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Article ; Online: Advancing racial equity and social justice for Black communities in US tobacco control policy.

Cwalina, Sam N / Ihenacho, Ugonna / Barker, Joshua / Smiley, Sabrina L / Pentz, Mary Ann / Wipfli, Heather

2021 Volume 32, Issue 3, Page(s) 381–384

Abstract: The US Food and Drug Administration (FDA) applies the Population Health Standard in tobacco product review processes by weighing anticipated health benefits against risks associated with a given commercial tobacco product at the population level. However, ...

Abstract	The US Food and Drug Administration (FDA) applies the Population Health Standard in tobacco product review processes by weighing anticipated health benefits against risks associated with a given commercial tobacco product at the population level. However, systemic racism (ie, discriminatory policies and practices) contributes to an inequitable distribution of tobacco-related health benefits and risks between white and Black/African Americans at the population level. Therefore, Black-centered, antiracist data standards for tobacco product review processes are needed to achieve racial equity and social justice in US tobacco control policy. Regardless of whether FDA implements such data standards, non-industry tobacco scientists should prioritise producing and disseminating Black-centred data relevant to FDA's regulatory authority. We describe how systemic racism contributes to disparities in tobacco-related outcomes and why these disparities are relevant for population-level risk assessments, then discuss four possible options for Black-centred data standards relevant to tobacco product review processes.
MeSH term(s)	Humans ; United States ; Tobacco Control ; Racial Groups ; Tobacco Products ; Social Justice ; Policy ; Nicotiana ; Racism
Language	English
Publishing date	2021-09-15
Publishing country	England
Document type	Editorial ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	1146554-2
ISSN	1468-3318 ; 0964-4563
ISSN (online)	1468-3318
ISSN	0964-4563
DOI	10.1136/tobaccocontrol-2021-056704
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Zs.A 3651: Show issues

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Article ; Online: A Systematic Review and Meta-Analysis of Smoking and Circulating Sex Hormone Levels Among Premenopausal Women.

Ihenacho, Ugonna / Sriprasert, Intira / Mack, Wendy J / Hamilton, Ann S / Unger, Jennifer B / Press, Michael F / Wu, Anna H

Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco

2022 Volume 24, Issue 11, Page(s) 1705–1713

Abstract: Introduction: It is established that higher prediagnostic circulating androgen and estrogen levels are associated with increased breast cancer risk in premenopausal and postmenopausal women. Pooled analyses in postmenopausal women report higher androgen ...

Abstract	Introduction: It is established that higher prediagnostic circulating androgen and estrogen levels are associated with increased breast cancer risk in premenopausal and postmenopausal women. Pooled analyses in postmenopausal women report higher androgen and estrogen levels in current heavy cigarette smokers compared to nonsmokers. However, evidence among premenopausal women has been inconsistent. Aims and methods: We conducted a systematic review and meta-analysis to estimate differences in standardized mean hormone levels among current premenopausal smokers compared to nonsmokers. We reviewed and collated publications with sex hormone levels by smoking status among healthy, premenopausal women who were nonusers of exogenous hormones, including oral contraceptives, using PubMed through December 2019. A random effects meta-analysis was conducted to combine the standardized mean differences (SMD) and 95% confidence intervals (CIs) for estradiol, progesterone, testosterone, dehydroepiandrosterone, dehydroepiandrosterone-sulfate, and sex hormone-binding globulin by smoking status. Findings were summarized by menstrual cycle phase and overall. Results: Nineteen published peer-reviewed articles were included. Significantly increased testosterone levels among smokers compared to nonsmokers were identified from cross-sectional studies with varied menstrual phase timing (SMD 0.14; 95% CI 0.0005, 0.29) and significantly increased dehydroepiandrosterone-sulfate levels were found over all phases (SMD 0.12; 95% CI 0.01, 0.22). However, substantial heterogeneity existed in these studies. Conclusions: This meta-analysis suggests that smoking may increase blood androgen levels in healthy premenopausal women which may increase breast cancer risk; however, the differences were modest. Larger and covariate-adjusted studies with standardized collection over the menstrual cycle are needed to better understand this relationship and to reduce heterogeneity. Implications: Existing research has described associations between high prediagnostic estradiol and androgen levels with breast cancer risk among premenopausal women and has established active smoking as a breast cancer risk factor. However, the smoking and circulating sex hormone associations among premenopausal women remain inadequately studied. In this meta-analysis, we identified an association between smoking and higher mean testosterone and dehydroepiandrosterone-sulfate levels with consideration of menstrual phase, providing additional information on smoking's potential pathway to premenopausal breast cancer.
MeSH term(s)	Female ; Humans ; Sex Hormone-Binding Globulin/analysis ; Sex Hormone-Binding Globulin/metabolism ; Androgens ; Progesterone ; Cross-Sectional Studies ; Gonadal Steroid Hormones ; Estradiol ; Testosterone ; Breast Neoplasms/epidemiology ; Breast Neoplasms/etiology ; Estrogens ; Smoking ; Dehydroepiandrosterone ; Contraceptives, Oral ; Sulfates/metabolism
Chemical Substances	Sex Hormone-Binding Globulin ; Androgens ; Progesterone (4G7DS2Q64Y) ; Gonadal Steroid Hormones ; Estradiol (4TI98Z838E) ; Testosterone (3XMK78S47O) ; Estrogens ; Dehydroepiandrosterone (459AG36T1B) ; Contraceptives, Oral ; Sulfates
Language	English
Publishing date	2022-03-15
Publishing country	England
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1452315-2
ISSN	1469-994X ; 1462-2203
ISSN (online)	1469-994X
ISSN	1462-2203
DOI	10.1093/ntr/ntac066
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Zs.A 5789: Show issues

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Article ; Online: Characterizing breast cancer incidence and trends among Asian American, Native Hawaiian, and non-Hispanic White women in Hawai'i, 1990-2014.

Ihenacho, Ugonna / McKinley, Meg A / Vu, Annie / Hernandez, Brenda Y / Loo, Lenora W M / Gomez, Scarlett Lin / Wu, Anna H / Cheng, Iona

Cancer causes & control : CCC

2022 Volume 34, Issue 3, Page(s) 241–249

Abstract: Purpose: To characterize breast cancer (BC) incidence by age at diagnosis and BC subtype among disaggregated Asian American, Native Hawaiian, and Pacific Islander (AANHPI) women and non-Hispanic White (NHW) women in Hawai'i.: Methods: Using 1990-2014 ...

Abstract	Purpose: To characterize breast cancer (BC) incidence by age at diagnosis and BC subtype among disaggregated Asian American, Native Hawaiian, and Pacific Islander (AANHPI) women and non-Hispanic White (NHW) women in Hawai'i. Methods: Using 1990-2014 data from the Hawai'i tumor registry, we estimated age-adjusted incidence rates (AAIR) of BC and the annual percent change in BC incidence by age (<50 and ≥50 years) and BC subtype (hormone receptor [HR]+/human epidermal growth factor receptor 2 [HER2]-, HR+/HER2+, HR-/HER2+, triple negative BC) for Filipino American (FA), Japanese American (JA), Native Hawaiian (NH), and NHW women. Results: Among young (<50 years) women, annual BC incidence increased 2.9% (1994-2014) among JA and 1.0% (1990-2014) among NHW women. Incidence was highest among young JA women (2010-2014 AAIR 52.0 per 100,000; 95% confidence interval [CI] 45.6, 58.9). HR+/HER2- BC, the major BC subtype, was similarly highest among young JA women (AAIR 39.5; 95% CI 33.9, 45.4). Among older (≥50 years) women, annual BC incidence increased 1.6% (1990-2014) among FA and 4.2% (2006-2014) for JA women. BC incidence was highest among older NH women (AAIR 137.6, 95% CI 128.2, 147.4), who also displayed highest incidence of two subtypes: HR+/HER2- (AAIR 106.9; 95% CI 98.6, 115.5) and HR+/HER2+ (AAIR 12.1; 95% CI 9.4, 15.1). Conclusion: We observed high and increasing BC incidence among JA women ages <50 years and high incidence among NH women ages ≥50 years. These results highlight racial and ethnic differences in BC incidence among disaggregated AANHPI populations in Hawai'i by age and BC subtype.
MeSH term(s)	Female ; Humans ; Middle Aged ; Breast Neoplasms/epidemiology ; Hawaii/epidemiology ; Incidence ; Triple Negative Breast Neoplasms/epidemiology ; White/statistics & numerical data ; Asian American Native Hawaiian and Pacific Islander/statistics & numerical data
Language	English
Publishing date	2022-12-11
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1064022-8
ISSN	1573-7225 ; 0957-5243
ISSN (online)	1573-7225
ISSN	0957-5243
DOI	10.1007/s10552-022-01659-7
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Zs.A 3375: Show issues

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Article ; Online: Incident testicular cancer in relation to using marijuana and smoking tobacco: A systematic review and meta-analysis of epidemiologic studies.

Song, Ashley / Myung, No Kang / Bogumil, David / Ihenacho, Ugonna / Burg, Madeleine L / Cortessis, Victoria K

Urologic oncology

2020 Volume 38, Issue 7, Page(s) 642.e1–642.e9

Abstract: Background: Recent epidemiologic studies identified credible associations between marijuana smoking and risk of nonseminomatous testicular germ cell tumors (TGCTs), but did not distinguish exposure to cannabinoid compounds from exposure to other ... ...

Abstract	Background: Recent epidemiologic studies identified credible associations between marijuana smoking and risk of nonseminomatous testicular germ cell tumors (TGCTs), but did not distinguish exposure to cannabinoid compounds from exposure to other constituents of smoke. Methods: We implemented a systematic review of scholarly literature followed by random effects meta-analysis to quantitatively synthesize published data relating incident TGCT to each of 2 exposure histories: ever using marijuana, and ever smoking tobacco. Results: We identified four epidemiologic studies of marijuana use and 12 of tobacco smoking. Summary data concur with earlier reports of a specific association of marijuana use with nonseminoma, summary odds ratio [sOR] = 1.71 (95% confidence interval [CI] 1.12-2.60), and identify a positive association, sOR = 1.18 (95% CI 1.05-1.33), between tobacco smoking and all TGCT. Conclusions: Available data accord with positive associations between incident TGCT and each exposure, implicating both cannabinoid compounds and other constituents of smoke. Etiologic interpretation awaits epidemiologic studies that assess associations between tobacco smoking and nonseminomatous TGCT, investigating not only these exposures but also both co-use of tobacco and marijuana and smoke-free sources of cannabinoids, while adequately evaluating potential confounding among all of these exposures.
MeSH term(s)	Adolescent ; Adult ; Epidemiologic Studies ; Humans ; Incidence ; Male ; Marijuana Smoking/adverse effects ; Testicular Neoplasms ; Nicotiana/adverse effects ; Young Adult
Language	English
Publishing date	2020-05-12
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Systematic Review
ZDB-ID	1336505-8
ISSN	1873-2496 ; 1078-1439
ISSN (online)	1873-2496
ISSN	1078-1439
DOI	10.1016/j.urolonc.2020.03.013
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Zs.A 4817: Show issues

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Article ; Online: Association of Endocrine Disrupting Chemicals With the Metabolic Syndrome Among Women in the Multiethnic Cohort Study.

Ihenacho, Ugonna / Guillermo, Cherie / Wilkens, Lynne R / Franke, Adrian A / Tseng, Chiuchen / Li, Yuqing / Sangaramoorthy, Meera / Derouen, Mindy C / Haiman, Christopher A / Stram, Daniel O / Le Marchand, Loïc / Cheng, Iona / Wu, Anna H

Journal of the Endocrine Society

2023 Volume 7, Issue 12, Page(s) bvad136

Abstract: Metabolic syndrome (MetS) is associated with a high risk of cardiovascular disease, a leading cause of death among women. MetS is a diagnosis of at least 3 of the following: high blood pressure, high fasting glucose, high triglycerides, high waist ... ...

Abstract	Metabolic syndrome (MetS) is associated with a high risk of cardiovascular disease, a leading cause of death among women. MetS is a diagnosis of at least 3 of the following: high blood pressure, high fasting glucose, high triglycerides, high waist circumference, and low high-density lipoprotein cholesterol. Epidemiological studies suggest that endocrine disrupting chemical (EDC) exposure is positively associated with individual components of MetS, but evidence of an association between EDCs and MetS remains inconsistent. In a cross-sectional analysis within the Multiethnic Cohort Study, we evaluated the association between 4 classes of urinary EDCs (bisphenol A [BPA], triclosan, parabens, and phthalates) and MetS among 1728 women. Multivariable logistic regression was used to estimate odds ratios and 95% CI for the association between tertiles of each EDC and MetS adjusting for age, body mass index (BMI), racial and ethnic group, and breast cancer status. Stratified analyses by race and ethnicity and BMI were conducted. MetS was identified in 519 (30.0%) women. We did not detect statistically significant associations of MetS with BPA, triclosan, or phthalate metabolite excretion. MetS was inversely associated with total parabens (
Language	English
Publishing date	2023-11-17
Publishing country	United States
Document type	Journal Article
ISSN	2472-1972
ISSN (online)	2472-1972
DOI	10.1210/jendso/bvad136
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Article ; Online: Lifetime alcohol consumption patterns and young-onset breast cancer by subtype among Non-Hispanic Black and White women in the Young Women's Health History Study.

Hirko, Kelly A / Lucas, Darek R / Pathak, Dorothy R / Hamilton, Ann S / Post, Lydia M / Ihenacho, Ugonna / Carnegie, Nicole Bohme / Houang, Richard T / Schwartz, Kendra / Velie, Ellen M

Cancer causes & control : CCC

2023 Volume 35, Issue 2, Page(s) 377–391

Abstract: Purpose: The role of alcohol in young-onset breast cancer (YOBC) is unclear. We examined associations between lifetime alcohol consumption and YOBC in the Young Women's Health History Study, a population-based case-control study of breast cancer among ... ...

Abstract	Purpose: The role of alcohol in young-onset breast cancer (YOBC) is unclear. We examined associations between lifetime alcohol consumption and YOBC in the Young Women's Health History Study, a population-based case-control study of breast cancer among Non-Hispanic Black and White women < 50 years of age. Methods: Breast cancer cases (n = 1,812) were diagnosed in the Metropolitan Detroit and Los Angeles County SEER registry areas, 2010-2015. Controls (n = 1,381) were identified through area-based sampling and were frequency-matched to cases by age, site, and race. Alcohol consumption and covariates were collected from in-person interviews. Weighted multivariable logistic regression was conducted to calculate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for associations between alcohol consumption and YOBC overall and by subtype (Luminal A, Luminal B, HER2, or triple negative). Results: Lifetime alcohol consumption was not associated with YOBC overall or with subtypes (all p Conclusions: Our findings suggest alcohol consumption has a different association with YOBC than postmenopausal breast cancer-lifetime consumption was not linked to increased risk and younger age at alcohol use initiation was associated with a decreased risk of triple-negative YOBC. Future studies on alcohol consumption in YOBC subtypes are warranted.
MeSH term(s)	Female ; Humans ; Alcohol Drinking/epidemiology ; Alcohol Drinking/adverse effects ; Breast Neoplasms/epidemiology ; Breast Neoplasms/etiology ; Case-Control Studies ; Receptor, ErbB-2 ; Receptors, Progesterone ; Risk Factors ; Triple Negative Breast Neoplasms/epidemiology ; Triple Negative Breast Neoplasms/etiology ; Black or African American ; White ; Age of Onset
Chemical Substances	Receptor, ErbB-2 (EC 2.7.10.1) ; Receptors, Progesterone
Language	English
Publishing date	2023-10-03
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1064022-8
ISSN	1573-7225 ; 0957-5243
ISSN (online)	1573-7225
ISSN	0957-5243
DOI	10.1007/s10552-023-01801-z
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Zs.A 3375: Show issues

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Article ; Online: Association between Airport Ultrafine Particles and Lung Cancer Risk: The Multiethnic Cohort Study.

Bookstein, Arthur / Po, Justine / Tseng, Chiuchen / Larson, Timothy V / Yang, Juan / Park, Sung-Shim L / Wu, Jun / Shariff-Marco, Salma / Inamdar, Pushkar P / Ihenacho, Ugonna / Setiawan, Veronica Wendy / DeRouen, Mindy C / Le Marchand, Loïc / Stram, Daniel O / Samet, Jonathan / Ritz, Beate / Fruin, Scott / Wu, Anna H / Cheng, Iona

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

2024

Abstract: Background: Ultrafine particles (UFPs) are unregulated air pollutants abundant in aviation exhaust. Emerging evidence suggests that UFPs may impact lung health due to their high surface area-to-mass ratio and deep penetration into airways. This study ... ...

Abstract	Background: Ultrafine particles (UFPs) are unregulated air pollutants abundant in aviation exhaust. Emerging evidence suggests that UFPs may impact lung health due to their high surface area-to-mass ratio and deep penetration into airways. This study aimed to assess long-term exposure to airport-related UFPs and lung cancer incidence in a multiethnic population in Los Angeles County. Methods: Within the California Multiethnic Cohort, we examined the association between long-term exposure to airport-related UFPs and lung cancer incidence. Multivariable Cox proportional hazards regression models were used to estimate the effect of UFP exposure on lung cancer incidence. Subgroup analyses by demographics, histology and smoking status were conducted. Results: Airport-related UFP exposure was not associated with lung cancer risk [per one IGR HR = 1.01, 95% CI: 0.97-1.05] overall and across race/ethnicity. A suggestive positive association was observed between a one IQR increase in UFP exposure and lung squamous cell carcinoma (SCC) risk [HR = 1.08, 95% CI: 1.00-1.17] with a Phet for histology=0.05. Positive associations were observed in 5-year lag analysis for SCC [HR = 1.12, CI: 1.02-1.22] and large cell carcinoma risk [HR = 1.23, CI: 1.01-1.49] with a [Phet for histology = 0.01]. Conclusions: This large prospective cohort analysis suggests a potential association between airport-related UFP exposure and specific lung histologies. The findings align with research indicating that UFPs found in aviation exhaust may induce inflammatory and oxidative injury leading to SCC. Impact: These results highlight the potential role of airport-related UFP exposure in the development of lung SCC.
Language	English
Publishing date	2024-02-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	1153420-5
ISSN	1538-7755 ; 1055-9965
ISSN (online)	1538-7755
ISSN	1055-9965
DOI	10.1158/1055-9965.EPI-23-0924
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Zs.A 3693: Show issues

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Article ; Online: Lifetime personal cigarette smoking and risk of young-onset breast cancer by subtype among non-Hispanic Black and White women in the Young Women's Health History Study.

Ihenacho, Ugonna / Hamilton, Ann S / Mack, Wendy J / Wu, Anna H / Unger, Jennifer B / Pathak, Dorothy R / Hirko, Kelly A / Houang, Richard T / Press, Michael F / Schwartz, Kendra L / Marcus, Lydia R / Velie, Ellen M

Breast cancer research and treatment

2022 Volume 195, Issue 3, Page(s) 353–366

Abstract: Purpose: To evaluate the association between lifetime personal cigarette smoking and young-onset breast cancer (YOBC; diagnosed <50 years of age) risk overall and by breast cancer (BC) subtype, and whether risk varies by race or socioeconomic position ( ... ...

Abstract	Purpose: To evaluate the association between lifetime personal cigarette smoking and young-onset breast cancer (YOBC; diagnosed <50 years of age) risk overall and by breast cancer (BC) subtype, and whether risk varies by race or socioeconomic position (SEP). Methods: Data are from the Young Women's Health History Study (YWHHS), a population-based case-control study of non-Hispanic Black (NHB) and White (NHW) women, ages 20-49 years (n = 1812 cases, n = 1381 controls) in the Los Angeles County and Metropolitan Detroit Surveillance, Epidemiology, and End Results (SEER) registry areas, 2010-2015. Lifetime personal cigarette smoking characteristics and YOBC risk by subtype were examined using sample-weighted, multivariable-adjusted polytomous logistic regression. Results: YOBC risk associated with ever versus never smoking differed by subtype (P Conclusion: Findings confirm prior reports of a positive association between cigarette smoking and Luminal A YOBC and identify a novel association between smoking and HER2-type YOBC.
MeSH term(s)	Adult ; Breast Neoplasms/epidemiology ; Breast Neoplasms/etiology ; Case-Control Studies ; Cigarette Smoking/adverse effects ; Cigarette Smoking/epidemiology ; Female ; Humans ; Middle Aged ; Pregnancy ; Receptor, ErbB-2 ; Receptors, Estrogen ; Receptors, Progesterone ; Risk Factors ; Young Adult
Chemical Substances	Receptors, Estrogen ; Receptors, Progesterone ; Receptor, ErbB-2 (EC 2.7.10.1)
Language	English
Publishing date	2022-08-04
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	604563-7
ISSN	1573-7217 ; 0167-6806
ISSN (online)	1573-7217
ISSN	0167-6806
DOI	10.1007/s10549-022-06675-4
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Zs.A 1655: Show issues

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Article ; Online: Neonatal hypoglycemia after initiation of late preterm antenatal corticosteroids.

Uquillas, Kristen R / Lee, Richard H / Sardesai, Smeeta / Chen, Ellison / Ihenacho, Ugonna / Cortessis, Victoria K / Barton, Lorayne

Journal of perinatology : official journal of the California Perinatal Association

2020 Volume 40, Issue 9, Page(s) 1339–1348

Abstract: Objective: To compare the frequency and severity of neonatal hypoglycemia in pregnancies treated with and without late preterm antenatal corticosteroids.: Study design: We conducted a retrospective cohort study of late preterm deliveries at LAC + USC ...

Abstract	Objective: To compare the frequency and severity of neonatal hypoglycemia in pregnancies treated with and without late preterm antenatal corticosteroids. Study design: We conducted a retrospective cohort study of late preterm deliveries at LAC + USC (2015-2018). Neonatal outcomes were compared between pregnancies treated with and without corticosteroids. Results: 93 pregnancies (39.9%) received corticosteroids and 140 (60.1%) did not. Neonates born to women given corticosteroids were more likely to be hypoglycemic (47.3 vs. 29.3%, OR Conclusion: Administration of late preterm corticosteroids was associated with an increased incidence and severity of neonatal hypoglycemia.
MeSH term(s)	Adrenal Cortex Hormones/adverse effects ; Female ; Gestational Age ; Humans ; Hypoglycemia/chemically induced ; Hypoglycemia/epidemiology ; Infant, Newborn ; Pregnancy ; Prenatal Care ; Retrospective Studies
Chemical Substances	Adrenal Cortex Hormones
Language	English
Publishing date	2020-02-14
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	645021-0
ISSN	1476-5543 ; 0743-8346
ISSN (online)	1476-5543
ISSN	0743-8346
DOI	10.1038/s41372-020-0589-1
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Zs.A 2412: Show issues

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Article ; Online: Systematic Review and Meta-analysis of Testicular Germ Cell Tumors Following In Utero Exposure to Diethylstilbestrol.

Hom, Marianne / Sriprasert, Intira / Ihenacho, Ugonna / Castelao, J Esteban / Siegmund, Kimberly / Bernstein, Leslie / Cortessis, Victoria K

JNCI cancer spectrum

2019 Volume 3, Issue 3, Page(s) pkz045

Abstract: Background: Early exposure to estrogen-like compounds has been implicated in the etiology of testicular cancer, but individual level epidemiologic data addressing this hypothesis are scarce. The synthetic estrogen diethylstilbestrol (DES) was ... ...

Abstract	Background: Early exposure to estrogen-like compounds has been implicated in the etiology of testicular cancer, but individual level epidemiologic data addressing this hypothesis are scarce. The synthetic estrogen diethylstilbestrol (DES) was administered during pregnancy from 1948 to 1971, but sequelae of in utero exposure have been more extensively characterized in females than in males. Methods: By systematic review, we sought to identify all epidemiologic research relating testicular cancer to a history of in utero exposure to diethylstilbestrol. Identified studies were critically appraised to assemble a set of nonredundant data in which any in utero exposure to DES was compared between men with incident testicular cancer and cancer-free men. These data were synthesized using random effects meta-analysis to estimate the summary association between in utero DES exposure and testicular cancer. Results: By meta-analysis of data from the six qualifying studies, the summary odds ratio estimate of the in utero DES-testicular cancer association was 2.98 (95% confidence interval = 1.15 to 7.67). Conclusions: Results of this comprehensive meta-analysis accord with a threefold increase in testicular cancer risk among men who were exposed in utero to DES, implicating early hormonal exposures in etiology of testicular cancer. Because use of DES ceased in 1971, this work may provide the most comprehensive estimate of this association that will be made.
Language	English
Publishing date	2019-06-28
Publishing country	England
Document type	Journal Article
ISSN	2515-5091
ISSN (online)	2515-5091
DOI	10.1093/jncics/pkz045
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