Diethylstilbestrol exposure: evaluation of the doses received in France
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In an analysis of two prospective studies on the relationship between DES exposure in utero and breast cancer, Adami et al.  oppose a dose dependent excess risk after the age of 40 years  and the absence of evidence of such an excess risk . Indeed, the American study  suggested an excess risk of breast cancer for women exposed in utero aged 40 years or more. The Incidence Rate Ratio (IRR) was 1.91 (95 % CI 1.09–3.33) relative to unexposed cohorts. Nevertheless, IRR was significant for high dose exposure (IRR = 2.16, 95 % CI, 1.18–3.96) but not for low-dose exposure (IRR = 1.63, 95 % CI, 0.87–3.08) relative to unexposed cohort. The Dutch study  by contrast revealed no increase of breast cancer for DES-exposed daughters.
One hypothesis that may explain these discordant results, besides possible differences in age of the cohorts and methods, concerns the differences in doses of DES given in the United States and in the Netherlands. This could stimulate a renewed interest in...