Department of Epidemiology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.
Cancer Causes Control. 2010 Jul;21(7):999-1007. doi: 10.1007/s10552-010-9526-5. Epub 2010 Mar 4.
We examined long-term risk of cancer in women exposed to diethylstilbestrol (DES) in utero.
A total of 12,091 DES-exposed women in the Netherlands were followed prospectively from December 1992 till June 2008. Cancer incidence was assessed through linkage with the Dutch pathology database (PALGA) and the Netherlands Cancer Registry and compared with the Dutch female population.
A total of 348 medically verified cancers occurred; median age at end of follow-up was 44.0 years. No overall increased risk of cancer was found (standardized incidence ratio [SIR] = 1.01; 95% confidence interval [CI] = 0.91, 1.13). The risk of clear cell adenocarcinoma of the vagina and cervix (CCA) was statistically significantly increased (SIR = 24.23; 95% CI = 8.89, 52.74); the elevated risk persisted above 40 years of age. The risk of melanoma diagnosed before age 40 was increased (SIR = 1.59; 95% CI = 1.08, 2.26). No excess risks were found for other sites, including breast cancer.
Except for an elevated risk of CCA, persisting at older ages, and an increased risk of melanoma at young ages, we found no increased risk of cancer. Longer follow-up is warranted to examine cancer risk at ages when cancer occurs more frequently.
我们研究了子宫内暴露于己烯雌酚（DES）的女性的长期癌症风险。
荷兰共有 12091 名 DES 暴露女性进行了前瞻性随访，随访时间从 1992 年 12 月至 2008 年 6 月。通过与荷兰病理学数据库（PALGA）和荷兰癌症登记处的链接评估癌症发病率，并与荷兰女性人群进行比较。
共发生 348 例经医学证实的癌症；中位随访结束时年龄为 44.0 岁。未发现癌症总体风险增加（标准化发病比 [SIR] = 1.01；95%置信区间 [CI] = 0.91, 1.13）。阴道和宫颈透明细胞腺癌（CCA）的风险呈统计学显著增加（SIR = 24.23；95%CI = 8.89, 52.74）；该风险在 40 岁以上持续升高。40 岁之前诊断出的黑色素瘤风险增加（SIR = 1.59；95%CI = 1.08, 2.26）。其他部位（包括乳腺癌）未发现风险增加。
除了 CCA 的风险升高（持续到老年）和年轻时黑色素瘤的风险增加外，我们未发现癌症风险增加。需要更长时间的随访来检查年龄较大时癌症的发生风险更高。
