{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T03:10:11Z","timestamp":1788491411145,"version":"build-2803163510"},"reference-count":36,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2020,10,28]],"date-time":"2020-10-28T00:00:00Z","timestamp":1603843200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["J Dev Orig Health Dis"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Prenatal diethylstilbestrol (DES) exposure is associated with increased risk of hormonally mediated cancers and other medical conditions. We evaluated the association between DES and risk of pancreatic cancer and pancreatic disorders, type 2 diabetes, and gallbladder disease, which may be involved with this malignancy. Our analyses used follow-up data from the US National Cancer Institute DES Combined Cohort Study. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) adjusted for age, sex, cohort, body mass index, smoking, and alcohol for the association between prenatal DES exposure and type 2 diabetes, gallbladder disease (mainly cholelithiasis), pancreatic disorders (mainly pancreatitis), and pancreatic cancer among 5667 exposed and 3315 unexposed individuals followed from 1990 to 2017. Standardized incidence rate (SIR) ratios for pancreatic cancer were based on age-, race-, and calendar year-specific general population cancer incidence rates. In women and men combined, the hazards for total pancreatic disorders and pancreatitis were greater in the prenatally DES exposed than the unexposed (HR = 11, 95% CI 2.6\u201351 and HR = 7.0, 95% CI 1.5\u201333, respectively). DES was not associated overall with gallbladder disease (HR = 1.2, 95% CI 0.88\u20131.5) or diabetes (HR = 1.1, 95% CI 0.9\u20131.2). In women, but not in men, DES exposure was associated with increased risk of pancreatic cancer compared with the unexposed (HR: 4.1, 95% CI 0.84\u201320) or general population (SIR: 1.9, 95% CI 1.0\u20133.2). Prenatal DES exposure may increase the risk of pancreatic disorders, including pancreatitis in women and men. The data suggested elevated pancreatic cancer risk in DES-exposed women, but not in exposed men.<\/jats:p>","DOI":"10.1017\/s2040174420000872","type":"journal-article","created":{"date-parts":[[2020,10,28]],"date-time":"2020-10-28T13:46:55Z","timestamp":1603892815000},"page":"619-626","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":11,"title":["Prenatal diethylstilbestrol exposure and risk of diabetes, gallbladder disease, and pancreatic disorders and malignancies"],"prefix":"10.1017","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3520-2916","authenticated-orcid":false,"given":"Rebecca","family":"Troisi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Hyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Titus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie R.","family":"Palmer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth E.","family":"Hatch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dezheng","family":"Huo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kjersti M.","family":"Aagaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William C.","family":"Strohsnitter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert N.","family":"Hoover","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2020,10,28]]},"reference":[{"key":"S2040174420000872_ref10","doi-asserted-by":"publisher","DOI":"10.1002\/em.22155"},{"key":"S2040174420000872_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/S0300-483X(01)00437-1"},{"key":"S2040174420000872_ref6","doi-asserted-by":"publisher","DOI":"10.1001\/jama.280.7.630"},{"key":"S2040174420000872_ref5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1013961"},{"key":"S2040174420000872_ref28","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2014.01.038"},{"key":"S2040174420000872_ref34","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1093\/oxfordjournals.aje.a009487","article-title":"Validity of self-reported cancers in a prospective cohort study in comparison with data from state cancer registries","volume":"147","author":"Bergmann","year":"1998","journal-title":"Am J Epidemiol."},{"key":"S2040174420000872_ref29","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2019.07.003"},{"key":"S2040174420000872_ref30","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.07.066"},{"key":"S2040174420000872_ref25","volume-title":"Analysis of Survival Data","author":"Cox","year":"1984"},{"key":"S2040174420000872_ref12","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8091427"},{"key":"S2040174420000872_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.03.007"},{"key":"S2040174420000872_ref17","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2011.56"},{"key":"S2040174420000872_ref33","doi-asserted-by":"publisher","DOI":"10.1016\/j.mce.2009.02.024"},{"key":"S2040174420000872_ref3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197104222841604"},{"key":"S2040174420000872_ref13","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0000000000001367"},{"key":"S2040174420000872_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.reprotox.2015.09.006"},{"key":"S2040174420000872_ref27","volume-title":"GI Epidemiology","author":"Vege","year":"2007"},{"key":"S2040174420000872_ref4","first-page":"287","article-title":"Vaginal and cervical abnormalities after exposure to stilbestrol in utero","volume":"40","author":"Herbst","year":"1972","journal-title":"Obstet Gynecol"},{"key":"S2040174420000872_ref1","doi-asserted-by":"publisher","DOI":"10.1038\/141247b0"},{"key":"S2040174420000872_ref8","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-06-0109"},{"key":"S2040174420000872_ref20","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-197804000-00014"},{"key":"S2040174420000872_ref26","unstructured":"26. Data: Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Stat Database: Incidence \u2013 SEER 9 Regs Research Data, Nov 2018 Sub (1975\u20132016) <Katrina\/Rita Population Adjustment> \u2013 Linked To County Attributes \u2013 Total U.S., 1969\u20132017 Counties, National Cancer Institute, DCCPS, Surveillance Research Program, released April 2019, based on the November 2018 submission."},{"key":"S2040174420000872_ref15","doi-asserted-by":"publisher","DOI":"10.1038\/137996a0"},{"key":"S2040174420000872_ref24","first-page":"300","article-title":"Vaginal epithelial changes in young women enrolled in the National Cooperative Diethylstilbestrol Adenosis (DESAD) project","volume":"53","author":"O\u2019Brien","year":"1979","journal-title":"Obstet Gynecol."},{"key":"S2040174420000872_ref9","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/93.7.545"},{"key":"S2040174420000872_ref23","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198411293112201"},{"key":"S2040174420000872_ref11","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e318289bdf7"},{"key":"S2040174420000872_ref21","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1984.03350210032025"},{"key":"S2040174420000872_ref36","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.22631"},{"key":"S2040174420000872_ref35","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwg006"},{"key":"S2040174420000872_ref31","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-017-4510-5"},{"key":"S2040174420000872_ref22","first-page":"1","article-title":"Follow-up study of male and female offspring of DES-exposed mothers","volume":"49","author":"Bibbo","year":"1977","journal-title":"Obstet Gynecol"},{"key":"S2040174420000872_ref32","first-page":"144","article-title":"Diabetes type 2 and pancreatic cancer: a history unfolding","volume":"17","author":"De Souza","year":"2016","journal-title":"JOP."},{"key":"S2040174420000872_ref2","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1016\/0002-9378(48)90440-2","article-title":"Diethylstilbestrol in the prevention and treatment of complications of pregnancy","volume":"56","author":"Smith","year":"1948","journal-title":"Am J Obstet Gynecol"},{"key":"S2040174420000872_ref14","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0000000000000502"},{"key":"S2040174420000872_ref18","doi-asserted-by":"publisher","DOI":"10.1001\/jama.300.11.1303"}],"container-title":["Journal of Developmental Origins of Health and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2040174420000872","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T15:24:47Z","timestamp":1625757887000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2040174420000872\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,28]]},"references-count":36,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,8]]}},"alternative-id":["S2040174420000872"],"URL":"https:\/\/doi.org\/10.1017\/s2040174420000872","relation":{},"ISSN":["2040-1744","2040-1752"],"issn-type":[{"value":"2040-1744","type":"print"},{"value":"2040-1752","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,28]]},"assertion":[{"value":"\u00a9 National Cancer Institute and Information Management Services 2020. This is a work of the US Government and is not subject to copyright protection within the United States. Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}