DES daughters at higher risk of cancer

WOMEN whose mothers took diethylstilboestrol (DES) in pregnancy are at increased risk of a spectrum of reproductive complications and gynaecological cancers, a large US study concludes.

The study looked at 4600 women whose mothers had taken DES to prevent pregnancy complications from the 1940s to the early 1970s and compared their health with 1900 women whose mothers had not taken the synthetic oestrogen.

The researchers found that women exposed in utero were 2.4 times as likely as unexposed women to be infertile, 4.7 times as likely to have a pre-term delivery and 2.4 times as likely to have an early menopause.

Exposed women were also 1.8 times as likely to have breast cancer, 2.3 times as likely to have CIN 2 or higher and at 40 times the risk of developing the rare vaginal cancer, clear-cell adenocarcinoma.

Australian DES campaigners say about 185,000 Australian women were exposed to the drug in utero and have called on the Federal Government to better educate the daughters of women who took the drug about the need for annual cancer checks.

A NSW spokeswoman for DES Action Australia, Carol Devine, said despite a raft of anecdotal evidence about the health problems of so-called ‘DES daughters’, the government had refused to promote the importance of annual mammograms and special
DES examinations for these women.

"This study must act as a wake-up call for health authorities to promote information about DES directly to Australians in public health programs," Ms Devine said.

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) recommends that exposed women have an annual gynaecological check-up, including separate cervical and vaginal Pap smears, a bimanual pelvic exam,
and a breast exam.

N Engl J Med 2011; 365:1304-14