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Most women prefer clinic cervical screening

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Most women still prefer clinic cervical screening over at-home self-sampling, despite home testing devices becoming available, a study has found.

However, women who reported discrimination in healthcare, those on lower incomes and those who distrust the healthcare system were more likely to prefer at-home sampling or be unsure which option to choose.

The US Food and Drug Administration approved the first at-home self-sampling device for cervical cancer screening in May 2025. The US Preventive Services Task Force has not recommended at-home screening.

The study analysed data from a nationally representative survey of US adults, including 2,300 women aged 21 to 65, who were asked whether they preferred at-home vaginal self-sampling (collecting their own sample) or clinic-based testing.

The mean age was 45.5 years, more than 90 per cent had health insurance and more than three-quarters said they had at least two healthcare visits in the last year outside emergency care.

Overall, 60.8 per cent of respondents preferred clinic-based testing, while 20.4 per cent favoured at-home self-sampling and 18.8 per cent were unsure.

Some groups were more likely to prefer at-home sampling. Women who had experienced prejudice or discrimination during medical care were about twice as likely to choose at-home sampling as those who had not.

However, non-Hispanic Black women were less likely than non-Hispanic White women to prefer at-home sampling.

Women who were not heterosexual or did not know their sexual orientation, women with an annual income below US$50,000, and those reporting little or no trust in the healthcare system were more likely to be unsure which option to choose.

Among women who preferred at-home self-sampling, and those who were unsure, the most common reason for considering it was privacy.

That was followed by not wanting to take time off work, avoiding embarrassment and saving on transport costs.

Age, income, education level, marital status, location, insurance coverage and sexual orientation were not linked to preferring at-home sampling over clinic-based screening.

The researchers called for at-home self-sampling to be added to US guidelines and backed by the medical community to increase screening rates and reduce cervical cancer inequalities.

They said tailored interventions and information campaigns are needed, “particularly focusing on high-risk groups such as non-Hispanic Black individuals and women who experience prejudice or discrimination when seeking medical care.”

Diagnosis

New test could cut need for invasive womb cancer checks

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A urine and vaginal fluid test could help rule out womb cancer in women with postmenopausal bleeding, potentially reducing invasive checks.

In a study of 1,864 women with postmenopausal bleeding, the test identified 80 of 99 womb cancers and correctly gave a negative result for 93 per cent of women without the disease.

Researchers said the test was not accurate enough to rule out cancer on its own, but could help fast-track women at the highest risk for urgent investigation while reducing immediate invasive testing for those at lower risk.

Professor Emma Davidson, of the University of Manchester and Manchester University NHS Foundation Trust, said: “Bleeding after the menopause is understandably alarming for women because it can be a sign of cancer, but the vast majority of those investigated will not have the disease.

“At the moment, many women face invasive, uncomfortable tests that can be stressful as well as costly for health services before cancer can be ruled out.

“Our study shows that a simple test using urine and vaginal samples could help identify the women most likely to have cancer while safely reassuring many others much earlier in the diagnostic pathway.

“If further studies confirm these findings in routine practice, this approach has the potential to transform care for thousands of women every year.”

Developed at the University of Manchester and Manchester University NHS Foundation Trust, the test examines cells collected from urine and vaginal fluid samples.

Postmenopausal bleeding currently triggers an urgent cancer referral, although only about 5 to 10 per cent of women who report it have an underlying cancer.

Current investigations include an internal ultrasound scan, a biopsy of the womb lining and hysteroscopy, in which a camera is passed into the womb.

Women taking part in the study attended seven hospitals in north-west England and provided urine and vaginal fluid samples before undergoing their routine tests.

Five per cent of participants, 99 of 1,864 women, were diagnosed with womb cancer through biopsy or surgery.

Cytologists assessed the samples without knowing the women’s diagnoses.

Researchers said the test could be used to triage women suspected of having womb cancer, with lower-risk patients monitored through repeat sampling or given a full assessment if symptoms continued.

They cautioned that the samples were assessed by highly trained specialist cytologists, so it is not yet known whether the same accuracy could be achieved in other settings.

The test has also not been studied in women without symptoms.

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Diagnosis

Targeted nanotherapy shows endometriosis promise

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A targeted nanotherapy reduced endometriosis lesions and pain sensitivity after a single dose in mice, early research has found.

The experimental treatment uses a nanoparticle to deliver an existing drug to immune cells associated with endometriosis.

Researchers hope the approach could eventually lead to a treatment for people with the chronic condition, but it has not yet been tested in humans.

Kanako Hayashi, professor in Washington State University’s School of Molecular Biosciences in the College of Veterinary Medicine and a corresponding author of the research, said: “We found the disease-specific immune cell, and then we had a drug, but we couldn’t target the cell with the drug alone.

“So we used this nanocarrier that delivers the drug specifically to the disease site.”

The Washington State University team developed the therapy after previously identifying a distinct population of macrophages associated with endometriosis. Macrophages are white blood cells involved in immune defence.

They designed a nanocarrier, a specialised molecule used to transport drugs to the disease site, to target these cells without affecting surrounding cells and tissue.

The treatment uses niclosamide, a drug approved to treat intestinal tapeworms that is also being studied for other potential uses, including cancer treatment.

Previous research by the team found that niclosamide could reduce endometriosis lesions. However, the drug has low solubility, meaning large amounts are needed for it to work and limiting how long it can safely be taken.

The researchers engineered a nano-sized molecule called a dendrimer to bond with niclosamide and deliver it in a more soluble form.

In a mouse model, a single injection reduced the size and number of endometriosis lesions as well as sensitivity to pain.

Endometriosis affects roughly 190 million women worldwide and occurs when lesions similar to tissue inside the uterus grow outside it.

Symptoms can include chronic pain, severe cramps, pain during sex and infertility. Hormonal therapies can help manage symptoms but may affect fertility and bone density, while surgery can remove lesions but its effectiveness may be short-term.

Recent research has focused on immune system dysfunction in endometriosis, particularly problems involving macrophages.

The researchers are working with the WSU Office of Entrepreneurship and Innovation as they pursue patenting and commercialisation opportunities and seek support to test the technology in human trials.

Hayashi said: “Although we still need to clear multiple phases, this study is telling us the efficacy is strong, and this nanocarrier is stable, so far, for two weeks—and we think we can go longer.

“The idea is that if it’s stable for a month, you could go to the doctor once a month, get the shot, either IV or muscle injection, and then go home.”

 

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Insight

Charity launches Women’s Health Plan to tackle inequalities in long-term conditions

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 Chest Heart & Stroke Scotland has launched a three-year Women’s Health Plan setting out actions to improve prevention, diagnosis, treatment and support for women in Scotland.

The 2026 to 2029 plan includes commitments on health information, prevention and early detection, professional training, peer support, post-diagnosis care, policy and research.

It comes amid disparities affecting women with chest, heart and stroke conditions, including differences in diagnosis, testing and treatment.

Figures cited by the charity show women in Scotland are 50 per cent more likely than men to receive an initial misdiagnosis after a heart attack.

Jane-Claire Judson, chief executive of Chest Heart & Stroke Scotland, said: “Women have been telling us for years that their symptoms aren’t being taken seriously, and the evidence backs them up.

“When we talk about women’s health, we need to look beyond reproductive and maternal health alone.

“Women experience inequalities across a wide range of conditions, including chest, heart, stroke and Long Covid conditions, and they deserve equitable access to the information, support and care they need.

“Our CHSS Women’s Health Plan is about listening to those experiences and turning them into meaningful action.”

Across the UK, women are twice as likely to be misdiagnosed with heart failure, with many waiting an average of 20 weeks for a diagnosis, compared with 3.6 weeks for men.

There are more than 4,600 incidences of stroke in women in Scotland each year, with more than 1,200 dying as a result.

Asthma and chronic obstructive pulmonary disease (COPD) are also more common among women, while women are nearly twice as likely as men to die from asthma.

Women are less likely to be offered diagnostic testing within 72 hours of a heart attack and less likely to be prescribed medication that reduces the risk of a second heart attack, according to the charity.

CHSS also said conditions that predominantly affect women, including Long Covid and heart conditions such as coronary microvascular dysfunction, remain under-researched and under-diagnosed.

Four in five women say they are not listened to by healthcare professionals, while UK female life expectancy has fallen from 20th to 26th place among 38 OECD countries in recent years.

The Women’s Health Plan includes developing women-specific health information and launching a prevention and early detection programme through CHSS’s Health Defence and Community Healthcare Support Service.

Other commitments include raising the visibility of women’s health, strengthening training for healthcare professionals, CHSS colleagues and volunteers, expanding peer support and post-diagnosis care, and campaigning for changes to policy, funding and women’s inclusion in research.

The charity also plans to drive continuous improvement in its women’s health work, shaped by lived experience.

CHSS said it will seek to address inequalities through prevention programmes, professional education, policy influence and improved support for women across Scotland.

The plan builds on CHSS’s women’s health work launched in 2021 and its wider No Life Half Lived strategy. It also aligns with phases one and two of the Scottish Government’s Women’s Health Plan.

More than 140 responses to a national survey helped shape the plan, alongside consultation with health and social care professionals and people with lived experience through CHSS’s Voices of Experience Panel.

Judson said: “By improving awareness, supporting earlier detection and diagnosis, and ensuring women are heard when they seek help, we can begin to address inequalities that have persisted for far too long.

“Our first plan, launched in 2021, established important foundations.

“This next phase builds on that progress and reflects our commitment to a Scotland, where nobody is left behind because of their sex or gender.

“At Chest Heart & Stroke Scotland, our No Life Half Lived mission means working towards a future where everyone can live well with their condition. By bringing together women with lived experience, health professionals, policymakers and partners, we can create lasting change and help build a fairer, healthier Scotland for women.”

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