Environment and Breast Cancer: Science Review

Evidence From Humans
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Risk of breast cancer in women exposed to diethylstilbestrol in utero: prelimiinary results (United States)
Palmer, J. R., Hatch, E. E., Rosenberg, C. L., Hartge, P., Kaufman, R. H., Titus-Ernstoff, L., Noller, K. L., Herbst, A. L., Rao, R. S., Troisi, R., Colton, T., Hoover, R. N. Cancer Causes Control. 2002. 13:8, 753-8.
Topic area
Early life exposures - Pharmaceutical hormones
Study design
Prospective cohort
Study Participants
Number of Cases
58 (43 among exposed women/15 among unexposed women)
Menopausal Status
The menopausal status of women included in this study is listed here.
Number in Cohort
Cohort: 6916 (4821 exposed women and 2095 unexposed women)
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: Women participating in Diethylstilbestrol-Adenosis (DESAD) Project or participating in the study of male and female offsprings of DES-exposed mothers (Dieckmann), or daughters of women who were treated with DES by an infertility specialist in Boston, MA area (Horne), or daughters of women participating in the DES-exposed and unexposed women of the Women's Health Study
Exposure Investigated
Exposures investigated
In utero exposure to DES
How exposure was measured
Medical record (not reported for women from the WHS)
Exposure assessment comment
Dosage, duration not reported, few unexposed cases in stratified results
Statistical Analysis
Breast cancer outcome investigated
Primary incident breast cancer
Ethnic groups with separate analysis
If this study provided a separate analysis by ethnic or racial group, the groups are listed here.
Confounders considered
Other breast cancer risk factors, such as family history, age at first birth, and hormone replacement therapy use, that were taken into account in the study.
Race, BMI, alcohol consumption
Genetic characterization included
If the study analyzed relationships between environmental factors and inherited genetic variations, this field will be marked “Yes.” “No”, if not.
Description of major analysis
Poisson regression model adjusted for year of birth, age at menarche, age at first birth, and number of births. Years of education, calendar year of entry, original cohort, duration of oral contraceptive use, family history, menopausal status, and use of
Strength of associations reported
Entire cohort: 1.4 (0.7-2.6)
Results Comments
The results suggest that in-utero exposure to DES may lead to an increased risk of breast cancer, but the data are not definitive
Author address
Slone Epidemiology Unit, Boston University School of Medicine, MA 02215, USA. jpalmer@slone.bu.edu