| Popis: |
To determine whether the incidence of in situ cervical carcinoma was increased among a cohort of women who received transcervical insertions of quinacrine hydrochloride pellets into the uterine cavity as a method of nonsurgical sterilization.Retrospective review of Papanicolaou (Pap) test results, comparing incidence of high-grade lesions among quinacrine acceptors with a comparison population.Outpatient clinics, Santiago, Chile.Women attending a family planning clinic (quinacrine acceptors) and a comparison population from another area of Santiago.Incidence of in situ cervical carcinoma.During 3,668 woman-years of follow-up, 8 women in the quinacrine group were found to have in situ carcinomas for an age-adjusted rate of 2.62 per 1,000 woman-years. The incidence in a comparison population was 1.62 per 1,000 woman-years, but the difference was not statistically different.The age-standardized incidence of in situ carcinoma among the quinacrine sterilized women was not significantly different from the rate in a comparison population of women in Santiago. However, the study has a number of limitations.To determine whether transcervical quinacrine hydrochloride sterilization increases the risk of in situ cervical cancer, Papanicolaou smear data from 1061 women who underwent this procedure in Santiago, Chile, in 1977-90 were compared to those from a similar group of nonsterilized Santiago women. The average length of follow-up was 3.5 years in the quinacrine group and 2.4 years among controls. The 3285 woman-years of exposure recorded in the quinacrine group yielded 8 cases of in situ cervical carcinoma; among controls, there were 22 cases in 12,355 woman-years of observation. The crude incidence rates of high-grade cervical pathology were 2.18/1000 woman-years in the quinacrine group and 1.78/1000 among controls, for a crude rate ratio of 1.37 (95% confidence interval, 0.61-3.07). The age-standardized rates were 8.62/3285 or 2.62/1000 woman-years and 19.96/12.355 or 1.62/1000 woman-years, respectively, yielding a nonsignificant rate ratio of 1.62 (95% confidence interval, 0.73-3.61). Although this study suggests that quinacrine sterilization is not associated with an increased risk of cervical carcinoma, the analysis was limited by differences in the length of follow-up between the two groups, the non-uniformity of recruitment and follow-up procedures, and an absence of data on other risk factors for cervical cancer. Additional research on the toxicity of quinacrine is planned to better assess its possible carcinogenicity. |
