Diethylstilbestrol (DES) Update: Recommendations for the Identification and Management of DES-Exposed Individuals

Barbara Hammes, CNM, MS, Cynthia J. Laitman, PhD

Disclosures

J Midwifery Womens Health. 2003;48(1) 

In This Article

Adverse Health Effects Associated With DES Exposure

Women who took DES during pregnancy ("DES mothers") have a modest but statistically significant increased risk of breast cancer compared with women who are not exposed to DES. In a study of 3,029 DES-exposed women and 3,029 unexposed mothers who delivered live babies at four centers in the United States between 1940 and 1960, Colton et al. found a slightly increased rate of breast cancer in DES mothers (RR 1.35; 95% CI 1.05-1.74). The risk did not appear to increase greatly over time.[3]

The largest and most complete study of breast cancer risk was sponsored by the National Cancer Institute and published in 2001 by Titus-Ernstoff et al.[2] These researchers studied the long-term risks of cancer in DES mothers in two cohorts, the Mothers Study cohort from Rochester, MN, Portland ME, Boston, MA, and Hanover, NH, and mothers from the Dieckmann Study cohort at the University of Chicago. Again, a modest association between DES exposure and elevated breast cancer risk (RR 1.27; 95% CI 1.07-1.52) was found. The modest increased risk of breast cancer in women who were given DES in pregnancy (DES mothers) was not further increased by a family history of breast cancer, history of oral contraceptive use, or use of hormone replacement therapy. They found no evidence that DES was associated with higher risks for development of other cancers, including ovarian and endometrial cancer.

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