Why is DES exposure important to document?

• A. DES-exposed females have a higher risk of cervicovaginal cancer
• B. DES exposure reduces cervical cancer risk
• C. DES exposure has no health effects
• D. DES exposure increases breast cancer risk only

Answer: (A)

Documenting DES exposure matters because in utero exposure to diethylstilbestrol is associated with a significantly higher risk of clear cell adenocarcinoma of the vagina and cervix in the offspring. This risk can present in adolescence or young adulthood, so knowing a patient’s DES exposure status directly informs targeted gynecologic surveillance and counseling. DES exposure can also cause other reproductive tract abnormalities and fertility issues, but the cancer risk is the most clinically critical reason to document it. The remaining statements are not supported: DES does not reduce cervical cancer risk, it does have health effects, and the risk is not limited to breast cancer.