MORTALITY IN A COHORT OF WOMEN GIVEN X-RAY THERAPY FOR METROPATHIA HAEMORRHAGICA

Mortality to January 1, 1991, has been studied in 2,067 women in Scotl and given X-ray therapy for metropathia haemorrhagica during the perio d 1940-1960. Average follow-up was 28 years. Overall, 1,313 deaths wer e observed compared with 1,297.01 expected from Scottish rates [standa rdized mortality ratio (SMR): 1.01]. Mortality was increased for cance rs of heavily irradiated pelvic sites (SMR 5+ years after irradiation: 1.46) following mean doses to organs in the vicinity of the pelvis in the range 2.6-5.3 Gy. For these cancers the SMR was higher 30+ years after irradiation than at 5-29 years, indicating that the effects of e xposure last for over 30 years, and in this period bladder cancer mort ality was exceptionally high (SMR = 4.91). Mortality was also raised f or leukaemia (SMR 2+ years after irradiation: 2.05), following a mean bone-marrow dose of 1.3 Gy, and for multiple myeloma (SMR 5+ years aft er irradiation: 2.59). For leukaemia the SMR was lower 30+ years after irradiation than at earlier periods, but remained greater than unity. For other cancers mortality was similar to Scottish rates, except for breast cancer for which mortality was low (SMR 5+ years after irradia tion: 0.53), even in women aged over 50 at irradiation (SMR 5+ years a fter irradiation: 0.14). The deficit was principally due to a large de ficit of breast cancer in women with ovarian doses of at least 5 Gy. ( C) 1994 Wiley-Liss, Inc.