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Researchers find differences in ovarian cancer risk factors by background

Ovarian cancer has one of the lowest survival rates of any cancer in Australia

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Selected ovarian cancer risk factors vary for women of different racial and ethnic backgrounds, researchers from Sydney have found.

Led by Dr Melissa Merritt and Dr Nicola Meagher from the Daffodil Centre in collaboration with researchers from the University of Hawaii Cancer Center, the study, published in the American Journal of Epidemiology, focused on factors that increase or reduce risk in women of Asian, native Hawaiian and Pacific Islander, Hispanic and Non-Hispanic white groups.

The team analysed data from 11 studies involving more than 27,000 women with and without ovarian cancer, including one study in Australia and 10 in the USA and Canada.

Racial and ethnic backgrounds were self-reported by the study participants.

“We noted selected differences in the strength of these protective and risk factor associations across racial and ethnic groups,” said Merritt.

“For example, the study showed that some factors associated with a lower risk of epithelial ovarian cancer, such as the use of oral contraceptives, and having children, had an even stronger reduction in risk for Native Hawaiian, Pacific Islander and Asian women.”

The research showed that women who used oral contraceptives for over five years had a lower risk of developing ovarian cancer, but Asian, Native Hawaiian and Pacific Islander women had an almost 70 per cent lower risk compared to women who had never used oral contraception, while Hispanic and white women had around a 50 percent lower risk.

Similarly, Hispanic and white women saw only a 50 per cent reduction in ovarian cancer risk after having three or more children, while Asian, Native Hawaiian and Pacific Islander women had a 68-90 per cent lower risk compared to women with no children.

Dr Merritt said: “Interestingly, we observed that Native Hawaiian or Pacific Islander women who reported having their tubes tied had a 75 per cent lower risk of developing ovarian cancer compared to those who did not have this procedure.

“The same comparison in Asian, Hispanic and white women, by contrast, showed only a 22-32 per cent reduction in risk. However, because this was the first study to evaluate tubal ligation and ovarian cancer risk in Native Hawaiian or Pacific Islander women, more research needs to be done to confirm these findings.”

Ovarian cancer has one of the lowest survival rates of any cancer in Australia and, unlike many other cancers, survival has only slightly improved in recent decades.

These findings are believed to be significant because they show the importance of people’s racial and ethnic backgrounds when assessing their risk for ovarian cancer and when implementing public health measures to lower risk.

“It was already known that there were differences in ovarian cancer incidence rates between racial and ethnic groups, but assessment of ovarian cancer risk factors has so far been done mainly in White women,” explained Merritt.

“This is the first study of its scale to separate Native Hawaiian and Pacific Islander women from Asian women, and the results will be important in delivering ovarian cancer public health programmes in the future.”

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‘Groundbreaking’ endometriosis study identifies patient priorities

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A “groundbreaking” study into endometriosis has identified three areas for future research that can help improve the outcomes for women with the condition.

The study, commissioned by Endometriosis New Zealand, attracted 1,262 participants, including 1,024 people with confirmed endometriosis, making it the largest ever study involving endometriosis patients and supporters in New Zealand.

Study participants identified the management and treatment of endometriosis, the need for a better understanding of its cause and improvements to diagnostic capability as the three main priorities for further research.

While these findings provide a clear pathway for future work, Endometriosis New Zealand chief executive, Tanya Cooke, said endometriosis research had historically been underfunded.

“With an estimated 120,000 New Zealanders living with endometriosis, much more needs to be invested into finding solutions,” Cooke explained.

“The reality is the outcomes for many endometriosis patients are pretty poor, with diagnosis often taking many years and treatment patchy across the country.”

Estimates based on Australian data suggest that endometriosis is likely to be costing New Zealand somewhere in the range of $1.3-1.5bn annually through increased healthcare costs and lost workforce productivity.

Cooke said: “The good news is that our findings align closely with those in Australia and provide three clear priorities for future research – improved treatment options, causation and better diagnostic capability.

“What New Zealand now requires is proper funding for a future research programme that can investigate these priorities more closely and improve the outcomes for individuals living with endometriosis.”

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Virtual care platform secures US$46m to address US maternal health crisis

Pomelo Care will use the funding to scale its care model and improve maternal and infant outcomes

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Marta Bralic Kerns, founder and CEO of Pomelo Care

The US virtual maternity care platform Pomelo Care has secured US$46m in funding to address the US maternal health crisis.

One in 10 babies born in the US today start their life in a neonatal intensive care unit.

Healthcare access continues to worsen, with one in eight births occurring in US counties with limited-to-no access to maternal care. Due to significant gaps in postpartum care, about half of pregnancy-related deaths in the US occur after hospital discharge.

The evidence exists for how to identify people at highest risk for complications and which interventions are most effective, but existing data gaps and provider capacity challenges make it difficult to apply these interventions at scale.

Pomelo has developed a care model that aims to address these challenges by analysing claims and health record data to identify individual risk factors and providing virtual pregnancy, postpartum, and infant care to patients to reduce those risks.

“We’ve long known what works to reduce maternal and infant complications,” said Marta Bralic Kerns, founder and CEO of Pomelo Care.

“The questions have always been: can you identify the patients who are at highest risk, can you deeply engage them in care to drive uptake of the prevention strategies we know work, and can you do it in the highest risk populations with the most limited access to care?”

“This data demonstrates that we absolutely can. And with this additional funding, we’ll have the opportunity to scale our care model to more pregnant people across the country.”

The funding, led by existing investors First Round Capital and Andreessen Horowitz (a16z) Bio + Health, is hoped to help Pomelo accelerate its partnerships with payors across the US and increase access to “evidence-based” care.

Josh Kopelman, partner at First Round Capital and Pomelo board member, said: “It’s rare to come across an opportunity where the incentives between patient, provider and payor are all aligned.

“Marta and the Pomelo team have found an incredible opportunity to dramatically improve outcomes for the highest risk populations, while helping payors reduce their avoidable costs.”

Vineeta Agarwala, general partner at a16z Bio + Health and Pomelo board member, added: “Pomelo is one among a small set of health tech companies that have earned true scale.

“This scale is evident in our partnerships with major Medicaid and commercial plans covering over three million lives, which create the opportunity to collaborate with OB providers, labour and delivery wards, and NICUs nationwide, while serving hundreds of thousands of expecting mothers and newborns with high quality, technology-enabled care.”

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One in three UK fertility patients seek treatment abroad due to high costs

Expensive fertility treatments prompt UK patients to seek help abroad

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One in three fertility patients in the UK seek treatment abroad due to high costs, a new survey has shown.

Fertility Family has gathered insights from 429 UK participants who have experienced difficulties with infertility.

The Infertility Awareness Report found that the high cost of fertility treatment in the UK has driven over one in four people to spend over £10,000 on both treatments and investigative procedures.

The research showed around 35 per cent of people struggling with infertility have considered seeking fertility treatment abroad due to the prospect of lower costs.

Of those seeking fertility treatment in a foreign country, however, only 14 per cent believed that clinics abroad have a higher success rate.

Of those actively trying to conceive almost one in five have used their life savings in the pursuit of having a child, whilst 25 per cent have paid for their fertility treatments using a credit card.

Dr Gill Lockwood, consultant at Fertility Family, said: “While we tend to cast our gaze on women when it comes to infertility, case studies have shown that infertility can impact both women and men in similar ways. However, women have been observed to seek help more than men.

“Although the psychological struggles of infertility can be overwhelming, many patients ultimately reach some type of resolution. Some of the alternatives include becoming parents to a relative’s children, adopting children, or deciding to adopt a child-free lifestyle.

“Needless to say, this resolution is usually psychologically demanding, and patients may feel forever impacted by the experience of infertility.”

A combination of fertility struggles and accessible healthcare have impacted people across the UK significantly, with one in two admitting to feeling “ashamed” due to their difficulties trying to conceive.

A further 31 per cent reported feeling that other people think “less” of them due to their fertility struggles, showcasing the need for better mental health support.

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