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Environ Mol Mutagen. 2019 Jun;60(5):395-403. doi: 10.1002/em.22155. Epub 2017 Nov 10.

Prenatal diethylstilbestrol exposure and cancer risk in women.

Author information

1
Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland.
2
Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts.
3
Departments of Epidemiology and Pediatrics, Geisel School of Medicine at Dartmouth, the Norris Cotton Cancer Center, and the Hood Center for Children and Families, Lebanon, New Hampshire.
4
Department of Molecular, Cell, and Cancer Biology, University of Massachusetts Medical School, Worcester, Massachusetts.
5
Department of Public Health Sciences, University of Chicago, Chicago, Illinois.
6
Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas.
7
Department of Pathology, Duke University School of Medicine, Durham, North Carolina.
8
Information Management Services, Inc, Rockville, Maryland.
9
Slone Epidemiology Unit, Boston University, Boston, Massachusetts.

Abstract

In the Diethylstilbestrol [DES] Combined Cohort Follow-up, the age- and calendar-year specific standardized incidence ratio [SIR] for clear cell adenocarcinoma [CCA] was 27.6 (95% confidence interval [CI] 7.51-70.6) for the exposed women. The SIR for breast cancer was 1.17 (95% CI 1.01-1.36) and the hazard ratio [HR] adjusted for birth year and cohort for comparison with the unexposed was 1.05 (95% CI 0.79-1.41). The SIR for pancreatic cancer was 2.43 (95% CI 1.21-4.34) and the adjusted HR for comparison with unexposed women was 7.16 (95% CI 0.84-61.5). There was little evidence of excess risk for other sites. There appeared to be a deficit in risk for endometrial cancer among the exposed (SIR 0.61; 95% CI 0.35-0.98), and an excess in the unexposed (SIR 1.55; 95% CI 0.95-2.40); the adjusted HR was 0.45 (95% CI 0.22-0.93) for the internal comparison. There was no overall excess cancer risk in exposed women compared with general population rates (1.06; 95% CI 0.95-1.17) or with unexposed participants (adjusted HR 1.03; 95% CI 0.84-1.25). These data do not support the suggestion that there is a diathesis of cancers in DES exposed female offspring The excess risk of breast and pancreatic cancers that we observed is concerning and warrants continued follow-up and mechanistic investigation. Environ. Mol. Mutagen. 60:395-403, 2019. Published 2017. This article is a US Government work and is in the public domain in the USA.

KEYWORDS:

DES; cancer; diethylstilbestrol; endocrine disruptors; estrogen

PMID:
29124779
DOI:
10.1002/em.22155
[Indexed for MEDLINE]

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