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Journal of Lower Genital Tract Disease:
doi: 10.1097/LGT.0b013e31815ae980
Original Articles

Cervical Screening and General Physical Examination Behaviors of Women Exposed In Utero to Diethylstilbestrol

Camp, Elizabeth A. MSPH1; Coker, Ann L. PhD1; Troisi, Rebecca ScD2; Robboy, Stanley J. MD3; Noller, Kenneth L. MD4; Goodman, Karen J. PhD1; Titus-Ernstoff, Linda T. PhD5; Hatch, Elizabeth E. PhD6; Herbst, Arthur L. MD7; Kaufman, Raymond H. MD8,9; Adam, Ervin MD8,10

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Objective. To estimate whether women exposed in utero to diethylstilbestrol (DES) report receiving more cervical and general physical examinations compared to unexposed women.

Materials and Methods. 1994 Diethylstilbestrol Adenosis cohort data are used to assess the degree of recommended compliance of cervical screenings found in 3,140 DES-exposed and 826 unexposed women. Participants were enrolled at 4 sites: Houston, Boston, Rochester, and Los Angeles. Logistic regression modeling was used to analyze mailed questionnaire data, which included reported frequency over the preceding 5 years (1990-1994) of Papanicolaou smears and general physical examinations.

Results. Diethylstilbestrol-exposed women exceeded the recommended frequency of Papanicolaou smear screenings [adjusted odds ratio (aOR) = 2.15, 95% CI (confidence interval) = 1.60-2.88] compared to the unexposed. This association held among those without a history of cervical intraepithelial neoplasia (aOR = 1.88, 95% CI = 1.35-2.62). Diethylstilbestrol-exposed women exceeded annual recommendations for physical examinations (aOR = 2.27, 95% CI = 1.16-4.43) among women without a history of chronic disease when compared to unexposed women.

Conclusions. Most DES-exposed women are receiving cervical cancer screening at least at recommended intervals, but one third of the women are not receiving annual Papanicolaou smear examinations.

©2008The American Society for Colposcopy and Cervical Pathology


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