New research on women with cancer involved in the 'unfortunate experiment'

The late Associate Professor Herbert Green.

A new report on gynaecologist Dr Herbert Green's "unfortunate experiment" has described the medical experience of 82 women with microinvasive cancer.

The publication: Outcomes for women without conventional treatment for stage 1A carcinoma of the cervix is the first report that includes women with microinvasive cancer, who were involved in the unethical clinical study at National Women's Hospital during the 1960s to 1980s.

Previous reports had focused on women with CIN3 (pre-cancer), and excluded those with microinvasive cancer.

The recent report confirms that some women with microinvasive cancer underwent numerous procedures designed to observe, rather than treat, their condition and had a substantial risk of developing a higher stage of invasive cancer.

Among these 82, 15 developed a more advanced stage of cancer of the cervix or vaginal vault and eight died from their disease.

None of these women had received conventional treatment or appropriate follow-up.

Lead author, emeritus professor Charlotte Paul from the University of Otago's Department of Preventive and Social Medicine, said, "We have reported these findings in order to document and acknowledge the harm suffered by these women and to complete the picture of the effects of Dr Green's study."

The 10-storey wards block at the National Women's Hospital, in Greenlane.

The "unfortunate experiment" investigated the idea that lesions called cervical intraepithelial neoplasia (CIN) 3 were not related to cervical cancer.

Normal treatment of cone biopsy or hysterectomy was withheld from a group of women who had CIN3.

A follow-up analysis of the women in the experiment, published in 2008, found that those who had minimal disturbance of their lesion, by a small punch or wedge biopsy, had a greater than 30-fold increased risk of developing cancer over 30 years, when compared with women who were adequately treated.

A seven-month inquiry into Green's study, lead by Dame Silvia Cartwright in 1987-88, found that some patients had received inadequate treatment, and in some cases the women had died as a result.

The first independent publication on this study was in 1984. Since then there have been many papers recording outcomes for women of withholding treatment for cervical and vulval pre-cancer.

This is the second paper to specifically address the medical experience and outcomes for the women, and has been published in the Australian and New Zealand Journal of Obstetrics and Gynaecology.

Dr Green and three other doctors were charged with disgraceful conduct, although the charges against Dr Green, then 74, were dropped. The Medical Council found he was unfit to defend the charges. He died in 2001, aged 84.

All data abstracted from the National Women's Hospital files for these studies will be deposited in a special archive being established by the Auckland District Health Board.

Details of the whole human story can be found in the book by one of the study authors, gynaecologist Ron Jones: Doctors in Denial: The Forgotten Women in the 'Unfortunate Experiment', Otago University Press, 2017.