Incidence of squamous neoplasia of the cervix and vagina in women exposed prenatally to diethylstilbestrol (United States).

Published

Journal Article

OBJECTIVES: Women exposed prenatally to diethylstibestrol (DES) have an excess risk of clear-cell adenocarcinoma of the vagina and cervix, but the effect on the incidence of squamous neoplasia is uncertain. The purpose of the current study was to evaluate the long-term risk of developing high-grade squamous neoplasia of the genital tract among women exposed prenatally to DES. METHODS: A cohort comprising 3,899 DES-exposed and 1,374 unexposed daughters was followed for 13 years (1982 1995) for pathology-confirmed diagnoses of high-grade squamous intraepithelial neoplasia (HSIL) of the genital tract. Poisson regression analysis was used to compute relative risks (RR) and 95% confidence intervals (95% CI), adjusting for age, calendar year, and other covariates. RESULTS: The RR (95% CI) among DES-exposed versus unexposed, based on 111 cases of high-grade disease, was 2.1 (1.2-3.8). Adjustment for screening history estimated by the number of years since the last Pap smear had little effect. Risk estimates were higher with earlier intrauterine exposure; the RR (95% CI) for exposure within 7 weeks of the last menstrual period was 2.8 (1.4-5.5). Only two cases of invasive squamous cervical cancer occurred in total, precluding separate analysis. CONCLUSIONS: The findings support an association between in-utero DES exposure and high-grade squamous neoplasia, although a role for more intensive screening among DES-exposed women in the production of this excess could not be completely ruled out.

Full Text

Duke Authors

Cited Authors

  • Hatch, EE; Herbst, AL; Hoover, RN; Noller, KL; Adam, E; Kaufman, RH; Palmer, JR; Titus-Ernstoff, L; Hyer, M; Hartge, P; Robboy, SJ

Published Date

  • November 2001

Published In

Volume / Issue

  • 12 / 9

Start / End Page

  • 837 - 845

PubMed ID

  • 11714112

Pubmed Central ID

  • 11714112

International Standard Serial Number (ISSN)

  • 0957-5243

Digital Object Identifier (DOI)

  • 10.1023/a:1012229112696

Language

  • eng

Conference Location

  • Netherlands