What's the connection between DES and dysplasia?

Dear Nancy,

First, a quick primer on this topic: DES (short for diethylstilbestrol) is a type of synthetic (laboratory made) estrogen that was given to pregnant women from 1941 until the early 1970s to prevent miscarriage, preterm labor, and other pregnancy complications. The use of DES declined in the 1960s as it was discovered that DES did not prevent pregnancy complications; in the early 1970s, DES was linked to rare types of genital cancers in the daughters of women "treated" with DES during pregnancy. DES is no longer given to pregnant women, but is still used to treat other medical problems, such as prostate cancer in men, certain types of breast cancer, and health problems associated with menopause in women who are not expecting.

One of the possible complications from in utero exposure to DES is an increased risk among female offspring of developing cancer of the vagina or cervix when they are older. These "DES daughters" are advised to get annual checkups and Pap smears. Pap smears and biopsies (in which slightly larger samples of tissue are taken from the cervix) allow clinicians to examine microscopically the cells of the cervix and surrounding areas to look for abnormal cell growth. This abnormality can be one of the early warning signs of vaginal or cervical cancer, and its presence in the cervix is called dysplasia. Keep in mind that not all dysplasia is, or will become, cancerous. Most cases of low-grade dysplasia resolve on their own.

Each year more than half a million women are diagnosed with cervical dysplasia, but there are only about 13,000 new cases of cervical cancer a year. You and your health care provider are smart to follow up on this since early detection and treatment (including the removal of abnormal cervical cells that do not spontaneously resolve or seem to be spreading) can prevent invasive cervical cancer from developing. Power is in prevention!