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Objectives: This paper aims to comprehensively analyze trends in gynecological cancers among elderly women in the United States from 1975 to 2020. Methods: Surveillance, Epidemiology, and End Results (SEER) population data were utilized for the analysis. Annual Percentage Change (APC) and Average APC were estimated using join‐point regression to assess trends in mortality rates. Results: The study reveals an increasing pattern of incidence and mortality in all gynaecological cancer sites except cervical cancer among elderly. The incidence of cervical cancer decreased from 1975 to 2007 and then increased, whereas cancer‐specific mortality decreased from 1977 to 2020, indicating positive advancements in detection and treatment. Conclusions: Despite progress in managing certain gynecological cancers, challenges persist, particularly evidenced by increasing mortality rates for cancers in other female genital organs. This underscores the necessity for sustained research efforts and targeted interventions to address these ongoing challenges effectively. [ABSTRACT FROM AUTHOR]

In the United States, Black women's use of infertility treatments is relatively low, despite elevated or similar rates of infertility compared with White women. Ethical concerns about infertility treatments have been identified as a potential sociocultural factor contributing to these treatment-seeking disparities. Despite documented differences, the substance of these ethical concerns is unclear. Clarifying the nature of these concerns contributes to our understanding of the social forces that shape the contexts of infertility care. Using an intersectional and comparative analysis of semi-structured interviews with Black or African American and White women enrolled in U.S. graduate programmes, this paper investigates the nature and substance of ethical concerns about medicalized infertility treatments. Three central themes emerged: (i) ethical concerns were not binary; (ii) ethical concerns varied by modality, but not by race, and focussed primarily on infertility treatments involving third parties; and (iii) substantive non-ethical concerns were concentrated among Black women and were driven by discomfort with or preferences against treatments involving third-parties. The paper concludes with a discussion of the implications of these findings for researchers, providers, and policymakers. [ABSTRACT FROM AUTHOR]

A high level of educational and occupational achievements in science and engineering (S&E) in the US has changed the image of Asian Americans from the "yellow peril" to a "model minority." Behind this new identity is the belief that Asian Americans as a group have equaled, if not surpassed, the standards of success set by White America in S&E. It is further assumed that Asian American women are advancing equally in S&E. The reality is that they are over-represented as Asian Americans but under-represented as women in S&E occupations. They experience challenges associated with both, their ethnicity and gender. They face "double bind"—a term used for women of color who simultaneously experience sexism and racism in S&E. This paper presents Asian American women's unique situations within S&E organizations, with a particular focus on high-technology industry, where most of them are employed. It focuses on their identities and socio-cultural categorizations. [ABSTRACT FROM AUTHOR]

The overturning of Roe v. Wade marked a historical setback in the reproductive rights of American women, and led to major concerns about immigrant women specifically: a group that has historically dealt with sexual and reproductive health inequalities. It is, therefore, crucial to assess the current state of abortion access for immigrant women in the post-Roe era. This paper aims to answer the research question 'What are possible barriers in accessing abortion procedures amongst (undocumented) immigrant women in the United States, and what are possible consequences of the inability to do so?' by reviewing existing literature and news articles. This paper shows that barriers include insufficient health care and benefits regulations, discrimination, travel and cost-related concerns, and poor knowledge of the health care system. These barriers can have negative effects on long-term finances, criminalization, safety, and social, physical and psychological health. Overall, undocumented immigrant women are particularly vulnerable. This paper is concluded by recommendations to support immigrant women in the future. [ABSTRACT FROM AUTHOR]

Background: Melasma is an acquired melanogenesis dysfunction resulting in chronic hyperpigmentation commonly affecting the face and other frequently sun‐exposed areas of the body. Melasma typically presents in women of reproductive age and can significantly impact self‐esteem, negatively affecting one's quality of life. In the United States, melasma is often treated with application of topical agents that interfere with melanin synthesis, lasers, or chemical peels; however, in some East Asian countries, oral tranexamic acid (TXA) is widely administered to alleviate hyperpigmentation during and after childbirth. TXA is currently only FDA‐approved to treat hypermenorrhea and reduce blood loss in surgery but may offer women in the United States an additional therapeutic option to treat melasma. Aims: The aim of this paper is to evaluate the safety and baseline efficacy of oral transmexic acid as a treatment for melasma. Methods: We retrospectively surveyed 42 patients of Fitzpatrick skin types III‐VI that were prescribed 650 mg of TXA ½ tablet to be taken twice daily by mouth. Results: We found majority of patients saw noticeable improvement in their melasma. Of the 42 patients, only seven experienced side effects. The side effects noted were headaches, malaise and nausea, gastrointestinal upset, congestion, numbness in legs, hypomenorrhea, and hypermenorrhea. Patients who experienced unpleasant side effects discontinued taking oral TXA and were relieved of their symptoms. No long‐term side effects were discovered, and the side effects experienced may be due to other confounding factors. Conclusion: From this data, we concluded oral TXA is a safe and effective treatment option for patients with persistent melasma. [ABSTRACT FROM AUTHOR]

This paper critiques Jasmin Darznik's bestselling memoir, The Good Daughter: A Memoir of My Mother's Hidden Life (2011), in order to investigate the author's literary response to mainstream, (neo-)Orientalist literary representations of Iranian women in the United States. In doing so, this study sets out to examine whether the narrative reinforces dominant Western stereotypes of Iranian/Muslim women as passive, oppressed victims of social and religious patriarchy or offers a strategic discursive intervention in the American literary market to construct a space for reimagining Iranian womanhood. To this end, the author's adoption of strategic auto-Orientalism, as formulated by Martina Koegeler, as her representational modus operandi is analyzed to reveal the manner in which the narrative might promise new subjectivities and modes of writing for hyphenated female authors through exploiting the potentialities offered by the strategic appropriation of auto-Orientalism. [ABSTRACT FROM AUTHOR]

The number of sexual crimes committed against women in the United States is high, and the prevalence of these crimes is on the rise. Although these crimes are heinous and have severe consequences on survivors, they are highly excused in U.S. society, and the responsibility for the assault is often shifted from the perpetrators to the survivors. In this paper, we will review the influence of willing substance use and race and ethnicity on the attribution of blame and responsibility in rape crimes. More specific cally, we will present the results of an analysis of variance (N = 316) of (a) the willing use of alcohol, marijuana, and heroin and (b) race and ethnicity (Black, Hispanic, and White) on blame attribution in rape crimes. Additionally, we will review the findings on the influence of participants' demographics. Our results provide support for previous findings regarding the impact of alcohol and introduce new insight about the influence of race and ethnicity. [ABSTRACT FROM AUTHOR]

As a measure of gender inequality, the gender wage gap has come to play an important role both in academic research and the public debate. In 2016, the majority of full-time employed women in the United States earned significantly less than comparable men. The extent to which women were affected by gender inequality in earnings, however, depended greatly on socio-economic characteristics, such as marital status or educational attainment. In this paper, we analyse data from the 2016 American Community Survey using a high-dimensional wage regression and applying double lasso to quantify heterogeneity in the gender wage gap. We find that the wage gap varied substantially across women and that the magnitude of the gap varied primarily by marital status, having children at home, race, occupation, industry, and educational attainment. These insights are helpful in designing policies that can reduce discrimination and unequal pay more effectively. [ABSTRACT FROM AUTHOR]

This paper integrates a unique dimension of gender in the analysis of economic vulnerability in urban contexts by focusing on women aged 50 and older. We use a probit model to predict the likelihood of vulnerability with a zero-one dummy dependent variable, and four categories of socioeconomic characteristics as predictors: educational attainment, labour market participation, individual demographics, and household characteristics. Using a pooled cross-section of data from the American Community Survey (2013–2017 5-Year estimates), we explore the transmission channel of vulnerability across the four largest cities in the US. The results show, through average marginal effects, a strong association between economic vulnerability and key socioeconomic indicators. The findings support the view that gender differences in labour market participation remain key in explaining disparities. Our two policy prescriptions focus on a more targeted approach in implementing retirement policy changes and loosening the link between labour supply and income. [ABSTRACT FROM AUTHOR]

Background: Metastasis, the spread, and growth of malignant cells at secondary sites within a patient's body, accounts for over 90% of cancer-related mortality. Breast cancer is the most common tumor type diagnosed and the leading cause of cancer lethality in women in the United States. It is estimated that 10–16% breast cancer patients will have brain metastasis. Current therapies to treat patients with breast cancer brain metastasis (BCBM) remain palliative. This is largely due to our limited understanding of the fundamental molecular and cellular mechanisms through which BCBM progresses, which represents a critical barrier for the development of efficient therapies for affected breast cancer patients. Methods: Previous research in BCBM relied on co-culture assays of tumor cells with rodent neural cells or rodent brain slice ex vivo. Given the need to overcome the obstacle for human-relevant host to study cell-cell communication in BCBM, we generated human embryonic stem cell-derived cerebral organoids to co-culture with human breast cancer cell lines. We used MDA-MB-231 and its brain metastatic derivate MDA-MB-231 Br-EGFP, other cell lines of MCF-7, HCC-1806, and SUM159PT. We leveraged this novel 3D co-culture platform to investigate the crosstalk of human breast cancer cells with neural cells in cerebral organoid. Results: We found that MDA-MB-231 and SUM159PT breast cancer cells formed tumor colonies in human cerebral organoids. Moreover, MDA-MB-231 Br-EGFP cells showed increased capacity to invade and expand in human cerebral organoids. Conclusions: Our co-culture model has demonstrated a remarkable capacity to discern the brain metastatic ability of human breast cancer cells in cerebral organoids. The generation of BCBM-like structures in organoid will facilitate the study of human tumor microenvironment in culture. [ABSTRACT FROM AUTHOR]

Background: Breast imaging clinics in the United States (U.S.) are increasingly implementing breast cancer risk assessment (BCRA) to align with evolving guideline recommendations but with limited uptake of risk-reduction care. Effectively communicating risk information to women is central to implementation efforts, but remains understudied in the U.S. This study aims to characterize, and identify factors associated with women's interest in and preferences for breast cancer risk communication. Methods: This is a cross-sectional survey study of U.S. women presenting for a mammogram between January and March of 2021 at a large, tertiary breast imaging clinic. Survey items assessed women's interest in knowing their risk and preferences for risk communication if considered to be at high risk in hypothetical situations. Multivariable logistic regression modeling assessed factors associated with women's interest in knowing their personal risk and preferences for details around exact risk estimates. Results: Among 1119 women, 72.7% were interested in knowing their breast cancer risk. If at high risk, 77% preferred to receive their exact risk estimate and preferred verbal (52.9% phone/47% in-person) vs. written (26.5% online/19.5% letter) communications. Adjusted regression analyses found that those with a primary family history of breast cancer were significantly more interested in knowing their risk (OR 1.5, 95% CI 1.0, 2.1, p = 0.04), while those categorized as "more than one race or other" were significantly less interested in knowing their risk (OR 0.4, 95% CI 0.2, 0.9, p = 0.02). Women 60 + years of age were significantly less likely to prefer exact estimates of their risk (OR 0.6, 95% CI 0.5, 0.98, p < 0.01), while women with greater than a high school education were significantly more likely to prefer exact risk estimates (OR 2.5, 95% CI 1.5, 4.2, p < 0.001). Conclusion: U.S. women in this study expressed strong interest in knowing their risk and preferred to receive exact risk estimates verbally if found to be at high risk. Sociodemographic and family history influenced women's interest and preferences for risk communication. Breast imaging centers implementing risk assessment should consider strategies tailored to women's preferences to increase interest in risk estimates and improve risk communication. [ABSTRACT FROM AUTHOR]

Background: Postpartum contraception is essential to sexual and reproductive health (SRH) care because it encourages healthy spacing between births, helps women avoid unwanted pregnancies, and lessens the risks of health problems for mothers and babies. Sub-Saharan African immigrant and refugee populations are rapidly increasing in the United States, and they come from a wide range of cultural, linguistic, religious, and social origins, which may pose challenges in timely access to culturally acceptable SRH care, for preventing mistimed or unwanted childbearing. The objective of this scoping review is to assess the extent of the available literature on postpartum contraception among sub-Saharan African immigrant and refugee women living in the United States. Methods: We developed preliminary search terms with the help of an expert librarian, consisting of keywords including birth intervals, birth spacing, contraception, postpartum contraception or family planning, and USA or America, and sub-Saharan African immigrants, or emigrants. The study will include the following electronic databases: PubMed/MEDLINE, PsycINFO, CINAHL, EMBASE, and the Global Health Database. The sources will include studies on postpartum care and contraceptive access and utilization among sub-Saharan African immigrants living in the US. Citations, abstracts, and full texts will be independently screened by two reviewers. We will use narrative synthesis to analyze the data using quantitative and qualitative methods. Factors associated with postpartum contraception will be organized using the domains and constructs of the PEN-3 Model as a guiding framework. Conclusion: This scoping review will map the research on postpartum contraception among sub-Saharan African immigrant and refugee women living in the US. We expect to identify knowledge gaps, and barriers and facilitators of postpartum contraception in this population. Based on the findings of the review, recommendations will be made for advocacy and program and policy development toward optimizing interpregnancy intervals in sub-Saharan African immigrants living in the US. Trial registration: Review registration Open Science Framework: https://osf.io/s385j. [ABSTRACT FROM AUTHOR]

The contraceptive needs of women for whom the benefits of menstrual bleeding may outweigh its disadvantages have largely been overlooked, especially outside high-income countries. Some providers and researchers have assumed that users of nonhormonal birth control (non-HBC) are misinformed about the positive and negative effects of HBC and/or the need for menstrual bleeding. This study takes the position that many of those rejecting HBC in favor of methods that do not alter bleeding are, in fact, making informed decisions. Using questionnaire data from 4,255 contraceptive users in three countries, we compared current HBC users explicitly open to hormone use ("H-receptive") and non-HBC users explicitly rejecting hormones ("H-averse"). To the extent that menstrual bleeding attitudes affect contraceptive choice, these two groups should have the greatest contrasts in those attitudes. This novel study design mitigates ambiguities arising from posing hypothetical scenarios to those ambivalent about using hormones or who are not currently using contraception. In all three countries, of those agreeing with the prompt, "I don't want to change my natural menstrual cycle," the fractions of H-averse and H-receptive users are disproportionally high and low, respectively (p ≤.0026). Responses to other prompts varied across populations, revealing complex juxtapositions of multiple criteria, including bleeding preferences, that likely influence contraceptive choices. These patterns, reflecting personal and culturally salient values, highlight the necessity of not assuming that menstrual bleeding is undesirable or relying on a single criterion to ascertain clients' contraceptive needs and preferences. Rather, acknowledging a client's personal hierarchy of preferences regarding contraceptive attributes best serves their goals. [ABSTRACT FROM AUTHOR]

The concept of vulnerability to sex trafficking has been the subject of intense academic debate. It is well documented in the literature that child sex trafficking is facilitated by the abuse of a position of vulnerability, though limited research has focused on children's order of birth as an element of vulnerability to sex trafficking. The objective of this article, based on a sample of 112 Central American women smuggled to the United States for the sex trade before they had attained the age of eighteen years, is to examine whether the order of birth constitutes an element of vulnerability to sex trafficking. Trafficked minors had vulnerabilities linked to structural-level and individual-level factors. We conclude that sisters occupying the first place in the order of birth are the most susceptible to being recruited by an international network that smuggles women for prostitution. On the contrary, the youngest and middle sisters are less at risk due to the protection and guidance of the other sisters. [ABSTRACT FROM AUTHOR]

Introduction: Transgender women in the United States experience high HIV incidence and suboptimal Pre‐exposure prophylaxis (PrEP) engagement. We sought to estimate PrEP initiation and discontinuation rates and characterize PrEP discontinuation experiences among a prospective cohort of transgender women. Methods: Using a sequential, explanatory, mixed‐methods design, 1312 transgender women at risk for HIV acquisition were enrolled from March 2018 to August 2020 and followed through July 2022 (median follow‐up 24 months; interquartile range 15–36). Cox regression models assessed predictors of initiation and discontinuation. In‐depth interviews were conducted among 18 participants, including life history calendars to explore key events and experiences surrounding discontinuations. Qualitative and quantitative data were integrated to generate typologies of discontinuation, inform meta‐inferences and facilitate the interpretation of findings. Results: 21.8% (n = 286) of participants reported taking PrEP at one or more study visits while under observation. We observed 139 PrEP initiations over 2127 person‐years (6.5 initiations/100 person‐years, 95% CI: 5.5–7.7). Predictors of initiation included identifying as Black and PrEP indication. The rate of initiation among those who were PrEP‐indicated was 9.6 initiations/100 person‐years (132/1372 person‐years; 95% CI: 8.1–11.4). We observed 138 PrEP discontinuations over 368 person‐years (37.5 discontinuations/100 person‐years, 95% CI: 31.7–44.3). Predictors of discontinuation included high school education or less and initiating PrEP for the first time while under observation. Four discontinuation typologies emerged: (1) seroconversion following discontinuation; (2) ongoing HIV acquisition risk following discontinuation; (3) reassessment of HIV/STI prevention strategy following discontinuation; and (4) dynamic PrEP use coinciding with changes in HIV acquisition risk. Conclusions: PrEP initiation rates were low and discontinuation rates were high. Complex motivations to stop using PrEP did not consistently correspond with HIV acquisition risk reduction. Evidence‐based interventions to increase PrEP persistence among transgender women with ongoing acquisition risk and provide HIV prevention support for those who discontinue PrEP are necessary to reduce HIV incidence in this population. [ABSTRACT FROM AUTHOR]

Background: Electronic medical record software is common in healthcare settings. However, data privacy and security challenges persist and may impede patients' willingness to disclose health information to their clinicians. Positive patient-provider communication may foster patient trust and subsequently reduce information nondisclosure. This study sought to characterize information-withholding behaviors among women and evaluate the association between positive patient-provider communication and women's health information-withholding behavior in the United States. Methods: Data were pooled from the 2011 to 2018 Health Information National Trends Survey. We used descriptive statistics, bivariate, and logistic regression analyses to investigate whether positive patient-provider communication significantly impacted health information-withholding behaviors. Data from 7,738 women were analyzed. Results: About 10.8% or 1 in 10 women endorsed withholding health information from their providers because of privacy or security concerns about their medical records. After adjusting for the covariates, higher positive patient-provider communication scores were associated with lower odds of withholding information from the provider because of privacy and security concerns (aOR 0.93; 95% CI = 0.90–0.95). Additionally, we found that age, race/ethnicity, educational status, psychological distress, and smoking status significantly predicted women's willingness to disclose health information. Conclusions: Findings suggest that improving positive patient-provider communication quality may reduce women's privacy and security concerns and encourage them to disclose sensitive medical information. [ABSTRACT FROM AUTHOR]

Numerous articles and textbooks advise qualitative researchers on accessing "hard-to-reach" or "hidden" populations. In this article, I compare two studies that I conducted with justice-involved women in the United States: a yearlong ethnography inside a state women's prison and an interview study with formerly incarcerated women. Although these two populations are interconnected—and both are widely deemed hard-to-reach—the barriers to access differed. In the prison study, hard-to-reach reflected an issue of institutional legitimacy, in which researchers must demonstrate themselves and their proposed study as legible, appropriate, and worthy to organizational gatekeepers. In the reentry study, hard-to-reach reflected an issue of structural precarity, in which researchers must navigate the everyday vulnerabilities of research participants' social position to ensure the study is inclusive and feasible. Juxtaposing these two experiences, I propose greater nuance to the term hard-to-reach such that researchers may proactively address institutional and structural barriers to access. [ABSTRACT FROM AUTHOR]

Background: This study aimed to identify predictors of nonadherence to breast cancer screening guidelines in an urban screening clinic among high‐ and average‐risk women in the United States. Methods: We reviewed records of 6090 women who received ≥2 screening mammograms over 2 years at the Karmanos Cancer Institute to examine how breast cancer risk and breast density were associated with guideline‐concordant screening. Incongruent screening was defined as receiving supplemental imaging between screening mammograms for average‐risk women, and as not receiving recommended supplemental imaging for high‐risk women. We used t‐tests and chi‐square tests to examine bivariate associations with guideline‐congruent screening, and probit regression to regress guideline‐congruence unto breast cancer risk, breast density, and their interaction, controlling for age and race. Results: Incongruent screening was more likely among high‐ versus average‐risk women (97.7% vs. 0.9%, p < 0.01). Among average‐risk women, incongruent screening was more likely among those with dense versus nondense breasts (2.0% vs. 0.1%, p < 0.01). Among high‐risk women, incongruent screening was more likely among those with nondense versus dense breasts (99.5% vs. 95.2%, p < 0.01). The significant main effects of density and high‐risk on increased incongruent screening were qualified by a density by high‐risk interaction, showing a weaker association between risk and incongruent screening among women with dense breasts (simple slope = 3.71, p < 0.01) versus nondense breasts (simple slope = 5.79, p < 0.01). Age and race were not associated with incongruent screening. Conclusions: Lack of adherence to evidence‐based screening guidelines has led to underutilization of supplementary imaging for high‐risk women and potential overutilization for women with dense breasts without other risk factors. [ABSTRACT FROM AUTHOR]

The Supreme Court's decision to overturn Roe v. Wade has given rise to many uncertainties, including whether women's health data can be used as evidence in the prosecution of those who obtain an abortion. A notable percentage of young women in the United States use mobile applications to track their reproductive health. As the United States' privacy law is a patchwork framework, these apps are largely unregulated, and the sensitive user data remains unprotected and available to law enforcement. This Note examines the various preventative steps and responses taken to protect women's reproductive health data in the wake of the Dobbs decision. Further action, ranging from government action to user-controlled data minimization, is proposed to strengthen women's reproductive health data privacy. [ABSTRACT FROM AUTHOR]

Participatory interventions enable active user engagement, but research is needed to examine the longitudinal mechanisms through which engagement may generate outcomes. This study investigated the social processes following a web-based participatory media literacy intervention. In this program, young women were asked to create a digital counter message against the media content that promotes risk behavior. The effects of the message production were assessed at an immediate post-test and three- and six-month follow-ups. Message production increased collective efficacy at the immediate post-test, which then stimulated the sharing of self-generated messages and interpersonal conversation at the three-month follow-up. These sharing behaviors, in turn, led to critical media use and a negative attitude toward risk behavior at six months. Collective efficacy and sharing behavior sequentially mediated the effects of message production on outcomes. Theoretical and pragmatic implications are discussed. [ABSTRACT FROM AUTHOR]

Background Breast cancer (BC) is the most common cancer among US women, and institutional racism is a critical cause of health disparities. We investigated impacts of historical redlining on BC treatment receipt and survival in the United States. Methods Home Owners' Loan Corporation (HOLC) boundaries were used to measure historical redlining. Eligible women in the 2010-2017 Surveillance, Epidemiology, and End Results–Medicare BC cohort were assigned a HOLC grade. The independent variable was a dichotomized HOLC grade: A and B (nonredlined) and C and D (redlined). Outcomes of receipt of various cancer treatments, all-cause mortality (ACM), and BC-specific mortality (BCSM) were analyzed using logistic or Cox models. Indirect effects by comorbidity were examined. Results Among 18 119 women, 65.7% resided in historically redlined areas (HRAs), and 32.6% were deceased at a median follow-up of 58 months. A larger proportion of deceased women resided in HRAs (34.5% vs 30.0%). Of all deceased women, 41.6% died of BC; a larger proportion resided in HRAs (43.4% vs 37.8%). Historical redlining is a statistically significant predictor of poorer survival after BC diagnosis (hazard ratio = 1.09, 95% confidence interval [CI] = 1.03 to 1.15 for ACM, and hazard ratio = 1.26, 95% CI = 1.13 to 1.41 for BCSM). Indirect effects via comorbidity were identified. Historical redlining was associated with a lower likelihood of receiving surgery (odds ratio = 0.74, 95% CI = 0.66 to 0.83, and a higher likelihood of receiving palliative care odds ratio = 1.41, 95% CI = 1.04 to 1.91). Conclusion Historical redlining is associated with differential treatment receipt and poorer survival for ACM and BCSM. Relevant stakeholders should consider historical contexts when designing and implementing equity-focused interventions to reduce BC disparities. Clinicians should advocate for healthier neighborhoods while providing care. [ABSTRACT FROM AUTHOR]

In 2019, the United States (US) Advisory Committee on Immunization Practices (ACIP) recommended that healthcare providers engage in shared clinical decision making for adults aged 27–45 who may benefit from HPV vaccination. However, it is difficult to assess these benefits as there is a lack of data on HPV burden on young and mid-adult women. This analysis estimates the incidence of conization and the burden associated with treating pre-cancerous states related to HPV with a loop electrosurgical excision procedure (LEEP) or a cold knife conization (CKC) among commercially insured women aged 18–45. This retrospective cohort study used the IBM MarketScan commercial claims encounter database for women aged 18–45 treated with conization. We assessed the annual incidence of conization (2016–2019) and adjusted the two-year health care costs post-conization using a multivariable Generalized Linear Model (GLM)—accounting for follow-up time and other characteristics—stratified by the age groups, namely 18–26 and 27–45. The inclusion criteria were met by 6735 women, with a mean age of 33.9 years (SD = 6.2). Conization incidence was lowest for women aged 18–26 (41/100,000 to 62/100,000 women-years) and highest for women aged 31–35 (243/100,000 to 269/100,000). The GLM-adjusted, all-cause healthcare costs per patient per year were USD 7279 and USD 9249 in the 18–26 and 27–45 age groups, respectively. The adjusted costs for disease-specific care were USD 3609 and USD 4557 for women ages 18–26 and 27–45, respectively. The burden of conization and the associated costs were significant, indicating a potential healthcare benefit of HPV vaccination among young and middle-aged women. [ABSTRACT FROM AUTHOR]

Pelvic organ prolapse (POP) is a very common gynecological disorder greatly affecting the quality of life (QoL) of females in the society. Studies have shown that approximately 40% of women in the United States have POP that requires medical intervention. In clinical practice, there are four treatment options for POP: watchful waiting, conservative treatment, reconstructive surgery, and obliterative surgery. In this study, we utilize practical data obtained through surveys and clinical literature and develop a model to help physicians and POP patients dynamically select treatment options in order to maximize a patient's expected future QoL. Results from the model are presented in the form of optimal policy tables, which can be used by physicians and patients by entering several attributes as inputs, such as the patient's age, current observed QoL defined by the severity of POP symptoms, preferences over preserving coital function, and other potential restrictive conditions. The results show significant socioeconomic incentives for potential utilization of optimal treatment policies in POP treatment. We estimate based on QoL to dollar conversions that the expected value of improved QoL for an individual POP patient is around $10,000. When aggregated over the entire POP population seeking treatment, the total annual expected value for the society is at least $675 million under medium‐level valuations of QoL. Although the optimization‐based policies imply an overall increase of about $200 million in annual POP treatment costs, the net positive gains can make this trade‐off an acceptable one. [ABSTRACT FROM AUTHOR]

Introduction: Breast cancer continues to be the leading form of cancer among women in the United States. Additionally, disparities across the breast cancer continuum continue to increase for women of historically marginalized populations. The mechanism driving these trends are unclear, however, accelerated biological age may provide key insights into better understanding these disease patterns. Accelerated age measured by DNA methylation using epigenetic clocks is to date the most robust method for estimating accelerated age. Here we synthesize the existing evidence on epigenetic clocks measurement of DNA methylation based accelerated age and breast cancer outcomes. Methods: Our database searches were conducted from January 2022 to April 2022 and yielded a total of 2,908 articles for consideration. We implemented methods derived from guidance of the PROSPERO Scoping Review Protocol to assess articles in the PubMed database on epigenetic clocks and breast cancer risk. Results: Five articles were deemed appropriate for inclusion in this review. Ten epigenetic clocks were used across the five articles demonstrating statistically significant results for breast cancer risk. DNA methylation accelerated age varied by sample type. The studies did not consider social factors or epidemiological risk factors. The studies lacked representation of ancestrally diverse populations. Discussion: DNA methylation based accelerated age as captured by epigenetic clocks has a statistically significant associative relationship with breast cancer risk, however, important social factors that contribute to patterns of methylation were not comprehensively considered in the available literature. More research is needed on DNA methylation based accelerated age across the lifespan including during menopausal transition and in diverse populations. This review demonstrates that DNA methylation accelerated age may provide key insights for tackling increasing rates of U.S. breast cancer incidence and overall disease disparities experienced by women from minoritized backgrounds. [ABSTRACT FROM AUTHOR]

Cervical cancer continues to affect women in the United States and throughout the world despite an effective vaccine against human papillomavirus and cancer screening programs. For the women who develop cervical cancer, surgery, radiation, and chemotherapy have been the mainstays of treatment for years. Recently, novel therapeutics have been developed that offer new treatment opportunities for women living with advanced and/or recurrent disease. Immunotherapy has become an important tool against cervical cancer with the approval of pembrolizumab in the second line for advanced or recurrent disease. Checkpoint inhibitors have recently been approved in the front line for advanced and/or recurrent disease in combination with chemotherapy, and they are being studied in the front line in combination with chemoradiation. Antibody–drug conjugates—specifically tisotumab vedotin (TV)—also have recently received Food and Drug Administration (FDA) approval, and TV is currently being studied in combination with checkpoint inhibitors and with carboplatin. Tumor‐infiltrating lymphocytes have been studied in early‐phase trials and have shown promise in small patient series. Despite these new therapies, there continue to be racial, ethnic, and socioeconomic inequities with respect to access to care, access to and participation in clinical trials, and survival in the United States as well as globally. New FDA guidance requires researchers to work to reduce disparities by including women of more diverse backgrounds in clinical trials. Finally, as progress continues to be made in the treatment of established disease, prevention through vaccination and screening remains paramount. Plain language summary: The treatment of cervical cancer remains a significant problem in the United States and especially worldwide.Although early cases can be cured, cervical cancer that has spread remains difficult to treat.The past few years have seen significant advances in new therapies and combinations of therapies for women with advanced or recurrent disease.Although this is excellent news for these women, cervical cancer is a preventable disease through screening with Papanicolaou smears and vaccination with the human papillomavirus vaccine.By improving access to and acceptance of screening and vaccination, we can eradicate cervical cancer in the United States and the world. The past few years have seen US Food and Drug Administration approval of novel therapies and combinations for advanced and/or recurrent cervical cancer that are providing new hope for women with this disease. All cervical cancer can and must be eradicated by improving access to and acceptance of screening modalities and vaccination and by addressing disparities related to race, ethnicity, and socioeconomic status. [ABSTRACT FROM AUTHOR]

While the number of women in science, engineering, and math occupations has increased over the years, the technology career field has not reaped the same rewards. The goal of this correlation study was to learn the factors that women consider before deciding on a career in technology. The sample consisted of 106 Generation Z women in the United States between the ages of 18 to 25, in their first two years of postsecondary study, who had not chosen an IT program at a university offering information technology courses in degree programs. The findings revealed a stronger understanding of how women's learned experiences affect their career choices. The results from this study disclosed a strong relationship between gender bias, gender pay, and required courses in technology as reasons why these women did not choose a technology career field. [ABSTRACT FROM AUTHOR]

Breast cancer (BC) is the most common malignancy and the second leading cause of cancer death among women in the United States. The consumption of natural dietary components such as broccoli sprouts (BSp) and green tea polyphenols (GTPs) has demonstrated exciting potential in reducing the risk of BC through the regulation of epigenetic mechanisms. However, little is known about their impacts on reversing epigenomic aberrations that are centrally involved in the initiation and progression of BC. Previously, we have determined the efficacy of combined BSp and GTPs treatment on the inhibition of the growth of a mammary tumor in a transgenic Her2/neu mouse model. We sought to extend our previous study to identify universal biomarkers that represent common mechanistic changes among different mouse models in response to this dietary regime by including a new transgenic mouse model, C3(1)-SV40 TAg (SV40). As a result, we identified novel target genes that were differentially expressed and methylated in response to dietary botanicals when administered singly (BSp and GTPs) and in combination (BSp + GTPs) in both mouse models. We discovered more differentially expressed and methylated genes in the combination treatment group compared to the singly administered groups. Subsequently, several biological pathways related to epigenetic regulations were identified in response to the combination treatment. Furthermore, when compared to the BSp and GTPs treatment alone, the combinatorial treatment showed a more significant impact on the regulation of the epigenetic modifier activities involved in DNA methylation and histone modifications. Our study provides key insights about the impact of the combined administration of BSp and GTPs on BC using a multi-omics analysis, suggesting a combinatorial approach is more efficacious in preventing and inhibiting BC by impacting key tumor-related genes at transcriptomic and methylomic levels. Our findings could be further extrapolated as a comprehensive source for understanding the epigenetic modifications that are associated with the effects of these dietary botanicals on BC prevention. [ABSTRACT FROM AUTHOR]

Background: Real‐life validation is necessary to ensure our artificial intelligence (AI) skin diagnostic tool is inclusive across a diverse and representative US population of various ages, ancestries and skin phototypes. Objectives: To explore the relevance and accuracy of an automated, algorithm‐based analysis of facial signs in representative women of different ancestries, ages and phototypes, living in the same country. Methods: In a cross‐sectional study of selfie images of 1041 US women, algorithm‐based analyses of seven facial signs were automatically graded by an AI‐based algorithm and by 50 US dermatologists of various profiles (age, gender, ancestry, geographical location). For automated analysis and dermatologist assessment, the same referential skin atlas was used to standardize the grading scales. The average values and their variability were compared with respect to age, ancestry and phototype. Results: For five signs, the grading obtained by the automated system were strongly correlated with dermatologists' assessments (r ≥ 0.75); cheek skin pores were moderately correlated (r = 0.63) and pigmentation signs, especially for the darkest skin tones, were weakly correlated (r = 0.40) to the dermatologist assessments. Age and ancestry had no effect on the correlations. In many cases, the automated system performed better than the dermatologist‐assessed clinical grading due to 0.3–0.5 grading unit differences among the dermatologist panel that were not related to any individual characteristic (e.g. gender, age, ancestry, location). The use of phototypes, as discontinuous categorical variables, is likely a limiting factor in the assessments of grading, whether obtained by automated analysis or clinical assessment of the images. Conclusions: The AI‐based automatic procedure is accurate and clinically relevant for analysing facial signs in a diverse and inclusive population of US women, as confirmed by a diverse panel of dermatologists, although skin tone requires further improvement. [ABSTRACT FROM AUTHOR]

Background: Striking racial/ethnic disparities exist in pregnancy outcomes among various racial/ethnic Objective: To determine the incidence and risk factors associated with stillbirth in Asian-American women. Study design: We conducted this retrospective cohort study using the United States Birth and Fetal Death data files 2014–2017. We used the fetuses-at-risk approach to generate stillbirth trends by gestational age among Non-Hispanic (NH)-White and Asian-American births during the study period. We calculated the adjusted risk of stillbirth for Asian-Americans, overall, and for each Asian-American subgroup: Asian Indians, Koreans, Chinese, Vietnamese, Japanese and Filipinos, with NH-Whites as the referent category. Results: Of the 715,297 births that occurred among Asian-Americans during the study period, stillbirth incidence rate was 3.86 per 1000 births. From the gestational age of 20 weeks through 41 weeks, the stillbirth rates were consistently lower among Asian-Americans compared to NH-Whites. Stillbirth incidence ranged from a low rate of 2.6 per 1000 births in Koreans to as high as 5.3 per 1000 births in Filipinos. After adjusting for potentially confounding characteristics, Asian-Americans were about half as likely to experience stillbirth compared to NH-White mothers [adjusted hazards ratio (AHR) = 0.57, 95% confidence interval (CI) = 0.51–0.64]. This intrauterine survival advantage was evident in all Asian-American subgroups. Conclusion: The risk of stillbirth is twofold lower in Asian-Americans than in NH-Whites. It will be an important research agenda to determine reasons for the improved intrauterine survival among Asian-Americans in order to uncover clues for reducing the burden of stillbirth among other racial/ethnic minority women in the United States. [ABSTRACT FROM AUTHOR]

We found that one-quarter of participants have not thought about stopping breast cancer screening, highlighting the need to better inform older women that stopping screening may be an option even before women meet guideline criteria for stopping, which can occur through clinician counseling and public health messaging. Interventions that leverage clinicians to better inform older women that stopping screening may be an option and to address patients' cancer-related worries hold promise for optimizing breast cancer screening in older women. In a multivariable regression model, considering stopping screening was not associated with age or life expectancy but was associated with cancer worry, which has been reported as an important factor in screening decision making.[2] Notably, Black women were less likely to consider stopping. [Extracted from the article]

Objective: To determine the extent to which Black race is associated with the infant mortality rate (< 365 day, IMR) of births to US-born and foreign-born Latinx women. Methods: Stratified and multivariable binominal log-linear regression analyses were performed on the 2010–2013 National Center for Health Statistics linked birth–death certificate files of singleton infants. Results: The IMR of births to US-born Black Latinx women (N = 54,542) exceeded that of births to US-born White Latinx women (N = 1,320,084): 5.7/1000 vs 4.2/1000, RR = 1.4 (1.2, 1.5). In contrast, the IMR of births to foreign-born Black Latinx women (N = 35,544) approximated that of births to foreign-born White Latinx women (N = 1,372,172): 3.8/1000 vs 3.6/1000, RR = 1.0 (0.9, 1.2) The adjusted (controlling for maternal age, education, prenatal care, high parity, and region of residence) RR of infant mortality for births to US-born and foreign-born Black (versus non-Latinx White) Latinx women equaled 1.4 (1.2, 1.6) and 1.0 (0.8, 1.2), respectively. The adjusted RR of infant mortality for births to US-born and foreign-born White (versus non-Latinx White) Latinx women equaled 1.0 (0.9, 1.0) and 0.8 (0.7, 0.8), respectively. Conclusions: Black race is associated with a 1.4-fold higher IMR among births to US-born Latinx women. A similar phenomenon does not occur among foreign-born Latinx women. These intriguing findings highlight that the social construct of Black race across the life-course of Latinx women are detrimental to infant outcome. [ABSTRACT FROM AUTHOR]