Increased occurrence of autoimmune disease among women exposed in utero to diethylstilbestrol

Soon after recognition of the increased risk of vaginal clear cell adenocarcinoma in women with in utero exposure to diethylstilbestrol (DES), the National Cancer Institute funded a large multicenter epidemiologic cohort study, the DESAD Project. The purpose of this national project was to describe the prevalence of DES-associated genital tract changes among women exposed in utero and to compare these findings with an unexposed control group. Additionally, the study sought to determine the incidence of cancer and other diseases in the exposed and unexposed cohorts. Because of the possibility that prenatal exposure to DES might adversely affect the adult immune system, the participants in the DESAD Project were surveyed to determine the prevalence of autoimmune diseases. The lifetime history of these disease is reported in this preliminary communication.