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Women’s health among the UK government’s priorities in 2024

The government is looking to improve care for menstrual and gynaecological conditions and expand women’s health hubs

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The UK’s health secretary has named menstrual and gynaecological conditions and women’s health research among the government’s priorities in 2024.

Speaking at the Women’s Health Summit in London to mark the second year of the Women’s Health Strategy for England, Victoria Atkins said it would also prioritise improving maternity care and support for mothers who suffer birth trauma.

“We’re breaking historical barriers that prevent women getting the care they need, building greater understanding of women’s healthcare issues and ensuring their voices are listened to,” she said.

“We’ve made huge progress – enabling almost half a million women access to cheaper HRT, supporting women through the agony of pregnancy loss and opening new women’s health hubs – but I absolutely recognise there is more to do.

“We’re ensuring these changes benefit all women, regardless of socioeconomic background or ethnicity, because our Women’s Health Strategy is only a success if it works for all women.”

The 2024 priorities were developed from responses to the government’s call for evidence from over 100,000 healthcare professionals, women’s health champions, members of the public and other stakeholders across the health sector.

They aim to offer better care for menstrual and gynaecological conditions , expand women’s health hubs, tackle disparities and improve support for vulnerable women, bolster maternity care and accelerate research.

“Helping women and girls who suffer from bad periods can make a huge difference to their lives, education and careers. And any woman who has experienced trauma after giving birth – either mentally or physically – will know the impact it can have on all aspects of her life,” said Minister for Women’s Health, Maria Caulfield.

“These are issues that impact women but they should not be seen as ‘women’s problems’ – it is an everyone problem. We are doing more to put these issues on the agenda and keep them there, to close the gender health gap once and for all.

“We’ve made enormous strides in the first year of the strategy and I’m excited to see what 2024 will bring.”

As well as announcing its new priorities, the government announced the reappointment of Professor Dame Lesley Regan as women’s health ambassador for England for a further two years.

Professor Dame Lesley was appointed as the women’s health ambassador in 2022 and brings a raft of expertise spanning a 44-year career in women’s health as a practising clinician.

Speaking at the summit, she said: “Our Women’s Health Strategy is ambitious. It was created to ensure our healthcare system places women’s health on an equal footing to men.

“I want women everywhere to feel confident that when they seek advice from their healthcare professional, whether it’s for heavy or painful periods or issues following birth, they know they are going to receive world-class treatment.

“This is the ultimate goal of the strategy, and I am delighted that we have made such positive progress in the first year and generated so much enthusiastic help to succeed.”

She added: “This coming year offers us the opportunity of taking further steps forward in delivering better healthcare outcomes for every woman in our society.”

Emma Cox, CEO of Endometriosis UK, said: “Women’s health has long been an underfunded and under-researched area.

“Implementing the aspirations in the Women’s Health Strategy will provide a much needed boost to turning this around, improving treatment and the lives of those suffering from endometriosis and menstrual health conditions.

“At Endometriosis UK, we know that many women face an unacceptable delay in securing a diagnosis and appropriate care. With sufficient funding and support, women’s health hubs could offer a real opportunity to drive down diagnosis times and support women to access the support they need.”

Dr Ranee Thakar, president of the Royal College of Obstetricians and Gynaecologists, added: “The focus on improving care and treatment for women with gynaecological conditions, such as endometriosis and fibroids, which are often progressive, and have a huge impact on a woman’s quality of life, is hugely welcome.

“We have continually called for action to improve waiting lists in gynaecology services and know that women’s health hubs present a real opportunity to improve women’s health outcomes and reduce inequalities in access and outcomes for women across the country.

“I am also glad to see that ensuring high quality care following birth trauma, an area of care which has long been a professional and personal passion of mine, has been recognised as a key focus for government.”

Chief nursing officer for England, Ruth May, said: “The NHS is committed to ensuring women’s individual healthcare needs are met, which is why every area of England is being supported to develop a women’s health hub alongside the rollout of a network of Women’s Health Champions.

“The NHS is also rolling out dedicated pelvic health clinics and every local health system now has a specialist community perinatal mental health team, but there is clearly more to do.”

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Pregnant women told to avoid runny eggs amid salmonella outbreak

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Pregnant women are being advised to avoid runny or under-cooked eggs when eating out amid a developing salmonella outbreak.

The advice also applies to freshly made products that may contain uncooked eggs, including mayonnaise, soufflé and hollandaise sauce.

The FSA said well-cooked eggs served in restaurants, cafés and takeaways remain safe to eat.

The warning follows the UK Health Security Agency declaring a national outbreak of salmonella food poisoning after one person died and hundreds more fell ill.

Imported eggs or dishes containing them are thought to be behind the outbreak.

FSA chief scientific adviser Ian Young said: “If people are eating out or consuming eggs or egg-containing products from cafes and restaurants then for those people in particular who are young, elderly, pregnant or vulnerable, it’s important to make sure that any eggs or egg products that you consume in those settings have been very well cooked.”

He described the outbreak as “unusually large and rapidly increasing”, adding that “people need to be careful”.

The FSA said British eggs bought from supermarkets are not linked to the current outbreak because chickens bred in the UK are vaccinated against common strains of salmonella.

“There is no link to those eggs to this current outbreak,” Young said.

Mark Williams, chief executive of the British Egg Industry Council, said British eggs were safe to eat when runny, including for vulnerable people, and were widely available in restaurants and cafés.

“Customers who want to enjoy a runny egg should simply ask whether British Lion eggs are being used,” he said.

More than 200 cases in the UK have been linked to the outbreak, with the majority across England.

Genetic testing suggests the infections are part of the same outbreak and show similarities with previous outbreaks involving imported eggs.

Investigations into individual cases also suggest the eateries involved were buying eggs from abroad.

Salmonella are a family of bacteria that typically live harmlessly in the digestive systems of animals including cattle, pigs and chickens, which is why eggs and poultry are among foods commonly associated with infection.

People can become infected by eating contaminated food that has not been properly cooked, through cross-contamination between raw and cooked food or by coming into contact with infected animals.

Symptoms can include stomach cramps, diarrhoea, vomiting and fever.

Most people recover without further treatment, but older people, babies and people with weakened immune systems are at greatest risk of severe illness.

Hospital treatment with fluids and, in some cases, antibiotics may be needed for severe infections.

People who are concerned are being advised to contact their GP or out-of-hours service in the first instance.

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Study to tackle years-long delays in endometriosis diagnosis

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A study is examining where delays occur in diagnosing endometriosis  – a condition that can take seven to twelve years to diagnose.

Endometriosis affects an estimated 1.5 million women and people in the UK, but there is currently no consistent way of measuring where and why diagnostic delays happen.

The research aims to develop the first standardised framework for understanding the diagnostic journey and identifying points where interventions could improve care.

The international project involves researchers from the University of Sheffield, University of Liverpool, University of Oxford, Aarhus University in Denmark and the University of Edinburgh, alongside Endometriosis UK.

Dr Rebecca Mawson, NIHR clinical lecturer in primary care at the University of Sheffield, is part of the research team.

She said: “Our project asks: where exactly are people getting lost or let down on their journey to diagnosis, and how can we map those points in a systematic way to identify where interventions could make a real difference.”

The project is led by Dr Babu Karavadra, NIHR academic clinical fellow in general practice at the University of Liverpool, who has been awarded a World Endometriosis Society Early Career Investigator Award as lead principal investigator at the University of Liverpool.

Researchers will review existing evidence, gather experiences from people living with endometriosis and bring together an international panel to map the diagnostic pathway and agree common definitions for key points along the journey.

The work will focus particularly on people whose experiences are often missing from research, including Black women, people living in rural or deprived areas, LGBTQ+ communities and disabled people.

Primary care will also be central to the research because it is often where people first seek help with symptoms.

Mawson said: “Primary care needs to be at the heart of this work. Primary care is often where people first seek help with their symptoms, so it has a crucial role in understanding diagnostic delay.

“If we only look at what happens once someone reaches specialist gynaecology, we risk missing some of the barriers that shape the journey long before that point.”

Unlike cancer research, where internationally recognised standards exist for studying diagnostic delays, endometriosis research has been more fragmented, with studies measuring different parts of the diagnostic journey in different ways.

The researchers hope to create an ‘Endometriosis Diagnostic Pathway Framework’ to help identify where people are falling through the gaps and where healthcare could be improved.

They will also develop a ‘Snakes and Ladders’ style visual representation showing how systemic barriers, chance and individual experiences can influence whether someone reaches a diagnosis.

The project forms part of the PEARL network, Primary care Endometriosis and Adenomyosis Research and Learning, an international collaboration of primary care and community researchers and clinicians.

Mawson said: “Endometriosis diagnostic delay isn’t inevitable. If we can understand where and why people are experiencing barriers, we have a much better chance of designing interventions that actually make a difference.

“The scale of the problem demands that we look at the whole journey, listen to the people experiencing it and build an evidence base that can lead to real change.”

The framework could provide the foundations for future research, clinical guideline development, healthcare professional training and NHS service improvements, with potential applications to related conditions such as adenomyosis and chronic pelvic pain.

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Drug turns off ‘master switch’ in aggressive breast cancer

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A drug targeting a key regulator in triple-negative breast cancer reduced tumour growth and cancer stem cell viability in laboratory models.

Triple-negative breast cancer is an aggressive subtype that disproportionately affects women under 40 and accounts for about 15 to 20 per cent of breast cancers.

The disease lacks receptors for oestrogen, progesterone and the HER2 protein, which are targeted by several cancer drugs, making it particularly difficult to treat.

Researchers from the National University of Singapore’s Yong Loo Lin School of Medicine investigated mechanisms that allow triple-negative breast cancer cells to spread and resist treatment.

They examined regulators of Wnt signalling, a pathway involved in processes including cell growth and movement, and identified a master regulator called DP103.

DP103 is a gene that controls a major biological process. The researchers found it creates a cycle in which cancer cells continue to grow and spread while resisting treatment and maintaining cancer stem cells linked to disease recurrence.

The team then investigated whether a targeted drug known as Supinoxin, or RX-5902, could block DP103 and its effects in triple-negative breast cancer.

Analysis of 21 samples, including patient tumour tissue, laboratory-grown breast cancer cells and organoids derived from local cancer patients, found that the drug reduced cancer stem cell viability by 40 to 60 per cent.

Tumour growth in laboratory-grown tumour models fell by about 50 per cent.

In laboratory models, treatment also reduced tumour size by around 90 per cent while largely sparing healthy cells.

It also extended survival, with half of the treated laboratory models reaching 70 days and beyond, compared with none in the untreated group.

DP103 had previously been identified as a biomarker for triple-negative breast cancer by a team led by Alan Prem Kumar, an assistant professor with the NUS Centre for Cancer Research and principal investigator for the new study.

RX-5902 is already being studied as a treatment for breast cancer, and Kumar said the findings could help identify patients who may be more likely to benefit.

“Our findings suggest that DP103 could potentially serve as a diagnostic biomarker to identify the patients most likely to benefit from RX-5902 treatment, paving the way for a more precise, personalised approach to treating triple-negative breast cancer,” he said.

“Instead of treating all patients the same, future clinical trials could focus on those whose tumours have high levels of DP103, where the therapy is expected to have the greatest impact,” said Kumar.

First author Cai Wanpei said RX-5902 could prevent beta-catenin, a protein whose mutation is associated with various cancers, from entering the nucleus of human cells and switching off genes that drive cancer growth and spread.

“This slows tumour progression and triggers apoptosis – the natural death of cancer cells,” said Cai, who was a PhD student at the NUS Centre for Cancer Research and NUS Medicine’s pharmacology department during the research.

Study co-author Celestial T. Yap said triple-negative breast cancer remains particularly difficult to treat because conventional treatments such as surgery, chemotherapy and immunotherapy may not work for all patients.

She said DP103 could represent a “biological vulnerability” in the disease.

“This discovery offers new insights that could support more precise patient selection and open the door to better targeted strategies for durable disease control and improved clinical outcomes,” said Yap, an associate professor with the NUS Centre for Cancer Research and NUS Medicine’s physiology department.

The researchers said abnormal Wnt signalling also drives several other cancers, meaning the findings could offer avenues for treating other aggressive cancers.

Their next steps include validating DP103 as a predictive biomarker in larger patient groups and further developing therapies targeting the regulator for clinical testing.

The team will also investigate combining RX-5902 with existing therapies to further improve treatment outcomes.

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