Background: Animal studies suggest that prenatal exposure to the synthetic estrogen diethylstilbestrol (DES) causes epigenetic changes that may be transmitted to the next generation. Specifically, these studies show an elevated incidence of reproductive tumors in the female offspring of prenatally-exposed mice.
Methods: We assessed cancer and benign pathology diagnoses occurring in the offspring of women whose prenatal exposure to DES (or lack of exposure) was verified by medical record. Our data arose from 2 sources: the mothers' reports of cancers occurring in 8216 sons and daughters, and pathology-confirmed cancers and benign diagnoses self-reported by a subset of 793 daughters.
Results: Although statistical power is limited, our data are consistent with no overall increase of cancer in the sons or daughters of women exposed in utero to DES. Based on pathology-confirmed diagnoses reported by the daughters, we saw no association between DES and risk of benign breast disease or reproductive tract conditions. Based on 3 cases, the incidence of ovarian cancer was higher than expected in the daughters of women exposed prenatally to DES.
Conclusions: Our data do not support an overall increase of cancer risk in the sons or daughters of women exposed prenatally to DES, but the number of ovarian cancer cases was greater than expected. While preliminary, this finding supports continued monitoring of these daughters.
From the *Department of Community and Family Medicine, Dartmouth Medical School, and the Norris Cotton Cancer Center, Lebanon, New Hampshire; †Department of Pediatrics, Dartmouth Medical School, and the Hood Center for Children and Families, Lebanon, New Hampshire; ‡Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland; §Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts; ¶Information Management Services, Rockville, Maryland; ∥Slone Epidemiology Center, Boston University School of Public Health, Boston, Massachusetts; **Department of Obstetrics and Gynecology, Methodist Hospital, Houston, Texas; ††Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas; ‡‡Department of Obstetrics and Gynecology, New England Medical Center, Boston, Massachusetts; and §§Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois.
Submitted 24 May 2007; accepted 17 November 2007; posted 22 January 2008.
Supported by the National Cancer Institute: NO1 CP 01012 and NO1 CP 51010.
Correspondence: Linda Titus-Ernstoff, Department of Community and Family Medicine, Dartmouth Medical School, and the Norris Cotton Cancer Center, Lebanon, NH 03756. E-mail: firstname.lastname@example.org.