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However, in some studies, authors reported SIRs >1, with the highest being 1.53 (0.69–3.42) for rectal cancer [ 10, 13].
Seven of these reported SIRs for overall malignancy; eight for lymphoma, melanoma, and lung, colorectal and breast cancer; seven for prostate cancer; and four for cervical cancer.
Studies of cohorts with documented exposure to DES have reported SIRs for CCA of 24 [ 5] and close to 40 [ 4].
With one exception, all the reported SIRs clustered just below risk parity with the general population, and the summary estimate was 0.84 (95% CI 0.79 to 0.90).
The overall risk with the addition of the new studies is consistent with previously reported SIRs (2.08 [1.80–2.3.29 3.29 [2.56–4.22] and 1.95 [1.70–2.24], respectively) [ 6]; however, a slight increase in risk for non-Hodgkin disease was noted.
Our results are in accordance to previous population-based studies that reported SIRs from about 5 to 10 for developing HR-negative CBC among women with HR-negative first primary [ 6- 8].
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