Prenatal diethylstilbestrol exposure and cancer risk in women

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


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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adenocarcinoma, Clear Cell / chemically induced
  • Breast Neoplasms / chemically induced
  • Breast Neoplasms / epidemiology
  • Carcinogens / toxicity*
  • Diethylstilbestrol / toxicity*
  • Endometrial Neoplasms / chemically induced
  • Endometrial Neoplasms / epidemiology
  • Female
  • Humans
  • Maternal Exposure*
  • Maternal-Fetal Exchange / physiology*
  • Pancreatic Neoplasms / chemically induced
  • Pancreatic Neoplasms / epidemiology
  • Pregnancy
  • Prenatal Exposure Delayed Effects / pathology*
  • Surveys and Questionnaires


  • Carcinogens
  • Diethylstilbestrol