Agenda - Council - 06/25/1991 - Laserfiche WebLink

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Vo~,m3S/No. 10 1-17'1_ V-III~LA V -- Cont/nued M M~I R 155 4. CDC. Hetm-oaexual transmission of human T-lymphotropic virus type III/lymphader~opathy- associated virus. MMWR 1985;34:561-3. 5, CDC. Provisional public health services intec-a~enc¥ recommendations for screenir~g donated blood ar~ plasma for antibody to the virus causi~ a4:quired immunodeficiancy synclroma. MMWR 1985;34:1-5. CDC. Prevention of acquired immune deficiency sym:lrome (AIDS): report of inter-agency recom- mendatiorm. MMWR 1983;32:101-4. 7. CDC. Antibodies to a relrovirus etiologically associated with acquired immunodeficiency syndrome (AIDS) in I;>Opulations with increased inc~e~ces of Ihe syndrome. MMWR 1984;33:377-9. 8. CDC. Recommendations for assistir~g in the pcevefltion of perinata~ transmission of human T- lymphotropic virus type Ill/lymphadenopathy-associated virus and acquired immunodaficiency syn- drome. MMWR 1985;34:721-32. 9. Jt,~lson FN. Bodin G.c. Levin MJ. Ehret JM. IMaster~ HB. In vitro tests demonstrate condoms provide an effective barrier against chlamydia trachomatis ami herpes simplex wrus. Abstract in Program of the International Society for STD Research. Seattle, Washington, August I -3. 1983:176. 10. Conant MA. Sp'icer DW, Smith CD. Herp,a-s simplex virus transmission: condom studies. Sex Transm Dis t984;11:9,~-5. Report of the Recommendations of the 1985 DES Task Force of the U.S, Department of Health and Human Services In 1978, the U.$. Department of Health, Education, and Welfare set up a DES (diethytstil- bestrol [a synthetic estrogen]) Task Force to review all aspects of the DES question and to de- velop recommendations regarding health issues of DES and research gaps that exist. In 1985, a second DES Task Force of the U.S. Department of Health and Human Services (DHHS) was convened to review recent studies showing a possible increased risk of breast cancer among women given DES during pregnancy and a possible excess of precancerous abnormalities of the cervix ami vagina among women exposed to DES in utero ( 1 ). BREAST CANCER Since 1 978, results of four investigations re4evant to this issue have been published {2-5). Two of these studies were randomized clinical trials reporting the long-term follow-up results of the use of DES during pregnancy, tn one, 80 diabetic women received hormonal treatment, and 76 diabetic women received placebos. After 29 years of follow-up, four cases of breast cancer had occurred among the exposed women, and no~e, among the unexposed women (2). In another study, 10 cases of breast cancer were fou~l among 319 DES-exposed women, and nme, among 331 unexposed women, suggesting.thece was no excess risk. Exposure occurred in theeafly 1 950s. Two observational follow-up studies of women tTeated with DES during pregnancy have also been reported recently (4,5). In these studies, the overall relative risk of breast cancer among the exposed women ranged from 1.2 to 1.5. One study noted that there was no in- creased risk in the first 20 years of follow-up but that the relative risk rose to 1.6 during the 20-29 years after exposure and to 2,5 for those followed 30 years or more 15}. The t 985 Task Force concluded that: 1. These levels of excess risk are difficult to evaluate, since Jt is difficult to rule out various sources of bias that could be responsible for such excesses. 2. In the two observational studies, the interp~tation involves assessing whether the excess risks are due to the dru~ itself or to the indications fo,' the use of the drug. Data from two recent studies suggest that spontar~ous abortion before a first b~rth is a risk factor for the development of breast cancer (6, 7). In the observational studies, a pri- mary indication of DES use was previous spontaneous abortion. The Task Force felt it would be useful to analyze the data on risk according to frequency of spontaneous I I I I I I I I I I I I I I I I I