TAS::75 0849::TAS CONTINUATION OF FOLLOW-UP OF DES-EXPOSED COHORT

己烯雌酚(DES)是1938年首次合成的一种药物，在美国和欧洲为数百万孕妇提供了预防自然流产和早产的药物。1971年，Herbst报道了怀孕期间使用DES与暴露的女性后代中发生阴道透明细胞腺癌(CCA)之间的强烈关联。动物模型已经证明了子宫内暴露的DES对后代的一系列影响，包括生殖功能障碍、免疫系统变化、行为和性异常，以及男性和女性各种生殖癌症的增加。NCI与五个现场中心合作，重新组合了先前研究过的接触和未接触DES的母亲、女儿和儿子的队列，并通过队列中的家庭联系确定了有记录的接触状况的受试者，这些受试者以前没有被研究过。标准化的基线问卷被邮寄给队列成员，以确定癌症和其他疾病的风险。收集了已报告的癌症和癌前疾病的病理报告。已进行了三个不同阶段的后续行动。本研究的目的是通过邮寄问卷和收集病历的方式继续追踪，从研究的第一阶段开始。人们担心，接触DES的女儿患乳腺癌的风险可能更高。在子宫内暴露于高水平的内源性雌激素被认为会增加患乳腺癌的风险，而DES是一种有效的雌激素。还将继续评估儿子患癌症的风险，特别是前列腺癌风险增加的风险。由于在子宫中暴露于DES的后代目前已年近40，此时癌症发病率开始上升，因此继续对这些队列进行跟踪以确定癌症风险是否长期增加是很重要的。

Diethylstilbestrol (DES), a drug first synthesized in 1938, was administered to several million pregnant women in the U.S. and Europe for the prevention of spontaneous abortion and premature delivery. In 1971, Herbst reported a strong association between DES use in pregnancy and the occurrence of vaginal clear cell adenocarcinoma (CCA) in exposed female offspring. Animal models have demonstrated a range of DES effects on offspring exposed in utero, including reproductive dysfunction, immune system changes, behavioral and sexual abnormalities, and increases in various reproductive cancer in males and females. NCI, in collaboration with five field centers, reassembled previously studied cohorts of DES-exposed and unexposed mothers, daughters and sons, and identified subjects with documented exposure status who had not been studied previously, through familial links within the cohorts. Standardized baseline questionnaires were mailed to cohort members to ascertain the risk of cancer and other disorders. Pathology reports were collected for reported cancers and preneoplastic conditions. Three separate phases of follow-up have been conducted. The purpose of this study is to continue the follow-up, by means of mailed questionnaires and medical record collection, which was begun during the the first phase of the study. Concern has arisen that DES-exposed daughters may be at higher risk of breast cancer. Exposure to high levels of endogenous estrogen in utero has been hypothesized to increase the risk of breast cancer and DES is a potent estrogen. Cancer risk in the sons will also continue to be assessed, especially for increased risks of prostate cancer. since the offspring who were exposed to DES in utero are currently reaching their late forties, when cancer rates begin to rise, it is important to continue the follow-up of these cohorts to determine if there are long-term increases in cancer risk.