Increased Risk of Rare Cancer as DES Daughters Age

Diethylstibestrol (DES) is a drug that used to be given to pregnant women to prevent miscarriages and premature births. In 1971, the Food and Drug Administration told doctors to stop prescribing DES because it was linked to a rare type of cancer, clear cell adenocarcinoma of the vagina and cervix (CCA). About 2 to 4 million mothers and their babies in the United States may have been exposed to DES, mostly between 1947 and 1971.

The link between DES and CCA was first found in young women who were exposed to DES before they were born, often called “DES Daughters.” As DES Daughters get older, they still may be more likely to get CCA. This study compared the risk of getting CCA between women who were born between 1947 and 1971 to women who were born before 1947 or after 1971. Because data were available covering the entire country over many years, it was possible to study patterns in this rare cancer. The data came from two federal cancer registry programs, the National Program of Cancer Registries (NPCR) and the Surveillance, Epidemiology, and End Results (SEER) program.

Summary

• Women who were born between 1947 and 1971 got CCA more than other women.
• More cases of CCA than expected were diagnosed among women ages 40 to 54 years from 1998 to 2006. These women were born when DES was given during pregnancy.
• Women who were exposed to DES before they were born may still be more likely to get CCA as they get older.
• CCA is still very rare even in women who were exposed to DES.
• Doctors should ask women if they know if their mother took DES while pregnant. This information may help when making decisions about cancer screening tests.

Women who were exposed to DES before they were born should get Pap tests to screen for cervical cancer more often than other women, and cell samples should also be taken from the upper vagina for testing.

Citation

Smith EK, White MC, Weir HK, Peipins LA, Thompson TD. Higher incidence of clear cell adenocarcinoma of the cervix and vagina among women born between 1947 and 1971 in the United States. Cancer Causes and Control 2012;23(1):207–211.