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Objective: To describe the current testing practice, referral pathways and gynaecological services available to women with Lynch syndrome (LS) in the UK.Design: Cross-sectional nationwide survey of gynaecological oncologists and women with LS.Setting: United Kingdom.Methods: Gynaecological oncologists were contacted directly. Women with LS were identified from national and regional clinical databases and the patient support group, Lynch syndrome UK.Main Outcome Measures: Gynaecological oncologists were asked to report rates of LS testing and current practice regarding risk-reducing strategies and gynaecological surveillance for women with LS. Women with LS were asked to describe their experiences of gynaecological care.Results: In total, 41 gynaecological oncologists and 298 women with LS responded to the survey. Of the gynaecological oncologists surveyed, 37% were unfamiliar with any clinical guidelines for the management of LS. Only 29% of gynaecological oncologists supported universal testing of endometrial cancer for LS; one centre routinely performed such testing. In all, 83% said they perform risk-reducing gynaecological surgery and 43% were aware of a local gynaecological surveillance service for women with LS. Of women with LS, most had undergone a hysterectomy (n = 191/64.1%), most frequently to reduce their gynaecological cancer risk (n = 86/45%). A total of 10% were initially referred for LS testing by their gynaecologist and 55% of those eligible regularly attended gynaecological surveillance; however, 62% wanted more regular surveillance. Regional variation was evident across all standards of care.Conclusions: There is widespread variation in the services offered to women with LS in the UK. As a community, gynaecological oncologists should move towards a nationally agreed provision of services.Tweetable Abstract: A mismatch in care for mismatch repair. Survey finds significant variation in gynaecological care for #Lynchsyndrome in the UK. [ABSTRACT FROM AUTHOR]

Background: Developing a shared agenda is an important step in ensuring future research has the necessary relevance.Objective: To characterise research priority setting partnerships (PSPs) relevant to women's health.Search Strategy: Included studies were identified by searching MEDLINE and the James Lind Alliance (JLA) database.Selection Criteria: Priority setting partnerships using formal consensus methods.Data Collection and Analysis: Descriptive narrative to describe the study characteristics, methods, and results.Main Results: Ten national and two international PSPs were identified. All PSPs used the JLA method to identify research priorities. Nine PSPs had published a protocol. Potential research uncertainties were gathered from guidelines (two studies), Cochrane reviews (five studies), and surveys (12 studies). The number of healthcare professionals (31-287), patients (44-932), and others (33-139) who responded to the survey, and the number of uncertainties submitted (52-4767) varied. All PSPs entered confirmed research uncertainties (39-104) into interim priority setting surveys and healthcare professionals (31-287), patients (44-932), and others (33-139) responded. All PSPs entered a short list of research uncertainties into a consensus development meeting, which enabled healthcare professionals (six to 21), patients (eight to 14), and others (two to 13) to identify research priorities (ten to 15). Four PSPs have published their results.Conclusion: Future research priority setting studies should publish a protocol, use formal consensus development methods, and ensure their methods and results are comprehensively reported.Tweetable Abstract: Research published in @BJOGtweets highlights future research priorities across women's health, including @FertilityTop10, @jamesmnduffy. [ABSTRACT FROM AUTHOR]

The author discusses the study "Obesity and endometrial cancer: unanswered epidemiological questions," by A. G. Renehan, M. L. MacKintosh, and E. J. Crosbie, focuses on the epidemiology of endometrial cancer and obesity. Topics include the endometrial cancer in women in North America and European countries, the meta-analysis on the relationship between endometrial cancer risk and increasing body mass index (BMI), and the endometrial cancer prevention in population with obese or overweight.

The author reflects on the effectivity of the vaccination program for the prevention of cervical cancer in Great Britain. The authors highlighted Cervarix™ vaccine from GlaxoSmithKline, which works against human papillomavirus (HPV) types 16 and 18. The authors opine that HPV immunization would decrease the incident of common malignancies related to HPV. According to the authors, the program did satisfactorily in its first year upon implementation.

The authors examines whether disease management protocols in Great Britain are restricting innovations in the treatment of cancer, highlighting a legislative bill introduced by Lord Maurice Saatchi. The legislative bill is discussed which aims to promote responsible innovation in case the available treatment options are limited or are projected to fail. Other topics include the bill's section that prevents quackery, its possible impact on clinical trials, and stratification of medicine.

It is indeed plausible that women with certain vaginal microbiome CST groups are more prone to acquiring and failing to clear high-risk HPV and therefore identifying these CSTs is important to (1) predict cervical cancer risk, (2) develop targeted prevention strategies, and (3) test novel therapeutic strategies based on pre/probiotics. Well-designed longitudinal studies with adequate sample sizes, and using standardised sampling and analytical methods are now needed to provide robust evidence on what CST subtypes are linked with high-risk HPV and cervical cancer and importantly, to confirm causality. FundingKN is supported by a Cancer Research UK Manchester Cancer Research Centre Clinical Research Fellowship. [Extracted from the article]

The article considers the role of vaginal microbiome in the aetiology of gynecological cancers. Topics discussed are factors that influence the acquisition of genital human papillomavirus (HPV) that are important in the pathogenesis of cervical cancer, efficacy of hysterectomy or salpingectomy with ovarian conservation and tubal ligation in reducing the risk of ovarian cancer, and role of vaginal microbiome in endometrial carcinogenesis.

The article focuses on extension of BRCA1/2 germline testing to all high-grade serous ovarian cancer (HGSOC) regardless of family history. It mentions benefits of poly ADP ribose polymerase inhibitor (PARPi) therapies and no endometrioid types were recorded and identify somatic mutations that would otherwise go undetected but may determine sensitivity to PARPi. It also mentions affected women would then only require germline testing if a pathogenic variant were identified in tumour material.

The article discusses the article by M. Zakhour and colleagues about women with atypical endometrial hyperplasia (AEH) or endometrial cancer (EC) who were treated with progestins. Topics include the use of immunohistochemistry to define lesions as mismatch repair (MMR)-competent or MMR-deficient, the senescence, differentiation, and apoptosis induced by progestin, and the response rate to intrauterine progestins.

Despite the success of cervical screening, cancer of the cervix is the fourth most common cancer affecting women worldwide (CRUK 2014). Rates are particularly high in developing nations, which lack the requisite infrastructure for cytology and colposcopy-based screening, and in certain demographic groups, where uptake of screening is poor. Recent research has focussed on developing less invasive and potentially more acceptable means of identifying women at high risk of cervical intraepithelial neoplasia (CIN). Urinary HPV testing has received particular attention because of the ease of obtaining samples and the opportunity this affords to overcoming barriers to cervical screening like embarrassment and discomfort. This article is protected by copyright. All rights reserved. [ABSTRACT FROM AUTHOR]