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Cancer risk among women sterilized with transcervical quinacrine hydrochloride pellets, 1977 to 1991
D C Sokal1, J Zipper, R Guzman-Serani
1Family Health International, Research Triangle Park, North Carolina 27709, USA.
Objective:
To determine whether a cluster of eight cancers among 572 women who had received transcervical quinacrine hydrochloride was a random occurrence or evidence of an increased risk of cancer.
Design:
Retrospective cohort study using interviews and reviews of medical records. Cancer cases were evaluated using cohort analyses and space-time cluster methods.
Setting:
Santiago and Valdivia, Chile.
Subjects:
Fourteen hundred ninety-two women who received transcervical quinacrine pellets for sterilization between 1977 and 1989.
Main Outcome Measure:
Age- and site-specific incidence of invasive cancers.
Results:
Eight hundred two women were interviewed. From 1 to 14 years of data were available on 600 of the noninterviewed women from clinic records. During 7,852 women-years of follow-up, 17 invasive cancers were identified, compared with 11.8 expected, based on age-specific rates from the Cali, Colombia cancer registry. Five cases of cervical cancer were observed, compared with 3.96 expected. Only one other uterine cancer was observed, a leiomyosarcoma, compared with 0.2 or 0.3 other uterine cancers expected.
Conclusions:
The occurrence of an unusual cluster was confirmed, but no evidence was found of excess cancer risk associated with quinacrine pellet sterilization. However there was a single provocative observation (the leiomyosarcoma), and surveillance of the cohort is continuing.