Long term follow-up of patients with menorrhagia treated by irradiation

Two thousand and forty-nine patients treated for menorrhagia by ovarian irradiation at the Christie hospital in the period 1946–60 have been followed-up for an average of 14·6 years. The number of deaths occurring from different causes has been compared with the expected number, taking age, calendar period and region of residence into account. There was a slight excess of deaths from all causes, an excess of deaths from leukaemia, pelvic cancer, and coronary artery disease, but the excess was not significant at the 5 per cent level; the number of deaths from breast cancer was significantly below the expected figure. When examined by interval since irradiation, there were three deaths from leukaemia five to nine years after treatment compared with an expected figure of 0·37; this excess is significant at the 1 per cent level. Operative treatment by hysterectomy has a mortality of about one or two per 1,000 patients; the appropriate treatment can only be determined by clinical assessment of each patient.