Diethylstilbestrol (DES) Update: Recommendations for the Identification and Management of DES-Exposed Individuals

Authors

  • Barbara Hammes CNM, MS,

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    • clinical associate professor at the University of Wisconsin-Madison, School of Nursing, Women's Health NP Program.

  • Cynthia J. Laitman PhD

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    • clinical associate professor at the University of Wisconsin-Madison, School of Nursing, Women's Health NP Program.

    • holds an appointment in the Department of Surgery, University of Wisconsin Medical School and a consultancy with the University of Wisconsin Center of Excellence for Women's Health and Women's Health Research. Dr. Laitman is the author of DES: The Complete Story (New York: St. Martin's Press, 1981), was a coinvestigator for the National Cancer Institute-funded University of Wisconsin DES Education Project to educate physicians and the public.


  • This work was supported by the University of Wisconsin Center for Women's Health and Women's Health Research (A National Center of Excellence in Women's Health), Madison, WI; the U.S. Public Health Service's Centers for Disease Control and Prevention, Atlanta, GA; and PHS Office on Women's Health, Washington, DC (Contract No. 00T00225101D).

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Abstract

Diethylstilbestrol (DES) was etiologically linked to clear cell adenocarcinoma of the vagina in 1971. This article reviews on-going research and emerging information relevant to DES-related health risks, thereby enabling women's health care providers to maintain an evidence-based practice for their DES-exposed patients. To accomplish these goals, the Center for Disease Control and Prevention (CDC) has initiated a national education campaign. This article describes the reasons for this new initiative, the target audiences, the DES historical framework (including major studies and findings), and populations that are affected. Clinical steps for the identification and management of the DES-exposed individual and resultant implications for midwifery and women's health practices are reviewed.

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