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Risk of Benign Gynecologic Tumors in Relation to Prenatal Diethylstilbestrol Exposure

Lauren A. Wise, ScD^*, Julie R. Palmer, ScD^*, Kathleen Rowlings, MPH^*, Raymond H. Kaufman, MD, Arthur L. Herbst, MD, Kenneth L. Noller, MD, Linda Titus-Ernstoff, PhD^¶, Rebecca Troisi, ScD^||, Elizabeth E. Hatch, ScD^** and Stanley J. Robboy, MD

From the *Slone Epidemiology Center, Boston University, Boston, Massachusetts; DES Screening Clinic, Baylor College of Medicine, Houston, Texas; Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois; Department of Obstetrics and Gynecology, Tufts-New England Medical Center, Boston, Massachusetts; ¶Norris Cotton Cancer Center, Dartmouth Hitchcock Medical Center, 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; and Department of Pathology, Duke University Medical Center, Durham, North Carolina.

Address reprint requests to: Dr. Lauren A. Wise, Slone Epidemiology Center, Boston University School of Medicine, 1010 Commonwealth Avenue, Boston, MA 02215; e-mail: lwise{at}slone.bu.edu.

OBJECTIVE: To investigate the association between prenatal diethylstilbestrol (DES) exposure and risk of benign gynecologic tumors.

METHODS: We conducted a collaborative follow-up study of women with and without documented intrauterine exposure to DES. We compared the incidence of self-reported ovarian cysts, paraovarian cysts, and uterine leiomyomata confirmed by medical record in DES-exposed and unexposed women.

RESULTS: A total of 85 cases of uterine leiomyomata and 168 cases of ovarian or paraovarian cysts were confirmed histologically. After adjustment for age, no association was found between prenatal DES exposure and ovarian cysts or uterine leiomyomata. Prenatal DES exposure was positively associated with paraovarian cysts.

CONCLUSION: The present results do not support the hypothesis that prenatal DES exposure increases risk of uterine leiomyomata or ovarian cysts. Prenatal DES exposure was associated with an increased risk of paraovarian cysts, but detection bias cannot be ruled out as an explanation of this finding.

LEVEL OF EVIDENCE: II-2

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