Higher incidence of clear cell adenocarcinoma of the cervix and vagina among women born between 1947 and 1971 in the United States

Journal Article · Fri Oct 21 00:00:00 EDT 2011 · Cancer Causes and Control

DOI:https://doi.org/10.1007/s10552-011-9855-z· OSTI ID:1816625

Smith, Emily K. ^[1]; White, Mary C. ^[2]; Weir, Hannah K. ^[2]; Peipins, Lucy A. ^[2]; Thompson, Trevor D. ^[2]

---

1. Centers for Disease Control and Prevention (CDC), Atlanta, GA (United States). Division of Cancer Prevention and Control. Epidemiology and Applied Research Branch; Univ. of Georgia, Athens, GA (United States). College of Public Health
2. Centers for Disease Control and Prevention (CDC), Atlanta, GA (United States). Division of Cancer Prevention and Control. Epidemiology and Applied Research Branch

Although the association between in utero exposure to diethylstilbestrol (DES) and clear cell adenocarcinoma of the cervix and vagina (CCA) was first reported among young women, subsequent case reports and cohort studies suggest that an elevated risk for CCA may persist with age. Data from the National Program of Cancer Registries (NPCR) and the Surveillance, Epidemiology and End Results (SEER) Program were used to construct indirect standardized incidence ratios (SIR) comparing CCA risk among women born during the exposure period 1947 through 1971, when DES was prescribed to pregnant women, to the relevant time period for nonexposed women born before or after DES exposure period. CCA incidence among the women born before the DES exposure period (ages 30–54 at diagnosis of CAA) or after the DES exposure period (ages 15–29 at diagnosis) were used to calculate the expected rates for women born during the DES exposure period. Among women aged 15–29 years, CCA risk increased with age and peaked in the 25–29 year age group, but the risk estimates were unstable (SIR = 6.06; 95% CI: 0.97, -251.07, SEER data). Among women aged 40–54 years, CCA risk was greatest in the 40–44 year age group (SIR = 4.55; 95% CI: 1.11, 40.19, SEER data and SIR = 3.94; 95% CI: 1.06, 33.01, NPCR/SEER data) and remained significantly elevated throughout this age group in the combined data set. Risk was not elevated among women aged 30–39 years. The observed risk of CCA, if causally related to DES exposure, reflects a persistent health impact from in utero exposure that is widespread in the general population. When assessing a woman’s cancer risks, whether her mother took DES while pregnant may still be a relevant aspect of the medical history for women born during the period of DES use in pregnancy.

• Research Organization: Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN (United States)
• Sponsoring Organization: USDOE Office of Science (SC)
• Grant/Contract Number: SC0014664
• OSTI ID: 1816625
• Journal Information: Cancer Causes and Control, Vol. 23, Issue 1; ISSN 0957-5243
• Publisher: Springer Nature
• Country of Publication: United States
• Language: English

Related Subjects

59 BASIC BIOLOGICAL SCIENCES
Adenocarcinoma
clear cell
Diethylstilbesterol
Registries