What health problems might DES-exposed daughters have?

In 1971, DES was linked to clear cell adenocarcinoma in a small number of daughters of women who had used DES during pregnancy. This uncommon cancer of the vagina or cervix is usually diagnosed between age 15 and 25 in DES-exposed daughters. Some cases have been reported in women in their thirties and forties. The risk to women older than age 40 is still unknown, because the women first exposed to DES in utero are just reaching their fifties, and information about their risk has not been gathered. The overall risk of an exposed daughter to develop this type of cancer is estimated to be approximately 1 in 1,000 (0.1 percent). Although clear cell adenocarcinoma is extremely rare, it is important that DES-exposed daughters be aware of the risk and has regular physical examinations.

Scientists found a link between DES exposure before birth and an increased risk of developing abnormal cells in the tissue of the cervix and vagina. Physicians use a number of terms to describe these abnormal cells, including dysplasia, cervical intraepithelial neoplasia, and squamous intraepithelial lesions. These abnormal cells resemble cancer cells in appearance; however, they do not invade nearby healthy tissue as cancer cells do. Although these conditions are not cancer, they may develop into cancer if left untreated. DES-exposed daughters should have a yearly Pap test and pelvic exam to check for abnormal cells. DES-exposed daughters may also have structural changes in the vagina, uterus, or cervix, as well as irregular menstruation and an increased risk of miscarriage, ectopic (tubal) pregnancy, infertility, and premature births.

Evidence from a recent study suggests that daughters of women who took DES during pregnancy may have a slightly increased risk of breast cancer after age 40. The risk of breast cancer for DES-exposed women over age 40 was 1.9 times the risk of breast cancer for unexposed women of the same ages. The increased risk association was present for all breast cancer risk factors examined, and did not differ by tumor receptor status, tumor size, or lymph node involvement.

This answer is based on source information from from the National Cancer Institute.

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