Diethylstilbestrol Genetics, Teratogenesis, and Tumor Spectrum in Humans

Medical hypotheses, Lynch HT, Reich JW, March 1985


Diethylstilbestrol (DES) is the first example of transplacental carcinogenesis in humans, as evidenced by an excess of clear cell adenocarcinoma of the vagina and cervix in exposed women.

We hypothesize that:

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DiEthylStilbestrol usage review buttress the need for adequate and rigorous research into the use of drugs in pregnancy and ensure that they do more good than harm before being introduced.
  1. in utero DES exposure will be responsible for a broader spectrum of cancer with variable age of onset as a function of latency effects in exposed humans of both sexes;
  2. teratogenicity of DES will be more far-reaching than currently recognized and will harbor cancer implications in the face of known associations between teratogenesis and carcinogenesis;
  3. and genetic heterogeneity will be a critical etiologic discriminant in DES associated cancer.

This hypothesis embraces a prodigious body of data at the infrahuman level, as well as extant pharmacogenetic and ecogenetic observations in humans which signify heritable variations in response to environmental carcinogenic exposures. This hypothesis has important implications for drug testing with appropriate preventive strategies. Herein, particular restraints with monitoring through governmental legal channels must be employed. Past experience has clearly indicated negligence in shouldering this responsibility by both the pharmaceutical industry and government regulatory bodies.


  • Diethylstilbestrol, genetics, teratogenesis, and tumor spectrum in humans, NCBI, PMID: 3889564, 1985 Mar;16(3):315-32.
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