There is "clear" evidence that the daughters of mothers who were given the hormone DES prevten miscarriage have a greater than average chance of developing cancer, the government said yesterday.
Health, Education and Welfare Secretary Joseph A. Califano Jr. warned the 4 million to 6 million women who were given the drug before it was banned for this use that they and their daughters should have checkups - and their sons too should be checked for abnormalities.
Califano asked all doctors to check their records and try to find and warn all such patients or offspring.
His statement came as the result of years of effort by some doctors and health advocates to get the government to act in view of the drug's dangers, though other doctors continued to argue about these effects.
Califano credited Dr. Sidney Wolfe, head of Ralph Nader's Health Research Group, with calling his attention to this problem and spurring him to name a medical task force to make the findings on which he based yesterday's decision.
At the same news conference, Califano also announced a campaign to "seek to free the United States from measles by Oct. 1, 1982." He said this could be done by adding $4 million to $5 million in aid to state and local governments to help them give measles shots.
He said this goal has become possible because of "rapid progress" in preventing childhood diseases by immunizations, with just 23,170 measles cases so far this year, compared with 52,988 in the same period last year.
In a few states and the District of Columbia, no cases of measles at all were reported in the first 38 weeks of the year. Four cases were reported in Maryland, but 186 in Virginia.
Simultaneously yesterday, Dr. Wolfe accused another government agency, the White House's Office of Management and Budget, of "preventing prevention" of serious diseases by delaying or blocking HEW inquiries into the effects of both DES and birth control pills, and the role of the workplace and environment in causing cancers.
Califano promised to investigate this Wolfe charge, and praised Wolfe as "a very competent and thoughtful individual dedicated to the public interest."
Wolfe compiled federal documents and letters to show that officials of HEW's National Institutes of Health have been complaining that OMB clearance procedures have been forcing them to delay or water down several studies of drug or chemical effects on large populations.
An OMB spokesman said "we have been talking to HEW" about the problem but "have not yet decided" whether such surveys need OMB clearance.
Mainly between 1945 and 1955 but as recently as 1970, DES - the synthetic hormone diethylstilbestrol - was widely prescribed to prevent miscarriages.
It is still being used for hormone deficiencies, some menopause-related problems, treatment of some advanced breast and prostate cancers, as a post-intercourse or "morning after" contraceptive, and to suppress milk production in new mothers who don't breast-feed. The Food and Drug Administration is expected to act soon to rule out the last use.
"Based on what is currently known" - though more studies are needed - Califano said that among women who were given DES during pregnancy:
There is "a clear link" between DES exposure before a child's birth and a risk of vaginal or cervical cancer in a daughter. This risk is estimated as no more than 1.4 cases per 1,000 daughters, "not as high as originally feared."
There is "serious concern," though still no "established" danger, of breast or gynecologic cancer among the mothers themselves, and "an excess of abnormalities" of the genital and perhaps urinary tracts of their sons.
DES mothers should have annual physicals and examine their own breasts monthly. Their daughters should start getting regular examinations at age 14 or when menustration starts, whichever comes earlier. DES sons should see a doctor to see if they have any abnormalities.
All women who have exposed to DES should avoid "any further use of DES or other estrogens" (female sex hormones) because any cancer-causing effects may add up.