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Summary of the changes in the human female genital tract as a consequence of maternal diethylstilbestrol therapy

A L Herbst

    Journal of Toxicology and Environmental Health. Supplement
    |January 1, 1976
    PubMed

    Insights

    Maternal ingestion of synthetic estrogens like diethylstilbestrol (DES) is linked to rare genital tract cancers in daughters. These cancers and related abnormalities, such as vaginal adenosis, typically appear after age 14.

    Area of Science:

    • Gynecologic Oncology
    • Endocrinology
    • Reproductive Health

    Background:

    • Diethylstilbestrol (DES) is a synthetic estrogen previously prescribed to pregnant women.
    • Concerns exist regarding the long-term health effects of in utero DES exposure.
    • Clear-cell adenocarcinoma (CCA) is a rare cancer observed in DES-exposed individuals.

    Purpose of the Study:

    • To review the evidence linking maternal DES ingestion to genital tract cancers in offspring.
    • To characterize the types of nonneoplastic abnormalities associated with DES exposure.
    • To determine the age of onset and origin of DES-related malignancies.

    Main Methods:

    • Review of existing epidemiological and clinical evidence.
    • Analysis of cancer incidence and age of onset in DES-exposed populations.
    • Histopathological evaluation of associated nonneoplastic lesions.

    Main Results:

    • DES and related synthetic estrogens are implicated in rare genital tract cancers.
    • Tumors primarily affect exposed females over 14 years old, with a median age of 18-19.
    • Nonneoplastic findings include vaginal adenosis, cervical ectropion, and transverse ridges, with adenosis linked to early pregnancy exposure.

    Conclusions:

    • DES exposure in utero is associated with an increased risk of clear-cell adenocarcinoma.
    • Both neoplastic and nonneoplastic changes are believed to originate from müllerian epithelium.
    • Early pregnancy exposure appears to correlate with a higher incidence of vaginal adenosis.

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