Mortality Risk Persists for Cancer Tied to Prenatal DES Exposure
THURSDAY, May 3, 2018 -- Diethylstilbestrol (DES)-related clear-cell adenocarcinoma of the vagina and cervix is associated with increased risk of death, even in older women, according to a letter to the editor published in the May 3 issue of the New England Journal of Medicine.
Dezheng Huo, M.D., from the University of Chicago, and colleagues followed 695 patients with clear-cell adenocarcinoma through 2014. Evidence of prenatal DES exposure was documented in 415 patients.
The researchers found that 219 patients died during a median follow-up of 22.7 years, for a probability of 20-year survival of 69 percent. Patients with and without prenatal DES exposure had a difference in five-year probability of survival (86.1 versus 81.2 percent); the 20-year probability of survival was similar between the groups. The difference in probability of survival between patients with and without DES exposure was significant only in the first five years, after adjustment for tumor stage, histologic type, and age (P = 0.025). Patients with clear-cell adenocarcinoma had elevated mortality across their lifetime. Women with DES-related clear-cell adenocarcinoma had a 27-times higher risk of death compared with the general U.S. population for women aged 10 to 34 years; the risk was five times higher between 35 and 49 years of age, and two times higher between aged 50 and 65 years.
"It is therefore important to continue the surveillance of this unique cohort of patients with DES-related clear-cell adenocarcinoma to examine their health conditions late in life," the authors write.
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Posted: May 2018