title: Mammography screening behaviors of women exposed prenatally to diethylstilbestrol.
abstract: BACKGROUND
  In utero diethylstilbestrol (DES) exposure is a risk factor for rare development of vaginal and cervical cancer and may potentially be a risk factor for breast cancer. Mammography use in this population is relatively unknown; therefore, this study aims to determine if in utero DES exposure is associated with the frequency of mammography screening examinations while considering demographic and clinical factors.
  
  
  METHODS
  Using combined DES cohort questionnaire data, self-reported mammography screening over the past 5 years (2001-2006) was analyzed in women aged ≥45 years. Binary logistic regression assessed if DES exposure was associated with mammography use after adjustment for benign breast disease (BBD), previous cancer diagnosis, and whether insurance access influenced screening use.
  
  
  RESULTS
  Overall, the frequency of mammography examinations was similar for both DES-exposed and unexposed women. DES-exposed (n=2986) and unexposed women (n=1397) over the age of 44 reported receiving ≥3 mammography examinations in the past 5 years (73.8% and 74.0%, respectively). After adjustment, DES exposure was not associated with ≥3 mammograms in the past 5 years compared to ≤2 examinations (odds ratio [OR] 1.00, 95% confidence interval [CI] 0.86-1.17), p=0.99).
  
  
  CONCLUSIONS
  In utero DES exposure was not associated with mammography use, nor was health insurance status or a BBD or cancer diagnosis. Because of the potential elevated risk for breast cancer in women exposed prenatally to DES, continued monitoring of standard mammography recommendations is recommended for this group, which is predominantly over the age of 45.
authors.affiliation: University of Texas Health Science Center, Houston, Texas, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Camp
authors.forename: Stanley J
authors.initials: SJ
authors.lastname: Robboy
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Hatch
authors.forename: Linda T
authors.initials: LT
authors.lastname: Titus-Ernstoff
authors.forename: Arthur L
authors.initials: AL
authors.lastname: Herbst
authors.forename: William
authors.initials: W
authors.lastname: Strohsnitter
authors.forename: Raymond H
authors.initials: RH
authors.lastname: Kaufman
authors.forename: Ervin
authors.initials: E
authors.lastname: Adam
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis; D015331:Cohort Studies; D004054:Diethylstilbestrol / Q000009:adverse effects*; D004968:Estrogens, Non-Steroidal / Q000009:adverse effects*; D005260:Female; D015438:Health Behavior; D006801:Humans; D016015:Logistic Models; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced; D011795:Surveys and Questionnaires; D014481:United States
chemical_list: D004968:Estrogens, Non-Steroidal; D004054:Diethylstilbestrol