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Flashcards in DES exposure Deck (8)
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1

What is DES?

Diethylstilbestriol is an oestrogen given to women in the 1950-1980s to reduce adverse pregnancy outcomes. In the end there was no evidence of benefit, and the practice stopped as DES was linked to rare vaginal/cervical clear cell cancers.

2

What are the effects for women who took DES?

- Increased risk breast ca

3

What are the effects for women who were exposed in utero to DES?

- uterine abnormalities (T-shape cavity, hypoplasia, intracavity synechiae)
- Cervical abnormalities (hypoplasia, cervical hood, collar or polyps)
- Consequently subfertility, miscarriage and preterm birth
- increased vaginal and cervical clear cell cancer (40x increase risk)
- increased risk of high grade CIN/VAIN
- increased risk of breast cancer
- increased risk of premature menopause

4

What are the effects for men who were exposed in utero to DES?

- epididymal cysts
- hypogonadism
- undescended testes (2%)

- NO increase in rate of testicular cancer, except that relate to undescended testes

5

What is the ongoing health advice for women who used DES?

- Enrol in regular breast screening program through BreastScreen Aoteroa, for 2 yearly screening from 45-69 years
- Should be advised to inform their children they were exposed to DES

6

What is the ongoing health advice for females who were exposed in utero to DES?

- Ix and documentation for uterine/cervical structural abnormality
- Annual gynaecology review, including colposcopy of cervix and vagina, cervical smear and HrHPV co-testing, and bimanual examination
- Enrol in regular breast screening program through BreastScreen Aoteroa, for 2 yearly screening from 45-69 years

7

What is the ongoing health advice for males who were exposed in utero to DES?

- Investigate and document any testicular abnormality
- Surgery if required for undescended testis in early childhood

8

What proportion of clear cell carcinoma of the cervix are due to DES? And HrHPV?

2/3 associated with DES exposure
1/3 associated with HrHPV