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may well be fortuitous or related to the increasing use of this procedure, or may be related to the initial reason for advising sterilization. All three of our patients had psychological reasons for seeking sterilization and, in addition, one had already established hypertension on the basis of chronic pyelonephritis. The possibility exists that the relation between the use of oral contraceptives and the disease could be due to the contraception itself rather than to its methods of achievement. This might be worth looking into before concluding that oral contraceptives are a risk factor in acute myocardial infarction and before recommending sterilization as a preferable method of contraception.It is now well established that the risks of developing ischaemic heart disease prematurely are increased in association with excess cigarette smoking (Doll and Hill, 1964) , 1971). Obviously all these factors are interrelated and must be taken into account in interpreting the role of oral contraceptives in myocardial infarction.The available evidence suggests that it would be wise to identify those risk factors commonly associated with ischaemic heart disease in young women about to start oral contraceptive therapy. It is easy to screen for hypertension and to monitor blood pressure subsequently. In those with a family history of precocious ischaemic heart disease a case can be made for screening for abnormalities in blood lipid concentrations and also for giving advice against cigarette smoking. In those with identifiable risk factors alternative contraceptive measures should be advised or, if personal circumstances demand, the duration of oral contraceptive use should be limited.

APPROXIMATELY 4,000 men die every year in this country from carcinoma of the prostate. This is almost the same number of deaths as from carcinoma of the body of the uterus and cervix and is actually greater than the number of both sexes dying from carcinoma of the bladder (Registrar General, 1969). The major cause of death is from widespread metastases and this is in spite of the advances in treatment such as rational use of estrogens, orchidectomy, radiotherapy and hypophysectomy .