Prenatal Diethylstilbestrol Exposure and Cancer Risk in Males

UMMS Affiliation

Department of Molecular, Cell, and Cancer Biology

Publication Date


Document Type



Environmental Public Health | Epidemiology | Male Urogenital Diseases | Neoplasms | Oncology


BACKGROUND: The influence of prenatal diethylstilbestrol (DES) exposure on cancer incidence among middle-aged men has not been well-characterized. We investigated whether exposure to DES before birth impacts overall cancer risk, and risk of site-specific cancers.

METHODS: Men (mean age in 2016 = 62.0 years) who were or were not prenatally DES exposed were identified between 1953 and 1994 and followed for cancer primarily via questionnaire approximately every 5 years between 1994 and 2016. The overall and site-specific cancer rates of the two groups were compared using Poisson regression and proportional hazards modeling with adjustment for age.

RESULTS: DES exposure was not associated with either overall cancer [hazard ratio (HR), 0.94; 95% confidence interval (CI), 0.77-1.15] or total prostate cancer rates (HR, 0.95; 95% CI, 0.68-1.33), but was inversely associated with urinary tract cancer incidence (HR, 0.48; 95% CI, 0.23-1.00).

CONCLUSIONS: There was no increase in either overall or prostate cancer rates among men prenatally DES exposed relative to those unexposed. An unexpected risk reduction was observed for urinary system cancers among the exposed relative to those unexposed. These findings suggest that prenatal DES exposure is unlikely to be an important contributor to cancer development in middle-aged men.

IMPACT: The results of this study could lend reassurance to middle-aged men who were prenatally DES exposed that their exposure does not adversely influence their overall cancer risk.


Diethylstilbestrol (DES), Prenatal Exposure, Cohort Studies, Prostate Cancer, Epidemiology

DOI of Published Version



Strohsnitter WC, Hyer M, Bertrand KA, Cheville AL, Palmer JR, Hatch EE, Aagaard KM, Titus L, Romero IL, Huo D, Hoover RN, Troisi R. Prenatal Diethylstilbestrol Exposure and Cancer Risk in Males. Cancer Epidemiol Biomarkers Prev. 2021 Oct;30(10):1826-1833. doi: 10.1158/1055-9965.EPI-21-0234. Epub 2021 Jul 16. PMID: 34272263; PMCID: PMC8492497. Link to article on publisher's site

Journal/Book/Conference Title

Cancer epidemiology, biomarkers and prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology

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