Breast cancer screening in women exposed in utero to diethylstilbestrol.
OBJECTIVE
To determine if women exposed in utero to diethylstilbestrol (DES) are more likely than unexposed women to receive recommended or additional breast cancer screening examinations.


METHODS
1994 Diethylstilbestrol-Adenosis (DESAD) cohort data are used to assess the degree of recommended compliance of breast cancer screenings found in 3140 DES-exposed and 826 unexposed women. Participants were enrolled at four sites: Houston, Boston, Rochester, and Los Angeles. Logistic regression modeling was used to analyze mailed questionnaire data that included reported frequency over the preceding 5 years (1990-1994) of breast-self examinations (BSEs), clinical breast examinations (CBEs), and mammograms.


RESULTS
DES-exposed women exceeded annual recommendations for CBEs (aOR 2.20, 95% CI, 1.04-4.67) among women without a history of benign breast disease (BBD) compared with unexposed women. There were no other statistically significant differences between exposed and unexposed women who reported performing BSEs, CBEs (<40 years of age), and mammographies, regardless of BBD history.


CONCLUSIONS
The majority of DES-exposed women receive breast cancer screenings at least at recommended intervals, but over two thirds do not perform monthly BSEs. Future efforts should be focused on further educating this and other at-risk populations through mailed reminders and during patient consultations on the benefits of screening examinations.
Camp
Elizabeth A
EA
School of Public Health, University of Texas Health Science Center, Houston, Texas, USA.
Coker
Ann L
AL
Robboy
Stanley J
SJ
Noller
Kenneth L
KL
Goodman
Karen J
KJ
Titus-Ernstoff
Linda T
LT
Hatch
Elizabeth E
EE
Herbst
Arthur L
AL
Troisi
Rebecca
R
Kaufman
Raymond H
RH
Adam
Ervin
E
D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis*; D015331:Cohort Studies; D004054:Diethylstilbestrol / Q000009:adverse effects*; D004968:Estrogens, Non-Steroidal / Q000009:adverse effects*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D014481:United States
D004968:Estrogens, Non-Steroidal; D004054:Diethylstilbestrol