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A prospective study was devised in 1980 to assess the effect on survival of neoadjuvant Provera as part of the primary treatment of endometrial carcinoma in conjunction with surgery and radiotherapy. Between June 1980 and June 1985, 218 patients with Stage I adenocarcinoma of the corpus uteri were allocated on the basis of hospital of presentation to receive either neoadjuvant treatment with medroxyprogesterone acetate (MPA) 100 mg t.i.d. p.o. from diagnosis for 90 days, or no adjuvant treatment (the control group). The minimum follow-up was 5 years. There was no significant difference between the overall actuarial survival in the treatment group (123 cases) and that in the control group (95 cases). This was 83.7% and 69.2% at 5 and 10 years respectively in the treatment group and 78.9% and 70.7% in the control group (P > 0.1).

50 women aged up to 35 years were diagnosed as having carcinoma of the cervix in Brighton, England between 1980 and 1985. The overall 5-year actuarial survival was 65% and 73% for stage IB. The 5-year survival for those aged 29 years or less was significantly worse than for those aged between 30 and 35 years, 39% versus 80%. There was a higher incidence of advanced stage and high-grade tumours in the younger women. It is suggested that the natural history of the tumour in women under 30 years is shorter than that in older women, and this is likely to be associated with high-grade, rapidly advancing carcinomas of poor prognosis.