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Cancer Genetics

Cervical Cancer and Diethylstilbestrol

11/08/1999

Question:

Has it been proven that all cervical cancer is transmitted sexually? Has diethylstilbestrol(DES) been proven to be linked to cervical cancer?

Answer:

Squamous cell carcinoma of the cervix has been associated, in more than 90% of affected women, with evidence of a previous infection with human papillomavirus (HPV). HPV is spread by sexual transmission. An increased risk of cervical cancer has long been known to exist in prostitutes and in women who have first intercourse at a young age, multiple sexual partners, sexually transmitted diseases, or who bear children at a young age. Promiscuous sexual behavior in male partners is also an important risk factor since the male is the carrier for the virus.

Squamous cell carcinoma, however, is only one type of cancer to involve the cervix. Adenocarcinomas of the cervix do not necessarily have the same association with HPV infection.

Maternal ingestion of DES during pregnancy with a female fetus has been implicated with the subsequent development of clear cell carcinomas of the vagina in the girl. The peak risk period for exposed women is between the ages of 15 and 22 years. Only about 1 of every 1000 women exposed to DES develops clear cell carcinoma. As many as 25% of these women may also have abnormalities of the cervix.

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Response by:

Judith A Westman, MD Judith A Westman, MD
Associate Professor, Clinical Internal Medicine, Pediatrics and Medical Biochemistry
College of Medicine
The Ohio State University