Greenberg E R, Barnes A B, Resseguie L, Barrett J A, Burnside S, Lanza L L, Neff R K, Stevens M, Young R H, Colton T
N Engl J Med. 1984 Nov 29;311(22):1393-8. doi: 10.1056/NEJM198411293112201.
We compared the incidence of breast cancer in 3033 women who had taken diethylstilbestrol (DES) in pregnancy during the period from 1940 to 1960 with the incidence in a comparable group of unexposed parous women. We ascertained vital status in 95 per cent of the exposed women and in 93 per cent of the unexposed women and received completed questionnaires for 88 and 85 per cent, respectively. With over 85,000 woman-years of follow-up in each group, the incidence of breast cancer per 100,000 woman-years was 134 in the exposed group and 93 in the unexposed group, yielding a crude relative risk of 1.4 (95 per cent confidence interval, 1.1 to 1.9). The elevated incidence did not appear to be due to bias or to confounding by other risk factors measured in the study. Breast-cancer mortality was slightly higher in the exposed women (relative risk, 1.1) but not significantly so (95 per cent confidence interval, 0.7 to 2.0). We conclude that the incidence of breast cancer is moderately increased in women given DES, but we cannot exclude the possibility that some unrecognized concomitant of DES exposure accounts for this increase.
我们比较了1940年至1960年期间孕期服用己烯雌酚（DES）的3033名女性的乳腺癌发病率与一组未接触过DES的经产妇的发病率。我们确定了95%的接触过DES的女性和93%的未接触过DES的女性的生命状态，分别收到了88%和85%的完整问卷。每组随访超过85000人年，接触过DES的组每100000人年的乳腺癌发病率为134例，未接触过DES的组为93例，粗相对风险为1.4（95%置信区间为1.1至1.9）。发病率升高似乎并非由于研究中测量的其他风险因素导致的偏倚或混杂。接触过DES的女性乳腺癌死亡率略高（相对风险为1.1），但无显著差异（95%置信区间为0.7至2.0）。我们得出结论，服用DES的女性乳腺癌发病率适度增加，但我们不能排除DES接触的一些未被认识到的伴随因素导致这种增加的可能性。
