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UK medical team to lead study into access to cervical screening after birth

Current UK guidance suggests women should wait for 12 weeks after they have given birth to be screened

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A team of UK gynaecological oncology doctors have been awarded £300,000 to run a research study aimed at improving the uptake of cervical cancer screening among women who have recently given birth.

The team, based at the Somerset NHS Foundation Trust, will get people’s views on how to improve the take up on cervical screening and access to services.

While cervical screening is safe during pregnancy and may be needed, it is often delayed until afterwards, particularly if a woman’s screening was up-to-date and normal prior to pregnancy.

Current guidance from the national screening programme suggests women should wait for 12 weeks after they have given birth to be screened.

But women and GP practices told Dr Jo Morrison, consultant gynaecological oncologist at the NHS trust, and Dr Holly Baker-Rand and Dr Becky Newhouse, both specialty registrars and clinical fellows, that it may be easier to get this done at their regular six-week post-birth appointment. This would avoid coming back for a second appointment when women are busy and have other priorities.

It is not the first time the Somerset NHS Foundation Trust has been involved in cervical screening research with Morrison and former Musgrove postgraduate doctor, Dr Sarah Coleridge, winning a national Jo’s Cervical Cancer Trust Innovation Award for a project to improve the take up on cervical screening in young women who’d just had a baby.

One of the ideas that was generated on the back of Dr Coleridge’s project, largely from the women she spoke to, was that they would prefer to have had a postnatal follow-up smear at their six-week GP check-up.

“Current guidance says that a cervical smear test can only be done 12 weeks after a woman has given birth,” Dr Morrison explained.

“But we’ve listened to the feedback from women and investigated why the recommendation is to delay to 12 weeks.

“We found that it was based on just one very old study, involving only a few people, at a time when smear testing wasn’t as advanced as it is today, and before we tested for HPV.

“So we wanted to carry out research based on the idea that new mums might find it easier to get their screening done at that one appointment, rather than having to make another appointment six weeks later – much easier for our GP practices and the patients themselves, who would be less likely to miss it.

“Before we begin the ‘Postnatal Instead of Normally-timed Cervical Screening’ study  – or PINCS for short – we are running a study to check women’s view to make sure that this is absolutely something that women would want us to look into.

“If our study shows no difference in the quality of testing at six rather than 12 weeks, this could be offered to women earlier. Obviously, those who aren’t ready by six weeks would be free to delay the test.”

Morrison said her team would check the acceptability of testing with a urine test, rather than a normal smear test, and whether this is something that women might find easier.

“We’re calling this first part of the study, ‘Pre-PINCS’, where we’re testing what women think about the idea, and whether they would be willing to have a smear done six weeks after giving birth. If the reaction is positive, then we hope to get a full clinical study up and running,” she added.

“Pre-PINCS has involved a questionnaire given to women who’ve given birth within the past five years. We will also offer conversations with a few women who have given birth recently or are currently pregnant, to find out in more depth about their views on cervical screening in general, and any ideas they might have for the study.

“The only way we can change the national screening programme would be to prove that this is acceptable and as accurate as delaying screening to 12 weeks.”

Dr Becky Newhouse, who has been working as a clinical fellow in gynae-oncology in Somerset for the last couple of years, said she was pleased to be involved in this piece of research.

“We’ve already done some preliminary work with women to find out about the challenges they’ve faced in getting a smear test, which is a good first step,” she said.

“We know that pregnancy and caring for a newborn is a very busy time, so it’s natural that a smear test may not be at the top of a to-do list. But this means a lot of women are out-of-date with their smear tests in pregnancy and we want to do everything we can to make it easy for them to get their test – the six-week GP appointment is ideal in so many ways.”

She added: “Sadly, cervical cancer is most prevalent in the age range around the usual childbearing age so we want to make sure smear testing is as accessible as possible for that group of women so they can get pre-cancerous changes detected as early as possible so they can be easily treated and stop them developing a cancer.”

Mental health

Yoga and omega-3 as effective as therapy for depression in pregnancy, research finds

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Yoga and omega-3 supplements may be as effective as talking therapies for pregnancy depression, a major review suggests.

Globally, nearly one in three pregnant women experience depression, but most receive no treatment.

When support is available, women are often directed towards talking therapies such as cognitive behavioural therapy, or CBT, and mindfulness.

CBT is a structured talking therapy that helps people identify and change patterns of thought and behaviour affecting their mental health.

The review examined 115 clinical trials involving more than 12,000 participants across 30 countries.

It found that yoga, massage, omega-3 supplements and bright light therapy were broadly as effective as talking therapies at reducing depression symptoms during pregnancy.

Bright light therapy involves controlled exposure to bright light and is sometimes used to treat mood conditions.

The findings point to the importance of social support and increased connection, as all these approaches offer some element of contact or guided support.

Led by King’s College London, the research brought together trial evidence across every type and format of treatment for antenatal depression under a common framework.

Antenatal depression is depression that occurs during pregnancy.

The study was conducted as part of HappyMums, a European consortium led by the University of Milan that aims to improve mental health support during pregnancy and after birth.

Carmine Pariante, professor of biological psychiatry, said: “This is the most comprehensive analysis of treatments for depression in pregnancy ever conducted, and the findings should prompt a rethink of how we support women during this critical period.

“The evidence is clear that there is no single best approach. What matters is that women have access to a range of options, and that clinicians feel equipped to offer them.”

The researchers said yoga and omega-3 supplements could be legitimate treatment options, rather than stopgaps, for women on waiting lists or those who struggle to access mental health support.

However, the studies differed considerably in design, sample size and how results were measured, so the findings should be interpreted with care.

The team said non-psychological approaches could help women cope with long waits for care without ruling out other treatments alongside them.

Digital and online interventions, including apps and telephone-based support, were also found to be as effective as face-to-face treatment.

Researchers said this could affect how antenatal depression is managed, particularly for women who cannot travel or face long waits for in-person care.

The team found no randomised controlled trials of pharmaceutical treatments for antenatal depression, despite antidepressants being widely prescribed for depression outside pregnancy.

A randomised controlled trial is a study in which participants are randomly assigned to different treatment groups, allowing researchers to compare outcomes more fairly.

Evidence for drug treatment during pregnancy therefore relies on indirect research rather than trials carried out during pregnancy, reflecting long-standing caution around testing medicines in pregnant populations.

NICE guidelines recommend antidepressants for moderate to severe depression in pregnancy, while evidence from outside formal pregnancy trials suggests they can be safe and effective.

However, the researchers said trials are still needed, particularly for women who cannot access or engage with other forms of support.

Riddhi Laijawala, trial manager and PhD student, said: “Depression in pregnancy is common, but it is not inevitable, and it is treatable. What this review shows is that the options available to women are broader than many people realise.

“A yoga class, music therapy, or an online programme may not sound like clinical treatment, but the evidence suggests they can make a real difference, and for many women they may be easier (and quicker) to access than a course of therapy.”

Depression during pregnancy affects an estimated 28.5 per cent of pregnant people worldwide, but only around one in five receives appropriate and timely treatment.

The team said closing this treatment gap should be a priority for health systems because the condition can affect both parent and child.

The HappyMums project is supported by the European Union’s Horizon Europe research and innovation programme.

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Hormonal health

Type 2 diabetes rising among young women, experts warn

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Type 2 diabetes is rising among women in their 20s in England, with experts warning of a worrying increase since the Covid pandemic.

The rise has largely occurred since the pandemic and is closely linked to increasing obesity levels, according to an analysis of NHS data from 2011 to 2024.

The condition is serious and can lead to severe complications, including heart attacks and strokes.

Diabetes UK said it tends to be more aggressive when it develops at a younger age, raising the risk of serious complications and shorter lives.

The charity said early diagnosis is vital for people at risk to help prevent long-term organ damage.

The condition can sometimes be put into remission through healthy eating and maintaining a healthy weight, without relying on glucose-lowering medicines.

Researchers said newer obesity treatments, including GLP-1 injections and pills, may also help alongside healthy eating advice.

About 90 per cent of the six million people living with diabetes in the UK have type 2 rather than type 1, or insulin-dependent, diabetes.

The risk increases with age, and older adults still account for the largest proportion of new diagnoses.

However, NHS England estimates suggest that 12,000 people under 30 are now living with the condition, with women making up more of the younger cases.

Common symptoms include feeling very tired, urinating more often than usual and feeling thirsty all the time.

Researchers at Imperial College London analysed NHS data from the English National Diabetes Audit to examine trends over time.

The figures showed that cases are falling slightly among older adults, who still account for the largest share of new diagnoses.

However, diagnoses are increasing rapidly among people under 40, with some of the sharpest rises among women aged 20 to 29.

Body mass index at diagnosis has also been rising more quickly among younger adults than in older age groups, pointing to obesity as a likely factor.

Body mass index, or BMI, is a measure of obesity based on a person’s height and weight.

Separate NHS data for England shows obesity rates have worsened since the pandemic, with nearly one in three people now affected.

The largest increases over time have been among younger adults.

Between 2019 and 2025, new obesity cases rose by 16 per cent among people aged 20 to 29 and by almost 20 per cent among those aged 30 to 39.

Rates fell among adults aged 60 to 79 over the same period.

Lead researcher Dr Shivani Misra said: “We think that the earlier onset of severe obesity in young people is increasing their type 2 diabetes risk in early life and pulling down their age at diagnosis.

“This is really worrying given the poor health outcomes from early-onset type 2 diabetes.”

Misra said much of the discussion about rising rates among younger people had focused on ethnic minority groups, which have traditionally been considered at higher risk.

However, the new data suggests the trend extends well beyond those communities.

She added: “We now see that incidence is also increasing in white populations too, showing that this public health challenge is broadening across the generations.”

Diabetes UK said better follow-up care is also needed for mums-to-be diagnosed with gestational diabetes during pregnancy because it raises the risk of developing type 2 diabetes after childbirth.

Some studies have suggested that the risk of developing the condition may also increase after being ill with Covid, although the evidence remains inconclusive.

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Wellness

AstraZeneca drug approved for breast cancer in EU

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AstraZeneca’s breast cancer drug Etcamah has been approved in the EU as part of a combination treatment for advanced disease.

The European Commission acted on a positive opinion from the Committee for Medicinal Products for Human Use, the Cambridge, England-based drug maker said.

The decision followed positive results from the Serena-6 phase III trial, which showed a 56 per cent reduction in the risk of disease progression in advanced oestrogen receptor-positive breast cancer.

A phase III trial is a large, late-stage study used to assess a treatment’s safety and effectiveness before wider regulatory approval.

Oestrogen receptor-positive breast cancer is a form of the disease that can grow in response to the hormone oestrogen.

Etcamah, whose generic name is camizestrant, was tested in combination with a cyclin-dependent kinase 4/6 inhibitor.

Known as CDK4/6 inhibitors, these medicines block proteins that help cancer cells grow and divide.

AstraZeneca said the Etcamah combination has also been approved in Japan, the UAE and Saudi Arabia based on the Serena-6 trial results.

The company said breast cancer remains the leading cause of cancer death among women in Europe, with more than 140,000 deaths and more than 540,000 patients diagnosed in 2024.

AstraZeneca shares were down 0.6 per cent at 12,628 pence in London on Thursday.

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