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© 1994 Oxford University Press

other

Mortality Following Radiation Treatment for Infertility of Hormonal Origin or Amenorrhoea

ELAINE RON*, JOHN D BOICE, JR*, STANFORD HAMBURGER** and MARILYN STOVALL{dagger}

* Radiation Epidemiology Branch, National Cancer Institute NIH, Bethesda, MD, USA
** Center for Devices and Radiological Health, Food and Drag Administration Rockville, MD 20852, USA
{dagger} Department of Radiation Physics, University of Texas MD Anderson Cancer Center Houston, TX 77030, USA

BACKGROUND: Between 1920 and 1965, radiation treatment to the ovaries and/or pituitary gland was used for refractory hormonal infertility and amenorrhoea. The potential carcinogenic effects of hormonal infertility, as well as exposure to relatively low doses of ovarian and pituitary radiation can be studied among patients receiving these treatments.

METHODS: A cohort of 816 patients treated between 1925 and 1961 was identified from the medical records of a New York City radiologist. The mortality experience for 84% of these women was determined and radiation doses for individual patients were estimated. Doses were, on average, 87, 64, 54, and 29 cGy to the ovary, brain, colon, and active bone marrow, respectively.

RESULTS: Compared with mortality rates in the US population, the risk of death was less than expected (standardized mortality ratio [SMR] = 0.87; 95% confidence interval [Cl]: 0.75–1.00). Deaths due to circulatory and digestive diseases were significantly below expectation. Cancer mortality was about 10% higher than that expected based on New York City mortality rates. Based on a small number of cases, no increase was found for cancers of the ovary or brain, or leukaemia, sites for which direct radiation exposure occurred, but significant excesses of colon cancer and non-Hodgkin's lymphoma were observed A deficit In mortality from female genital cancers was surprising, since nullipariry has been a consistently reported nsk factor for cancers of the endometrium and ovary. Breast cancer mortality was close to expectation.

CONCLUSIONS: Overall, this study provided little evidence that either infertility or its treatment with radiation increased the risk of total or cancer mortality.

Received 1 May 1994


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