The Indian Health Service still prescribes Depo-Provera as a contraceptive for Indian women although the U.S. government rejected the drug for that use almost a decade ago.
The IHS said last week it has prescribed Depo-Provera for 150 to 200 Indian women in recent years and currently prescribes it for 35 women.
"What makes me nervous is the history of this country and how we've treated Indians -- we once gave them blankets infected with smallpox," said Rep. Sam Gejdenson (D-Conn.), chairman of the House Interior investigations subcommittee.
"Are we paying less attention to the health of these women because they're Indians?" he said.
However, Dr. Everett Rhoades, the IHS director, said the small number of Indian women currently receiving Depo-Provera -- 35 of a potential child-bearing population of 225,000 -- indicates the agency uses the drug with caution.
The drug, a synthetic version of the female hormone progesterone, was developed by the Upjohn Co. in the mid-1950s. In 1967, the company sought Food and Drug Administration approval of Depo-Provera as a contraceptive. The agency approved the drug in 1974 but reversed that position in 1978 after concerns arose that it might cause cancer.
The FDA's Center for Drugs and Biologics said of the drug: "Never has a drug whose target population is entirely healthy people been shown to be so pervasively carcinogenic in animals as has Depo-Provera."
The drug currently has U.S. approval for use only as a treatment for uterus and kidney cancer.
However, the American College of Obstetricians and Gynecologists said more than 90 countries have approved Depo-Provera for contraceptive purposes, including England and France, and an estimated 1.5 million women worldwide use the drug. It is injected every three months.
The World Health Organization uses the drug as a contraceptive, but the Agency for International Development and Planned Parenthood do not.
Of the 35 Indian women currently using the drug, the IHS described four to six as developmentally disabled and the others as unable to use other contraceptives.