[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[S. 834 Introduced in Senate (IS)]







105th CONGRESS
  1st Session
                                 S. 834

To amend the Public Health Service Act to ensure adequate research and 
                   education regarding the drug DES.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              June 5, 1997

 Mr. Harkin (for himself and Mr. Reed) introduced the following bill; 
 which was read twice and referred to the Committee on Labor and Human 
                               Resources

_______________________________________________________________________

                                 A BILL


 
To amend the Public Health Service Act to ensure adequate research and 
                   education regarding the drug DES.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``DES Research and Education 
Amendments of 1997''.

SEC. 2. FINDINGS.

    With respect to diethylstilbestrol (a drug commonly known as DES), 
the Congress finds as follows:
            (1) DES was widely prescribed to American women from 1938 
        to 1971 in the mistaken belief it would prevent miscarriage. 
        Approximately 5,000,000 pregnant women took the drug, resulting 
        in DES exposure for approximately 5,000,000 daughters and sons.
            (2) Studies conducted since the 1970s have shown that DES 
        damages the reproductive systems of those exposed in utero and 
        increases the risk for cancer, infertility, and a wide range of 
        other serious reproductive tract disorders. These disorders 
        include a five-fold increased risk for ectopic pregnancy for 
        DES daughters and a three-fold increase in risk for miscarriage 
        and preterm labor. Studies have indicated that exposure to DES 
        may increase the risk for autoimmune disorders and diseases.
            (3) An estimated 1 in 1,000 women exposed to DES in utero 
        will develop clear cell cancer of the vagina or cervix. While 
        survival rates for clear cell cancer are over 80 percent when 
        it is detected early, there is still no effective treatment for 
        recurrences of this cancer.
            (4) Studies also indicate a higher incidence of breast 
        cancer among mothers who took DES during pregnancy.
            (5) While research on DES and its effects has produced 
        important advances to date, much more remains to be learned.
            (6) Preliminary research results indicate that DES exposure 
        may have a genetic impact on the third generation--the children 
        of parents exposed to DES in utero--and that estrogen 
        replacement therapy may not be advisable for DES-exposed women.
            (7) All DES-exposed individuals have special screening and 
        health care needs, especially during gynecological exams and 
        pregnancy for DES daughters, who should receive high risk care.
            (8) Many Americans remain unaware of their DES exposure or 
        ignorant about proper health care and screening. There remains 
        a great need for a national education effort to inform both the 
        public and health care providers about the health effects and 
        proper health care practices for DES-exposed individuals.

SEC. 3. REVISION AND EXTENSION OF PROGRAM FOR RESEARCH AND 
              AUTHORIZATION OF NEW NATIONAL PROGRAM OF EDUCATION 
              REGARDING DRUG DES.

    (a) Permanent Extension of General Program.--Section 403A(e) of the 
Public Health Service Act (42 U.S.C. 283a(e)) is amended by striking 
``for each of the fiscal years 1993 through 1996'' and inserting ``for 
fiscal year 1997 and each subsequent fiscal year''.
    (b) National Program for Education of Health Professionals and 
Public.--From amounts appropriated for carrying out section 403A of the 
Public Health Service Act (42 U.S.C. 283a), the Secretary of Health and 
Human Services, acting through the heads of the appropriate agencies of 
the Public Health Service, shall carry out a national program for the 
education of health professionals and the public with respect to the 
drug diethylstilbestrol (commonly know as DES). To the extent 
appropriate, such national program shall use methodologies developed 
through the education demonstration program carried out under such 
section 403A. In developing and carrying out the national program, the 
Secretary shall consult closely with representatives of nonprofit 
private entities that represent individuals who have been exposed to 
DES and that have expertise in community-based information campaigns 
for the public and for health care providers. The implementation of the 
national program shall begin during fiscal year 1998.
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