Which factor is specifically associated with cervical cancer risk due to prenatal exposure?

• A. Immunocompromised status
• B. In-utero DES exposure
• C. Prior abnormal results
• D. Prior CIN2+ or cervical cancer

Answer: (B)

Prenatal exposure to diethylstilbestrol (DES) is the factor specifically tied to cancer risk from exposure before birth. DES was given to some pregnant women in the mid-20th century to prevent miscarriage, but it disrupts the development of fetal Mullerian-derived tissues, leading to structural changes in the cervix and vagina and a markedly increased risk of certain cancers, notably clear cell adenocarcinoma of the vagina and cervix, in the exposed offspring. This risk arises from exposure in utero, not from immune status or prior cervical disease. The other options involve factors related to the individual's immune system or past cytology, which do not reflect prenatal exposure.