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Risk of clear-cell adenocarcinoma of the vagina and cervix among US women with potential exposure to diethylstilbestrol in utero

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Abstract

Purpose

Women exposed to diethylstilbestrol (DES) in utero were at elevated risk of clear-cell adenocarcinoma of the vagina and cervix (CCA) as young women. Previous research suggested that this elevated risk of CCA may persist into adulthood. We extended a published analysis to measure CCA risk as these women aged.

Methods

Standardized incidence ratios (SIR) compared CCA risk among women born from 1947 through 1971 (the DES-era) to CCA risk among the comparison group of women born prior to 1947, using registry data that covered the US population.

Results

Incidence rates of CCA among both cohorts increased with age. Among the DES-era birth cohort, higher rates of CCA were observed across all age groups except 55–59 years. SIR estimates had wide confidence intervals that often included the null value.

Conclusions

Results are consistent with prior research and suggest an elevated risk of CCA in midlife and at older ages among women exposed in utero to DES. These results highlight unresolved issues regarding cancer risk among aging DES daughters and appropriate screening guidance. The examination of population-based cancer surveillance data may be a useful tool for monitoring trends in the incidence of other rare cancers over time among specific birth cohorts.

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Data availability

The data used in this study from the U.S. Cancer Statistics public-use databases are provided and analyzed through SEER*Stat software, which is distributed by the NCI’s SEER Program. As the databases contain data from both CDC’s NPCR and NCI’s SEER program, data-use agreements from both programs must be signed. Additional information on how to access these data are available at: https://www.cdc.gov/cancer/uscs/public-use/obtain-data.htm.

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Funding

Ashwini V. Soman’s work on this project was conducted under a support contract granted to Cyberdata Technologies, Inc. (Contract No. HHSN31620120007W 200-2017-F94805). The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

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Authors and Affiliations

  1. Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA

    Mary C. White, Hannah K. Weir, Lucy A. Peipins & Trevor D. Thompson

  2. Cyberdata Technologies, Inc., Herndon, VA, USA

    Ashwini V. Soman

  3. Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS S107-4, Chamblee, GA, 30341, USA

    Mary C. White

Authors
  1. Mary C. White
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  2. Hannah K. Weir
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  3. Ashwini V. Soman
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  4. Lucy A. Peipins
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  5. Trevor D. Thompson
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Contributions

MCW, HKW, LAP and TDT contributed to the study conception and design. Data analysis was directed by HKW and performed by AVS, with statistical oversight provided by TDT. The first draft of the manuscript was written by MCW, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Mary C. White.

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The authors have no relevant financial or non-financial interests to disclose.

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Supplementary Information

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10552_2022_1598_MOESM1_ESM.pdf

Supplementary file1 (PDF 47 kb) Supplementary Figure 1: Birth cohorts of women included in the analyses, by age and calendar of diagnosis

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White, M.C., Weir, H.K., Soman, A.V. et al. Risk of clear-cell adenocarcinoma of the vagina and cervix among US women with potential exposure to diethylstilbestrol in utero. Cancer Causes Control 33, 1121–1124 (2022). https://doi.org/10.1007/s10552-022-01598-3

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  • DOI: https://doi.org/10.1007/s10552-022-01598-3

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