PDF(Pubmed)
Abstract：
BACKGROUND: Females exposed prenatally to diethylstilbestrol (DES) have an elevated risk of cervical dysplasia, breast cancer, and clear cell adenocarcinoma (CCA) of the cervix/vagina. Testicular cancer risk is increased in prenatally exposed males. Epigenetic changes may mediate the transmission of DES effects to the next (\"third\") generation of offspring.
METHODS: Using data self-reported by third-generation females, we assessed DES in relation to the risk of cancer and benign breast and reproductive tract conditions. Using data from prenatally DES-exposed and unexposed mothers, we assessed DES in relation to cancer risk in their female and male offspring. Cancer risk was assessed by standardized incidence ratios (SIR) and 95% confidence intervals (CI); the risks of benign and malignant diagnoses were assessed by hazard ratios (HR) and 95% CI.
RESULTS: In self-reported data, DES exposure was not associated with an increased risk of overall cancer (HR 0.83; CI 0.36-1.90), breast cancer, or severe cervical dysplasia. No females reported CCA. The risk of borderline ovarian cancer appeared elevated, but the HR was imprecise (3.46; CI 0.37-32.42). Based on mothers\' reports, DES exposure did not increase the risk of overall cancer (HR 0.80; CI 0.49-1.32) or of other cancers in third-generation females. Overall cancer risk in exposed males appeared elevated (HR 1.41; CI 0.70-2.86), but the CI was wide. The risk of testicular cancer was not elevated in exposed males; no cases of prostate cancer were reported.
CONCLUSIONS: To date, there is little evidence that DES is associated with cancer risk in third-generation females or males, but these individuals are relatively young, and further follow-up is needed.
METHODS: Using data self-reported by third-generation females, we assessed DES in relation to the risk of cancer and benign breast and reproductive tract conditions. Using data from prenatally DES-exposed and unexposed mothers, we assessed DES in relation to cancer risk in their female and male offspring. Cancer risk was assessed by standardized incidence ratios (SIR) and 95% confidence intervals (CI); the risks of benign and malignant diagnoses were assessed by hazard ratios (HR) and 95% CI.
RESULTS: In self-reported data, DES exposure was not associated with an increased risk of overall cancer (HR 0.83; CI 0.36-1.90), breast cancer, or severe cervical dysplasia. No females reported CCA. The risk of borderline ovarian cancer appeared elevated, but the HR was imprecise (3.46; CI 0.37-32.42). Based on mothers\' reports, DES exposure did not increase the risk of overall cancer (HR 0.80; CI 0.49-1.32) or of other cancers in third-generation females. Overall cancer risk in exposed males appeared elevated (HR 1.41; CI 0.70-2.86), but the CI was wide. The risk of testicular cancer was not elevated in exposed males; no cases of prostate cancer were reported.
CONCLUSIONS: To date, there is little evidence that DES is associated with cancer risk in third-generation females or males, but these individuals are relatively young, and further follow-up is needed.
摘要：
背景：产前暴露于己烯雌酚（DES）的女性宫颈发育不良的风险升高，乳腺癌,宫颈/阴道透明细胞腺癌（CCA）。在产前暴露的男性中，睾丸癌的风险增加。表观遗传变化可能会介导DES效应传递给下一代（“第三代”）后代。
方法：使用第三代女性自我报告的数据，我们评估了DES与癌症和良性乳腺和生殖道疾病风险的关系.使用来自产前暴露于DES和未暴露的母亲的数据，我们在女性和男性后代中评估了DES与癌症风险的关系.通过标准化发生率（SIR）和95％置信区间（CI）评估癌症风险；通过风险比（HR）和95％CI评估良性和恶性诊断的风险。
结果：在自我报告的数据中，DES暴露与总体癌症风险增加无关（HR0.83；CI0.36-1.90），乳腺癌,或严重的宫颈发育不良。没有女性报告CCA。交界性卵巢癌的风险出现升高，但HR不精确（3.46；CI0.37-32.42）。根据母亲的报告，在第三代女性中，DES暴露并未增加总体癌症（HR0.80；CI0.49-1.32）或其他癌症的风险。暴露男性的总体癌症风险似乎升高（HR1.41；CI0.70-2.86），但是CI很宽。在暴露的男性中，睾丸癌的风险没有增加；没有前列腺癌的报道。
结论：迄今为止，几乎没有证据表明DES与第三代女性或男性的癌症风险有关，但是这些人相对年轻，需要进一步跟进。
方法：使用第三代女性自我报告的数据，我们评估了DES与癌症和良性乳腺和生殖道疾病风险的关系.使用来自产前暴露于DES和未暴露的母亲的数据，我们在女性和男性后代中评估了DES与癌症风险的关系.通过标准化发生率（SIR）和95％置信区间（CI）评估癌症风险；通过风险比（HR）和95％CI评估良性和恶性诊断的风险。
结果：在自我报告的数据中，DES暴露与总体癌症风险增加无关（HR0.83；CI0.36-1.90），乳腺癌,或严重的宫颈发育不良。没有女性报告CCA。交界性卵巢癌的风险出现升高，但HR不精确（3.46；CI0.37-32.42）。根据母亲的报告，在第三代女性中，DES暴露并未增加总体癌症（HR0.80；CI0.49-1.32）或其他癌症的风险。暴露男性的总体癌症风险似乎升高（HR1.41；CI0.70-2.86），但是CI很宽。在暴露的男性中，睾丸癌的风险没有增加；没有前列腺癌的报道。
结论：迄今为止，几乎没有证据表明DES与第三代女性或男性的癌症风险有关，但是这些人相对年轻，需要进一步跟进。
