Cancer risk in DES daughters

Objective We examined long-term risk of cancer in women exposed to diethylstilbestrol (DES) in utero. Methods A total of 12,091 DES-exposed women in the Netherlands were followed prospectively from December 1992 till June 2008. Cancer incidence was assessed through linkage with the Dutch pathology d...

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Bibliographic Details
Published in:Cancer causes & control 2010-07, Vol.21 (7), p.999-1007
Main Authors: Verloop, Janneke, van Leeuwen, Flora E, Helmerhorst, Theo J. M, van Boven, Hester H, Rookus, Matti A
Format: Article
Language:English
Subjects:
Adenocarcinoma, Clear Cell - chemically induced
Adenocarcinoma, Clear Cell - epidemiology
Adult
adverse effects
Age
Biomedical and Life Sciences
Biomedicine
Breast cancer
Cancer
Cancer Research
Cancer risk
Cervical cancer
Cervix
Cervix uteri
Cohort Studies
diethylstilbestrol
Diethylstilbestrol - adverse effects
Epidemiology
Estrogens
Estrogens, Non-Steroidal - adverse effects
Female
Follow-Up Studies
Hematology
Humans
Incidence
Maternal age
Medical records
Melanoma
Middle Aged
Mothers
Netherlands - epidemiology
Nuclear Family
Oncology
Original Paper
Pap smear
Pathology
Pregnancy
Prenatal exposure delayed effects
Prenatal Exposure Delayed Effects - chemically induced
Prenatal Exposure Delayed Effects - epidemiology
Prospective Studies
Public Health
Questionnaires
Registration
Registries - statistics & numerical data
Risk Factors
Surveillance
Surveys and Questionnaires
Tumors
Vagina
Vaginal Neoplasms - chemically induced
Vaginal Neoplasms - epidemiology
Womens health
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Summary:Objective We examined long-term risk of cancer in women exposed to diethylstilbestrol (DES) in utero. Methods A total of 12,091 DES-exposed women in the Netherlands were followed prospectively from December 1992 till June 2008. Cancer incidence was assessed through linkage with the Dutch pathology database (PALGA) and the Netherlands Cancer Registry and compared with the Dutch female population. Results A total of 348 medically verified cancers occurred; median age at end of follow-up was 44.0 years. No overall increased risk of cancer was found (standardized incidence ratio [SIR] = 1.01; 95% confidence interval [CI] = 0.91, 1.13). The risk of clear cell adenocarcinoma of the vagina and cervix (CCA) was statistically significantly increased (SIR = 24.23; 95% CI = 8.89, 52.74); the elevated risk persisted above 40 years of age. The risk of melanoma diagnosed before age 40 was increased (SIR = 1.59; 95% CI = 1.08, 2.26). No excess risks were found for other sites, including breast cancer. Conclusions Except for an elevated risk of CCA, persisting at older ages, and an increased risk of melanoma at young ages, we found no increased risk of cancer. Longer follow-up is warranted to examine cancer risk at ages when cancer occurs more frequently.
ISSN:0957-5243
1573-7225
1573-7225
DOI:10.1007/s10552-010-9526-5