November 29, 1947


Author Affiliations

Samuel Merritt Hospital, Oakland, Calif.

JAMA. 1947;135(13):869. doi:10.1001/jama.1947.02890130059025

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To the Editor:—  There is admittedly difference of opinion and conflicting clinical and experimental evidence as to the possible role of estrogenic hormones in the production of uterine cancer. There can be no difference of opinion, however, as to the harmful effects of estrogens when their ill advised use delays the diagnosis of uterine cancer and permits an early curable lesion to advance to a stage at which cure is no longer possible.Bleeding is usually the first sign of uterine cancer, and it is perhaps not surprising that the patient, particularly at the time of her menopause, often confuses pathologic bleeding with functional disturbances of menstruation. It is indeed a tragedy when her physician also confuses bleeding with abnormal menstruation and embarks on a program of estrogen therapy without first making certain that he is not dealing with uterine cancer. To realize that such a diagnostic error is by

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