Strohsnitter W C, Noller K L, Hoover R N, Robboy S J, Palmer J R, Titus-Ernstoff L, Kaufman R H, Adam E, Herbst A L, Hatch E E
Department of Obstetrics and Gynecology, Tufts University School of Medicine, Boston, MA, USA.
J Natl Cancer Inst. 2001 Apr 4;93(7):545-51. doi: 10.1093/jnci/93.7.545.
An association between prenatal diethylstilbestrol (DES) exposure and cancer in men, especially testicular cancer, has been suspected, but findings from case-control studies have been inconsistent. This study was conducted to investigate the association between prenatal DES exposure and cancer risk in men via prospective follow-up.
A total of 3613 men whose prenatal DES exposure status was known were followed from 1978 through 1994. The overall and site-specific cancer incidence rates among the DES-exposed men were compared with those of the unexposed men in the study and with population-based rates. The relative rate (RR) was used to assess the strength of the association between prenatal DES exposure and cancer development. All statistical tests were two-sided.
Overall cancer rates among DES-exposed men were similar to those among unexposed men (RR = 1.07; 95% confidence interval [CI] = 0.58 to 1.96) and to national rates (RR = 0.99; 95% CI = 0.65 to 1.44). Testicular cancer may be elevated among DES-exposed men, since the RRs for testicular cancer were 3.05 (95% CI = 0.65 to 22.0) times those of unexposed men in the study and 2.04 (95% CI = 0.82 to 4.20) times those of males in the population-based rates. The higher rate of testicular cancer in the DES-exposed men is, however, also compatible with a chance observation.
To date, men exposed to DES in utero do not appear to have an increased risk of most cancers. It remains uncertain, however, whether prenatal DES exposure is associated with testicular cancer.
人们怀疑产前接触己烯雌酚（DES）与男性癌症，尤其是睾丸癌之间存在关联，但病例对照研究的结果并不一致。本研究旨在通过前瞻性随访调查产前DES暴露与男性癌症风险之间的关联。
对1978年至1994年期间3613名已知产前DES暴露状况的男性进行随访。将DES暴露组男性的总体癌症发病率和特定部位癌症发病率与研究中的未暴露组男性以及基于人群的发病率进行比较。相对率（RR）用于评估产前DES暴露与癌症发生之间关联的强度。所有统计检验均为双侧检验。
DES暴露组男性的总体癌症发病率与未暴露组男性相似（RR = 1.07；95%置信区间[CI] = 0.58至1.96），与全国发病率也相似（RR = 0.99；95%CI = 0.65至1.44）。DES暴露组男性的睾丸癌发病率可能有所升高，因为研究中DES暴露组男性的睾丸癌RR是未暴露组男性的3.05倍（95%CI = 0.65至22.0），基于人群发病率中男性的2.04倍（95%CI = 0.82至4.20）。然而，DES暴露组男性较高的睾丸癌发病率也可能是偶然观察结果。
迄今为止，子宫内接触DES的男性患大多数癌症的风险似乎并未增加。然而，产前DES暴露是否与睾丸癌有关仍不确定。
