| Abstract: | A 3-year progress investigation of the results of continuing serial cytologic, cytochemical, colposcopic, histologic, and clinical studies i nvolving 782 women is reported. These patients were selected from 60,00 0 women by a cytodiagnostic screening group before medication was given. The drug used was the steroid contraceptive Enovid, a combination of 9.85 mg norethynodrel with .15 mg mestranol. The usual daily dose of Enovid was 2, 5, or 10 mg orally. Tablets were taken in 20 doses from D ay 5 to Day 24 of the menstrual cycles. In some, continuous therapy was given at the same dosage for 60-240 days. Response was not related to dosage. Medication was begun after a cell-diagnosis was made. Frequent periodic examinations were made of cells scraped from the squamo-columnal junction of the cervix. This method was considered much more accurate than smears from the vaginal area. Some were followed for 3-4 years. No case was found in which a lesion progressed to a stage of infiltration. In the 654 women found to have normal cytology, Enovid therapy appeared to have exerted no unfavorable influence. Of the 66 women who had preexisting inflammatory lesions with precancerous tendencies, slight progression was noted in 2 (6%) and remission in 20 (30%). In 42 (64%) no change was found after Enovid medication. Of 60 patients having marked dysplasia of cells or with beginning carcinoma in situ, 3 (5%) showed remission, 15 (25%) showed fluctuation of findings, and 42 (70%) showed unaltered expected progression. Cytochemical investigations included continuing fluorescent microscopic studies to evaluate changing levels of DNA and RNA, glycogen studies, and micropolysaccharide evaluations. It is concluded that Enovid showed no carcinogenic influence even in preexisting premalignant dysplasia or carcinoma in situ of the cervix. However, periodic examinations with cervical cytologic studies are recommended for those under Enovid medication. |
