Ageing
Few women in low- and middle-income countries receive early cancer diagnosis
Just one in five women with breast or cervical cancer in low- and middle-income countries are diagnosed early, compared with more than one in three in wealthier nations.
The analysis of data from more than 275,000 women across 39 countries shows stark inequalities in cancer detection and treatment between high-income countries (HICs) and low- and middle-income countries (LMICs).
For ovarian cancer, early-stage diagnosis rates remained below 20 per cent worldwide, with women in LMICs faring slightly worse overall.
The study, led by the Cancer Survival Group at the London School of Hygiene & Tropical Medicine as part of the VENUSCANCER project, examined breast, cervical and ovarian cancers diagnosed between 2015 and 2018.
Early detection for breast and cervical cancers reached 40 per cent or higher in HICs but dropped below 20 per cent in most LMICs, except in Cuba (30 per cent for breast) and Russia (36 per cent for cervix and 27 per cent for ovary).
Metastatic breast cancer – where the disease spreads from its original site – made up less than 10 per cent of cases in most HICs but ranged from 2 to 44 per cent in LMICs.
Ovarian cancer was mostly detected at advanced stages globally. Often called the “silent killer”, it can cause vague symptoms such as abdominal pain or bloating, meaning it often goes unnoticed for long periods.
Treatment patterns also varied widely. Surgery was offered to 78 per cent of women in HICs compared with 56 per cent in LMICs. Initial treatment for early-stage tumours was more likely to follow clinical guidelines for cervical and ovarian cancers than for breast cancer.
Across most European countries, women with early-stage breast cancer received breast-conserving surgery plus radiotherapy in 67 to 78 per cent of cases. Rates were lower in Canada (60 per cent) and the US (53 per cent). In LMICs, between 30 and 70 per cent of women with early-stage breast cancer underwent mastectomy – full breast removal – though this procedure was also common in Canada, the US, Estonia, the Netherlands and Portugal.
Researchers say the high mastectomy rates in LMICs are mainly due to a lack of radiotherapy facilities and surgeons trained in breast-conserving techniques. Other factors include personal choice and systemic barriers, such as beliefs among some older women in Thailand that mastectomy offers better cure rates, and US insurance policies that may not cover radiotherapy.
Older women were less likely to receive treatment in line with clinical guidelines than younger women across all three cancer types in both HICs and LMICs. In most LMICs, patients also faced longer waits for surgery after diagnosis.
“This study was a major undertaking, creating the largest and most detailed global population-based database for three of the most common cancers in women to date, including data on stage, staging procedures, treatment and biomarkers,” said Professor Claudia Allemani, professor of global public health at LSHTM and lead author.
“VENUSCANCER offers the first real-world picture of care patterns and consistency with clinical guidelines on a global scale. Treatment that aligns with international standards still varies widely, but it’s encouraging that when women are diagnosed early, prompt access to optimal care has improved in most countries. The challenge remains that far too few women are diagnosed early enough, particularly in low- and middle-income countries.”
Professor Allemani called for continued global efforts to strengthen early detection and ensure access to full treatment options, including more radiotherapy facilities and specially trained cancer surgeons in LMICs.
“Evidence from this study should help to inform global policy on cancer control, such as WHO’s Global Breast Cancer Initiative and the Cervical Cancer Elimination Initiative,” she added.
Dr Veronica Di Carlo, research fellow in the Cancer Survival Group at LSHTM and co-author, said: “We found there was variation in how countries followed international clinical guidelines.
“This suggests more work is needed to adapt recommendations to local realities, simplify them, and ensure they are available in local languages.
“Women everywhere should be able to discuss treatment choices with their doctors knowing that they can access the best available care in line with recommended standards.”
The research was funded through a European Research Council Consolidator Grant.
Women experience slightly worse recovery than men in the first year after stroke, with more difficulty with daily tasks such as eating, dressing and driving.
The differences persisted after adjusting for age, race and ethnicity, education and insurance status, according to the study.
The research, led by Chen Chen at the University of Michigan, examined recovery from ischaemic stroke, the most common type, which happens when blood flow to part of the brain is blocked.
“Stroke is a leading cause of disability in the US and with the ageing population, the number of stroke survivors is growing,” said Chen. “Since many people live with physical, cognitive and emotional challenges after stroke, it is important to find ways to improve recovery. Our study provides a better understanding of sex differences during stroke recovery.”
Researchers identified 1,046 people who experienced their first ischaemic stroke, average age 66. Recovery was tracked through records and interviews at three, six and 12 months, with neurological assessments, cognitive tests and quality-of-life questionnaires.
Participants were assessed on their ability to complete daily tasks, both simple and more complex, such as walking, bathing, cooking and doing housework.
Female participants had higher average scores than male participants, indicating poorer recovery, at three, six and 12 months. Female participants had an average score of 2.39 compared to 2.04 for male participants at three months. Scores for female participants decreased from three to 12 months, indicating some improvement, while male participants’ scores remained stable.
Chen noted the effect size was small. While there were no sex differences in other areas of recovery, both sexes improved in neurological function, which includes communicating and performing simple movements.
“Our results suggest that early and repeated assessments of a person’s ability to do daily tasks after stroke are needed, and particularly for female individuals, in order to reduce these differences in recovery,” said Chen. “When developing new interventions, these recovery patterns should be considered. Since the differences were mainly in activities such as doing heavy housework, shopping and carrying heavy weights, new interventions could include muscle-strengthening activities.”
A limitation was the lack of data on participants’ use of rehabilitation services.
The study was supported by the US National Institutes of Health.
Women with high psychosocial stress show early heart changes linked to cardiovascular disease, with no similar association in men, a recent study has found.
The findings support sex-specific effects of stress on cardiovascular health and suggest that risk assessment should include psychosocial factors and mental wellbeing.
Judy Luu is assistant professor at the Division of Clinical and Translational Research at McGill Faculty of Medicine.
She said: “From an epidemiological point of view, we have known for about two decades that stress is an important risk factor in cardiovascular health for people born female.
“But with this research stream, we’re really aiming to understand how stress physiologically impacts the heart.”
Cardiac MRI measures T1 and T2 in heart muscle, signals related to tissue composition and water; higher values can indicate early disease.
The study, conducted by researchers from McGill and Concordia universities in Canada, examined MRI heart scans of 219 adults aged 43 to 65, about half of whom were female.
The scans assessed T1 and T2 markers linked to early cardiac disease.
Participants were divided into two groups: those with at least one cardiovascular risk factor (such as diabetes, hypertension or smoking) but no heart disease, and healthy controls.
In both groups, women reporting high psychosocial stress had significantly higher T1 values than low-stress women.
T2 was also higher in the at-risk group only. No significant differences were seen between high- and low-stress men.
She added that the sex differences observed are not only a social question, but also a biological question.
Luu said: “Research points to the fact that there are biological differences in the way females physically handle stress.”
The next phase of the research will focus on blood markers and other biological explanations, such as hormones.
The team hopes the work can lead to better interventions to advance women’s heart health.
Long-term air pollution exposure is linked to more advanced heart disease, with notable differences between women and men, a large-scale study has found.
The findings show that even levels of pollution below or near regulatory standards are associated with early signs of disease, often before symptoms appear.
Felipe Castillo Aravena, study lead author and cardiothoracic imaging fellow at the University of Toronto, said: “Even at low exposure levels, air pollution is associated with more plaque in the coronary arteries.
“Overall, higher long-term exposure to air pollution was associated with more coronary artery disease on cardiac CT in both women and men.
“In women, long-term exposure to fine particulate matter was linked to higher calcium scores and more severe narrowing of the arteries.
“In men, higher long-term exposure to fine particulate matter was associated with higher calcium scores and higher plaque burden.”
Researchers analysed data from more than 11,000 adults who had undergone cardiac CT exams from 2012 through 2023 across three major hospitals in Toronto.
They linked patients’ residential postal codes with air quality data to estimate each person’s average exposure over the 10-year period prior to CT.
The study examined exposure to two common pollutants: fine particulate matter (PM2.5), tiny particles from vehicle exhaust, industrial emissions and wildfire smoke that can penetrate deep into the lungs and bloodstream, and nitrogen dioxide (NO2), a harmful gas produced mainly by burning fossil fuels.
For each increase in long-term PM2.5 of 1 microgram per cubic metre, there was an 11 per cent increase in calcium build-up in the coronary arteries, 13 per cent greater odds of more plaque and 23 per cent greater odds of obstructive disease.
Exposure to nitrogen dioxide showed similar trends, though with smaller effect sizes for every 1 part per billion increase.
Kate Hanneman, study senior author and cardiac radiologist at the University of Toronto, said: “Heart disease is the number one cause of death globally.
“The results of this study add to the growing body of evidence that air pollution is a modifiable cardiovascular risk factor and reinforce the need for further research to understand why these associations differ between men and women.”
-
Features1 week agoCannabis compounds kill ovarian cancer without harming healthy cells, research finds
-
Insight3 weeks agoFemtech in 2025: A year of acceleration, and what data signals for 2026
-
News4 weeks agoInnovate UK relaunches £4.5m women founders programme
-
Insight2 weeks agoMeta removes dozens of abortion advice and queer advocacy accounts
-
News3 weeks agoRound up: First wearable detects symptoms of perimenopause, and more
-
Insight2 weeks agoSperm donor with cancer-causing gene fathered nearly 200 children across Europe
-
Mental health3 weeks agoInsomnia combined with sleep apnea associated with worse memory in older women
-
Insight4 weeks agoCanada targets US$37bn femtech opportunity
1 Comment