International forum update: depot medroxyprogesterone acetate and endometrial carcinoma

In response to a recent report (Fam Plann Perspect 11: 47, 1979) that two of 12 rhesus monkeys given 50 times the human dose of depot medroxyprogesterone acetate (DMPA), by body weight, for ten years had developed endometrial carcinoma (CA), a retrospective survey of all hospital admissions for proven endometrial CA in two Thai provinces where DMPA contraceptive injections have been widely used since 1965 was made. From 1974 through 1978, 16 women were hospitalized with confirmed diagnoses of endometrial CA. None of the nine women successfully followed up had previously used oral or injectable contraceptives, nor has the recorded incidence of endometrial CA increased in these provinces. Base on the available evidence, the authors conclude that (a) the data on monkeys given very large doses of DMPA for ten years do not apply to women given normal doses of DMPA for prolonged periods and (b) widespread and long-term use of DMPA can and should be continued.