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US poll reveals ‘significant’ gaps in women’s knowledge about cervical cancer

Over 70 per cent of women have delayed getting a Pap test, the US medtech company BD has found

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New findings indicate a significant gap in women’s knowledge about the primary causes of cervical cancer and the most effective means of prevention.

Despite being one of the few cancers that is almost entirely preventable, according to the American Cancer Society (ACS), 14,000 women in the US are diagnosed with cervical cancer every year and more than 4,000 women die from it.

The online survey of US women between 18 and 64, conducted by The Harris Poll, found that 71 per cent of respondents have delayed getting a Pap test, also known as a smear test. 

Detecting cervical cancer early with a Pap smear can give women a greater chance at a cure. The test can also detect changes in a woman’s cervical cells that suggest cancer may develop in the future.

However, if the changes are not detected and treated appropriately, precancerous cells can turn into cervical cancer, experts warn.

Around 15 per cent of American women say their last OB/GYN visit for a routine care or check-up was more than three years ago, with nearly one in 10 saying they have never had a Pap test.

About one in 10 hispanic and black women say they have never had an OB/GYN visit for routine care and similar proportions say they have never had a Pap test.

When asked why they have delayed getting a Pap test, Hispanic women are more likely to report feeling embarrassed, afraid it would hurt or unable to access a OB/GYN.

“Racial and ethnic minorities, rural residents, sexual and gender minorities and those with limited English proficiency often face cultural, economic and geographical factors that preclude them from obtaining critical health screenings, including Pap and HPV tests,” said Brooke Story, worldwide president of Integrated Diagnostic Solutions for BD, the US medtech company that published the findings.

“Being that January is Cervical Cancer Awareness Month, there is no better time to analyse the sentiment women hold around such screenings.

“The survey results underscore that lack of knowledge is one of the biggest barriers to receiving timely screening.

“We need more patient-centered communications to educate everyone, including and especially marginalised and underserved groups, in addition to providing greater access to critical diagnostic tools and services.”

As many as 75 per cent of American women say one of their 2023 resolutions would be to get on track with their annual health screening appointments, like OB/GYN visits.

While 91 per cent say they are knowledgeable about women’s health in general, fewer report being knowledgeable about more specific aspects, such as how often they should get a Pap test or HPV test that looks for the virus responsible for causing cervical cancer.

The study found that 67 per cent of American women were unaware that almost all cervical cancers are caused by HPV.

Overall, 47 per cent of American women say they don’t understand the difference between a Pap test and an HPV test, with Black women (58 per cent) more likely to agree with this than non-Hispanic white women (44 per cent).

Similarly, 66 per cent of did not know that nearly all sexually active men and women get HPV at some point in their lives, while 61 per cent did not know there are different types of HPV strains.

More than 50 per cent of American women mistakenly believe that Pap tests screen for a variety of STDs, while 67 per cent mistakenly believe that women aged 30 to 65 need a Pap test every year.

The American College of Obstetricians and Gynecologists (ACOG) and US Preventive Services Task Force recommend screening begin at 21 years of age, with Pap testing every three years and average-risk individuals aged 30 years and older screen every five years with primary HPV testing or co-testing.

The American Cancer Society recommends screening begin at age 25 with primary HPV screening.

 

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Women with endometriosis face fourfold higher risk of ovarian cancer, study finds

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The risk of developing ovarian cancer could jump about fourfold among women with endometriosis compared with women without the condition, a new study has found.

A landmark study from researchers at the University of Utah and Boston University Chobanian & Avedisian School of Medicine found that women with severe endometriosis are 10 times more likely to get ovarian cancer compared to women who do not have the disease.

Prior studies have shown a causal connection between endometriosis and ovarian cancer but in using the Utah Population Database, a repository of linked health records housed at Huntsman Cancer Institute at the University of Utah, investigators were able to analyse the incidence rates of different types of endometriosis and subtypes of ovarian cancer for the first time.

Their research, which included a cohort of over 78,000 women with endometriosis, found that women with severe forms — either deep infiltrating endometriosis, ovarian endometriomas or both — have an overall ovarian cancer risk that’s “markedly increased,” at about 9.7 times higher, relative to women without endometriosis.

Women with deep infiltrating endometriosis, ovarian endometriomas or both, on the other hand, appear to face nearly 19 times the risk of type I ovarian cancer, which tends to grow more slowly, compared with women without endometriosis, according to the study.

In their calculations, researchers also found that women with any kind of endometriosis have a 4.2-fold risk of developing ovarian cancer compared to those who do not.

“These are really important findings,” said Jennifer Doherty, investigator and professor of the population health sciences department at the University of Utah.

“This impacts clinical care for individuals with severe endometriosis, since they would benefit from counselling about ovarian cancer risk and prevention.

“This research will also lead to further studies to understand the mechanisms through which specific types of endometriosis cause different types of ovarian cancer.”

However, women with endometriosis should not panic about the findings, researchers noted, because ovarian cancer itself is still rare. About 1.1 per cent of US women will be diagnosed with ovarian cancer at some point in their lifetime, according to the National Cancer Institute.

“Because of the rarity of ovarian cancer, the association with endometriosis only increased the number of cancer cases by 10 to 20 per 10,000 women,” Karen Schliep, senior author of the study and an associate professor in the Division of Public Health at the University of Utah School of Medicine, told CNN.

“We would not recommend, at this point, any change in clinical care or policy. The best way of preventing ovarian cancer is still the recommendation of exercise, not smoking and limiting alcohol.”

Women with endometriosis could pursue surgeries, such as hysterectomies or removal of the ovaries, investigators said. However, since these are invasive procedures, more research is needed to know if these are the right measures, they concluded.

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Study exposes gaps in menstrual health education in English schools

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A new study has revealed significant inadequacies in menstrual health education provision in English schools.

New research, led by the University of Bristol and Anglia Ruskin University, has highlighted a lack of practical information being offered, pupils being taught too late, and attitudes that perpetuate stigma across English schools.

Ten per cent of young women surveyed in the study, which sought to understand what and how menstrual health education information was delivered in English schools, did not receive or remember receiving any menstrual health education. Of those pupils who did, up to one in five did not receive education until after they had started their period.

Researchers surveyed 140 young women aged 18-24, who had attended either a private or state-funded primary and secondary school, on their menstrual health education. Of these, 99.3 per cent had experienced menstruation.

Participants were asked to take part in online surveys and in-depth interviews to share their experiences including what and how information was provided at school and reflect on their thoughts and feelings about their education.

From the survey results, researchers found lessons focussed on biological content with a lack of practical information needed to help students manage menstruation and menstrual health, with nearly seven in ten participants having reportedly received no practical information. None of the participants were taught about menstrual health conditions and only 3.2 per cent learnt about abnormal symptoms.

Serious long-term impacts were reported, as several participants put off seeking medical attention for debilitating symptoms because they thought their pain was normal, only to be later diagnosed with conditions such as endometriosis.

Overall, participants left school lacking basic knowledge and feeling ill-equipped with 62.4 per cent rating their education as “poor” or “very poor” in preparing them for managing menstruation.

In extreme cases, some were so unprepared that when they started their periods, they thought they were ill or even dying.

While schools were seen as an important source of information, many participants admitted that they had to rely on other sources, particularly the internet and social media.

Poppy Taylor, PhD researcher in population health sciences at the University of Bristol, and corresponding author, said: “Given the evidence that girls are starting their periods at ever-younger ages, there are concerns this will be too late for an increasing number of people. Denying young people with information about their bodies risks significant long-term harm.

“Our research provides strong evidence that the education system has been failing young girls and people who menstruate. We were shocked and disappointed, but sadly not surprised, with our findings.”

Globally, menstrual health is a key issue for gender equality. When menstrual needs are unmet, it can create barriers to education and employment, pose long-term health risks and threaten human rights.

Evidence suggests that persistent stigma and lack of public understanding about menstruation is preventing such needs from being met in the UK.

“Our findings suggest that for many young people, the menstrual health education they received failed to prepare them physically, mentally, or socially for their first period,” Taylor explained.

“We recommend that menstrual health education is improved through the delivery of earlier, more inclusive lessons with more practical content to ensure all young people are equipped to manage their menstrual health in a supportive environment.

“To support the UK government’s target of eradicating period stigma and poverty by 2030, universally accessible and comprehensive menstrual health education must be prioritised.”

The authors acknowledged that the reported experiences in the study, particularly from older participants, may not reflect current practices.

Due to the small sample size, they said, further research is needed to explore the experiences of students who are currently in the schooling system and to understand whether and how practices have changed.

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Maternal mental health start-up bags US$10.9m in series A funding

Seven Starling aims to help women navigate critical periods in their lives with evidence-based mental health support

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The US start-up Seven Starling has secured US$10.9m in series A funding to address unmet needs in women’s mental health.

More than 90 per cent of women do not seek help for perinatal mood and anxiety disorders due to high barriers including a shortage of therapists, limited in-network coverage and mental health stigma.

These conditions affect one in five women during the motherhood journey, yet only 20 per cent are screened for mental health issues, and 75 per cent of those who need treatment do not receive it.

Seven Starling aims to address these challenges by making its services accessible through its in-network coverage, integrated group therapy model, and partnerships with referring providers to make the process of getting started easier for patients.

The investment round, led by RH Capital, is hoped to expand access to essential mental health services for women going through critical periods, such as infertility, miscarriage and loss, pregnancy, postpartum and motherhood.

“We are thrilled to have successfully raised this round of funding, which will allow us to expand our reach and help more women who need support during critical life transitions,” said Tina Beilinson Keshani, co-founder and CEO of Seven Starling.

“This investment is a testament to the demand for a dedicated women’s mental health solution and our commitment to providing accessible, high-quality care. With the new funding, we will continue to successfully reduce the stigma around women’s mental health and ensure that every woman has access to the care she needs, when she needs it.”

The capital raised from this round, Keshani said, would be used to “fuel” national expansion, partnering with Medicaid plans, and developing innovative technology to further integrate with healthcare partners.

Alice Zheng, principal at RH Capital, said: “We are proud to partner with Seven Starling in this new chapter to expand access to maternal mental healthcare, an area of significant need.

“We are excited by the comprehensive and scalable offerings, including group therapy to expand access. As a recent mum of two myself, I have been shocked by the lack of perinatal mental health support available relative to need and am thankful to see Seven Starling filling that gap.”

Mar Hershenson, founder of Pear VC, added: “Seven Starling is addressing a huge problem not just around motherhood but the entire female lifespace from adolescence to menopause.

“Women are nearly twice as likely as men to be diagnosed with depression or an anxiety disorder in their lifetime, but lack a tailored solution designed to meet their unique needs. Pear has partnered with Seven Starling since day one and we are excited to double down on them.”

Kelly Ernst, March of Dimes SVP, chief impact officer, said mental health conditions, such as depression and anxiety, are among the most common complications for women during pregnancy and the postpartum period.

“However, many do not receive treatment they desperately need, which can lead to long lasting clinical, social, and economic consequences,” she explained.

“When these conditions are effectively treated and managed, everyone benefits. We’re proud to be investors in Seven Starling and look forward to seeing how their innovative and comprehensive approach improves the mental healthcare needs of women across the country.”

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