The 131st Annual Meeting (November 15-19, 2003) of APHA

The 131st Annual Meeting (November 15-19, 2003) of APHA

4056.0: Tuesday, November 18, 2003 - Board 6

Abstract #56347

What Health Care Providers Need to Know: Recognition of DES Risks

Elizabeth Blunt, PhD(c), MSN, FNP, College of Nursing and Health Professions, Drexel University, 1505 Race Street, Mail Stop 501, Philadelphia, PA 19102, 215-762-1644, emb27@drexel.edu

In the 1950's and 1960's, millions of pregnant women received a synthetic estrogen called diethylstilbestrol (DES) to prevent miscarriages and premature labor. Although the drug had been approved by the FDA as safe and effective, possible adverse effects on women's offspring had not been studied. An estimated 5 to 10 million women received DES during pregnancy or were exposed to the drug in utero. Exposure to DES has been associated with an increased risk for breast caner in DES mothers and a lifetime risk of clear cell cervico-vaginal cancer in DES daughters of 1/1000 to 1/10,000. The association between DES exposure and testicular cancer in DES sons remains controversial. Exposure to DES has also been linked to reproductive tract abnormalities in DES sons and daughters that consist of immune system disorders and psychosexual effects. No evidence for transgenerational effects exists. Health professionals need to have knowledge about appropriate ways to identify those at risk and how to screen and manage patients with DES exposure: women who took DES during the first trimester of pregnancy in 1950's and 1960's and women and men whose mothers or grandmothers were exposed to DES. During the last three years, both the AMA and the AMWA have passed resolutions advocating continuing DES education for health care students and providers. During 2001, the Centers for Disease Control, in conjunction with several educational institutions and individuals, developed a DES education curriculum for dissemination to a wide range of health care providers including medical students, physicians, physician's assistants, nurses, and nurse practitioners. Our University, one of the original author institutions, has now received a CDC grant to disseminate the DES curriculum to these groups. The program materials,which include case studies, student and faculty resource materials and photographs (all on CD) are available to any school of medicine, school of nursing, physician assistant school, physician, nurse or physician's assistant educator, staff development faculty, or others who may wish to use this material in their curriculum, continuing education program or practice. The materials may be adapted to be used as appropriate in your curriculum or programming. The case study content lends itself well to online course delivery and includes options for grand rounds presentations. All materials are free of charge as the program is supported by a CDC dissemination grant. This presentation is supported by a CDC grant for program dissemination.

Learning Objectives:

Keywords: Cancer Screening, Women's Health

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Center's for Disease Control
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Medical Care Section Poster Session #1

The 131st Annual Meeting (November 15-19, 2003) of APHA