thomas Fred Hutchinson Cancer Research Center, 1124 Columbia Street, Seattle, WA 98104

The World Health Organization Collaborative Study of Neoplasia and Steroid Contraceptives is a large multinational hospital-based case-control study of steroid contraceptives and gynecologic, hepatobiliary, and mammary neoplasms. Monthly injectable steroid contraceptives which contained the long-acting pro-gestogen dihydroxyprogesterone acetofenide plus a shorter-acting estrogen (usually estradiol enanthate) were used by women in two of the countries (Chile and Mexico) from which data were collected. In preliminary analyses of data from Chile (1979–1983), a strong association was observed between use of these products and invasive cervical cancer. Therefore, three additional data sets from these two countries were analyzed in further detail for this report. Analyses of additional data from Chile on invasive cervical cancer (1983–1985) and cervical carcinoma in situ (1979–1986) and of data on invasive cervical cancer from Mexico (1979–1986) failed to confirm the initially observed association. The original finding was probably due to chance, but a causal interpretation cannot be confidently ruled out, and additional studies are warranted.

cervix neoplasms; contraception agents; female; steriods


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