Cervical screening and general physical examination behaviors of women exposed in utero to diethylstilbestrol

J Low Genit Tract Dis. 2008 Apr;12(2):111-7. doi: 10.1097/LGT.0b013e31815ae980.

Abstract

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.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adenocarcinoma / diagnosis*
  • Adenocarcinoma / etiology
  • Administration, Intravaginal
  • Adult
  • Behavior*
  • Diethylstilbestrol / administration & dosage
  • Diethylstilbestrol / adverse effects*
  • Estrogens, Non-Steroidal / administration & dosage
  • Estrogens, Non-Steroidal / adverse effects
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Papanicolaou Test*
  • Patient Compliance
  • Physical Examination / methods
  • Physical Examination / psychology*
  • Physician-Patient Relations / ethics
  • Retrospective Studies
  • Risk Factors
  • Surveys and Questionnaires
  • Uterine Cervical Neoplasms / chemically induced
  • Uterine Cervical Neoplasms / diagnosis*
  • Vaginal Neoplasms / diagnosis*
  • Vaginal Neoplasms / etiology
  • Vaginal Smears / methods
  • Vaginal Smears / psychology*

Substances

  • Estrogens, Non-Steroidal
  • Diethylstilbestrol