News

The FDA has approved gedatolisib (Revtorpyk, Celcuity) plus fulvestrant, with or without palbociclib, for patients with HR-positive, HER2-negative locally advanced or metastatic breast cancer without a PIK3CA mutation detected following progression on or after treatment with at least 1 line of endocrine therapy in the metastatic setting.

Gedatolisib is a multitarget inhibitor of the PI3K/AKT/mTOR (PAM) pathway, a key oncogenic driver of HR-positive, HER2-negative breast cancer that contributes to treatment resistance. While previously approved medications target single components of the pathway, gedatolisib blocks PI3K and mTOR together, leading to more comprehensive suppression, which may in turn help restore sensitivity to endocrine therapy and anti-CDK4/6 inhibition.

Approval was based on the VIKTORIA-1 trial, which randomly assigned 392 patients evenly to either gedatolisib, palbociclib, and fulvestrant (gedatolisib triplet); gedatolisib plus fulvestrant (gedatolisib doublet); or fulvestrant alone.

Median progression-free survival, the major efficacy outcome, was 9.3 months in the gedatolisib-triplet group, 7.4 months in the gedatolisib-doublet arm, and 2 months with fulvestrant monotherapy. Overall survival data were not yet mature.

In a paper published in the Journal of Clinical Oncology in March, the investigators acknowledged that fulvestrant monotherapy is no longer standard of care in the second line after anti-CDK4/6 and aromatase inhibitor failure, and that it was chosen as a comparator to meet regulatory requirements.

Still, they said the median progression-free survival in the triplet arm is “among the longest reported for a chemotherapy-free second- to third-line regimen in a phase III trial.”

Grade 3 or higher treatment-related adverse events in the triplet and doublet groups included neutropenia (62.3%, 0.8%), stomatitis (19.2%, 12.3%), rash (4.6%, 5.4%), hyperglycemia (2.3%, 2.3%), and diarrhea (1.5%, 0.8%). Overall, 2.3% of triplet and 3.1% of doublet patients stopped treatment due to adverse events. There were two treatment-related deaths in the triplet arm, one from pneumonia and the other from liver failure.

In June, Celcuity reported similarly favorable survival outcomes among 350 patients in VIKTORIA-1 who had PIK3CA mutations. Median progression-free survival was over 11 months with both the gedatolisib triplet and doublet vs 5.6 months with alpelisib plus fulvestrant, which was the comparator in the cohort with PIK3CA mutations.

The company said it planned to submit a supplemental application to the FDA for approval in patients with PIK3CA mutations.

The recommended dosage for gedatolisib is 180 mg as an intravenous infusion once weekly on days 1, 8, and 15 of every 28-day cycle, in combination with fulvestrant, with or without palbociclib, until disease progression or unacceptable toxicity.

M. Alexander Otto is a physician assistant and award-winning journalist. He is also an MIT science journalism fellow. Email: [email protected]

A version of this article first appeared on Medscape.com.

The FDA has approved gedatolisib (Revtorpyk, Celcuity) plus fulvestrant, with or without palbociclib, for patients with HR-positive, HER2-negative locally advanced or metastatic breast cancer without a PIK3CA mutation detected following progression on or after treatment with at least 1 line of endocrine therapy in the metastatic setting.

Gedatolisib is a multitarget inhibitor of the PI3K/AKT/mTOR (PAM) pathway, a key oncogenic driver of HR-positive, HER2-negative breast cancer that contributes to treatment resistance. While previously approved medications target single components of the pathway, gedatolisib blocks PI3K and mTOR together, leading to more comprehensive suppression, which may in turn help restore sensitivity to endocrine therapy and anti-CDK4/6 inhibition.

Approval was based on the VIKTORIA-1 trial, which randomly assigned 392 patients evenly to either gedatolisib, palbociclib, and fulvestrant (gedatolisib triplet); gedatolisib plus fulvestrant (gedatolisib doublet); or fulvestrant alone.

Median progression-free survival, the major efficacy outcome, was 9.3 months in the gedatolisib-triplet group, 7.4 months in the gedatolisib-doublet arm, and 2 months with fulvestrant monotherapy. Overall survival data were not yet mature.

In a paper published in the Journal of Clinical Oncology in March, the investigators acknowledged that fulvestrant monotherapy is no longer standard of care in the second line after anti-CDK4/6 and aromatase inhibitor failure, and that it was chosen as a comparator to meet regulatory requirements.

Still, they said the median progression-free survival in the triplet arm is “among the longest reported for a chemotherapy-free second- to third-line regimen in a phase III trial.”

Grade 3 or higher treatment-related adverse events in the triplet and doublet groups included neutropenia (62.3%, 0.8%), stomatitis (19.2%, 12.3%), rash (4.6%, 5.4%), hyperglycemia (2.3%, 2.3%), and diarrhea (1.5%, 0.8%). Overall, 2.3% of triplet and 3.1% of doublet patients stopped treatment due to adverse events. There were two treatment-related deaths in the triplet arm, one from pneumonia and the other from liver failure.

In June, Celcuity reported similarly favorable survival outcomes among 350 patients in VIKTORIA-1 who had PIK3CA mutations. Median progression-free survival was over 11 months with both the gedatolisib triplet and doublet vs 5.6 months with alpelisib plus fulvestrant, which was the comparator in the cohort with PIK3CA mutations.

The company said it planned to submit a supplemental application to the FDA for approval in patients with PIK3CA mutations.

The recommended dosage for gedatolisib is 180 mg as an intravenous infusion once weekly on days 1, 8, and 15 of every 28-day cycle, in combination with fulvestrant, with or without palbociclib, until disease progression or unacceptable toxicity.

M. Alexander Otto is a physician assistant and award-winning journalist. He is also an MIT science journalism fellow. Email: [email protected]

A version of this article first appeared on Medscape.com.

The FDA has approved gedatolisib (Revtorpyk, Celcuity) plus fulvestrant, with or without palbociclib, for patients with HR-positive, HER2-negative locally advanced or metastatic breast cancer without a PIK3CA mutation detected following progression on or after treatment with at least 1 line of endocrine therapy in the metastatic setting.

Gedatolisib is a multitarget inhibitor of the PI3K/AKT/mTOR (PAM) pathway, a key oncogenic driver of HR-positive, HER2-negative breast cancer that contributes to treatment resistance. While previously approved medications target single components of the pathway, gedatolisib blocks PI3K and mTOR together, leading to more comprehensive suppression, which may in turn help restore sensitivity to endocrine therapy and anti-CDK4/6 inhibition.

Approval was based on the VIKTORIA-1 trial, which randomly assigned 392 patients evenly to either gedatolisib, palbociclib, and fulvestrant (gedatolisib triplet); gedatolisib plus fulvestrant (gedatolisib doublet); or fulvestrant alone.

Median progression-free survival, the major efficacy outcome, was 9.3 months in the gedatolisib-triplet group, 7.4 months in the gedatolisib-doublet arm, and 2 months with fulvestrant monotherapy. Overall survival data were not yet mature.

In a paper published in the Journal of Clinical Oncology in March, the investigators acknowledged that fulvestrant monotherapy is no longer standard of care in the second line after anti-CDK4/6 and aromatase inhibitor failure, and that it was chosen as a comparator to meet regulatory requirements.

Still, they said the median progression-free survival in the triplet arm is “among the longest reported for a chemotherapy-free second- to third-line regimen in a phase III trial.”

Grade 3 or higher treatment-related adverse events in the triplet and doublet groups included neutropenia (62.3%, 0.8%), stomatitis (19.2%, 12.3%), rash (4.6%, 5.4%), hyperglycemia (2.3%, 2.3%), and diarrhea (1.5%, 0.8%). Overall, 2.3% of triplet and 3.1% of doublet patients stopped treatment due to adverse events. There were two treatment-related deaths in the triplet arm, one from pneumonia and the other from liver failure.

In June, Celcuity reported similarly favorable survival outcomes among 350 patients in VIKTORIA-1 who had PIK3CA mutations. Median progression-free survival was over 11 months with both the gedatolisib triplet and doublet vs 5.6 months with alpelisib plus fulvestrant, which was the comparator in the cohort with PIK3CA mutations.

The company said it planned to submit a supplemental application to the FDA for approval in patients with PIK3CA mutations.

The recommended dosage for gedatolisib is 180 mg as an intravenous infusion once weekly on days 1, 8, and 15 of every 28-day cycle, in combination with fulvestrant, with or without palbociclib, until disease progression or unacceptable toxicity.

M. Alexander Otto is a physician assistant and award-winning journalist. He is also an MIT science journalism fellow. Email: [email protected]

A version of this article first appeared on Medscape.com.

This transcript has been edited for clarity.

Hi. My name is Dr Shikha Jain. I am a gastrointestinal medical oncologist at the University of Illinois Cancer Center, and also the founder of the nonprofit Women in Medicine. I’m here to talk to you today about some of the myths that we hear around food and diet and how it can impact cancer.

One of the most common myths that I hear in my clinic all the time is that sugar feeds cancer, and I can tell you that that is categorically not true. One of the reasons people sometimes think that is because a scan called a PET scan does capture cells that are rapidly replicating, and those rapidly replicating cells ingest sugar. Oftentimes, people think that because the PET scan is lighting up where those cells are rapidly replicating, the cancer is actually eating sugar.

That is not the way it works. I have patients who’ve tried to cut sugar completely out of their diets thinking it’s going to help them, and in actuality, it doesn’t help. In some situations, especially when you’re having nausea or feeling uncomfortable or having a stomach upset, sometimes sugar can make you feel better if that is what you’re craving at the time and you’re not really craving other foods.

I strongly recommend you eat a healthy diet. You don’t need to overdose on the sugar, and especially if you have diabetes, make sure you’re managing your sugar. Sugar does not feed cancer, so please do not cut sugar completely out of your diet because it won’t help you treat cancer, nor will it help you prevent cancer.

Another very common myth that I hear is talking about things like superfoods or things that might prevent cancer because they are considered to be antioxidants and kill off cancer cells. We know as oncologists that there are many different types of foods that can actually cause cancer. For example, if you eat a diet high in processed meats or high in red meat or processed foods in general, if you’re eating some of the candies, and some of the things that people use to quit smoking have nicotine and things in them.

We know smoking is very bad for cancer. Alcohol in excess can be very damaging to the liver and the pancreas and can also cause kidney cancer or bladder cancer. Those are all things from your diet that you can remove or avoid to help you stay healthy and prevent diagnosis of cancer.

For things like vitamin supplements — I hear often about vitamin C and about turmeric and other types of foods that might help prevent cancer — there are no data currently that show any of those foods prevent cancer. There is some evidence that turmeric can be an anti-inflammatory, so some people do take turmeric in small doses or in their food as an anti-inflammatory agent, and there’s nothing wrong with that. Again, you don’t want to take too much because too much of anything can be dangerous.

People also ask me about green tea because green teas are seen as a very healthy option for you to be drinking. Green tea can be healthy, and it can be good. It can be a good thing for you to drink occasionally, but what people don’t understand or know is that too much green tea can thin your blood and put you at a higher risk for bleeding.

Any sort of thing that you’re ingesting, make sure that you talk to your doctor so they understand exactly what you’re taking, and if there’s any possibility that it might cause any complications that you may not be aware of.

The other thing I tell all of my patients is that I believe in holistic care. I believe in healthy eating. I believe in diet and exercise as ways to stay healthy. I also believe that you need to make sure that you talk to your care team about what vitamins, what supplements, what you’re putting into your body. Because what some people don’t realize, especially if you’re on any chemotherapy or systemic therapies, some of the supplements that you might take might interact with some of the systemic therapies.

For example, if you’re on a chemotherapy agent and the supplement that you’re taking actually blocks absorption of that chemotherapy agent, it may not be as effective, or it could make it more toxic. You have to be careful that whatever you’re taking, you talk to your doctor and the pharmacy team to make sure that it’s not interacting in a negative way with the medications that you’re taking as prescribed for your cancer.

I think many people don’t realize how much exercise can impact and positively impact your life if you’re going through a cancer diagnosis. We know that exercise helps prevent heart disease and helps keep us healthy overall, but there’s studies that have shown that exercise during and after receiving treatment for your cancer can prolong your life almost as much as some standard therapies.

If your patient is taking standard therapy and feeling a little sluggish, that is completely understandable, but adding exercise into their diet can be a really impactful way to keep healthy and stay alive longer. There are many different ways to take supplements, take holistic care, and take good care of oneself.

Just make sure you’re talking about what is safe and what is not. You would not believe how many patients come to me with supplements or over-the-counter vitamins. I share stories with them of patients who took some of these supplements and, because they aren’t regulated by the FDA, some of those patients actually ended up in liver failure.

I had a patient when I was in training who took a supplement as it was “prescribed” or as it was listed on the bottle. She ended up needing a liver transplant with no other medical problems, and she was very young. Again, many of these supplements can be dangerous if they’re not taken properly and if they’re not monitored by a doctor.

The final thing I want to say that I think is so important is that doctors and patients are a team. We don’t know what happens when the patient goes home at the end of the day. We can give recommendations based on evidence and science, and our goal is to help keep you healthy, stay healthy, and stay alive as long as possible. In order to do that, we need to have an open and honest discussion, there needs to be shared decision-making, and we need to make sure the decisions being made are informed and are based on good science and evidence.

Be careful when there is a celebrity or somebody online trying to sell you a supplement, because oftentimes they have a secondary gain. They might be making money from the supplement, or they might have a brand deal with them. Patients need to be really cautious when people who aren’t their doctor are telling them different supplements and holistic things to take, because they may be selling these things for some secondary gain for themselves that doesn’t actually benefit the patient. It doesn’t mean that they’re bad people. It doesn’t mean that they’re malicious people. What it means is they have a reason for what they’re trying to sell, and your patients just need to make sure that they're thinking very carefully about what goes into their bodies.

Those are very common sources of myths about diet and exercise. I hope that you have a good doctor-patient relationship and are able to talk about these things; come up with exceptional science- and evidence-based, holistic ways to manage medical care; and find great ways to have a partnership with your care team so that the patient feels comfortable with the outcomes.

A version of this article first appeared on Medscape.com.

This transcript has been edited for clarity.

Hi. My name is Dr Shikha Jain. I am a gastrointestinal medical oncologist at the University of Illinois Cancer Center, and also the founder of the nonprofit Women in Medicine. I’m here to talk to you today about some of the myths that we hear around food and diet and how it can impact cancer.

One of the most common myths that I hear in my clinic all the time is that sugar feeds cancer, and I can tell you that that is categorically not true. One of the reasons people sometimes think that is because a scan called a PET scan does capture cells that are rapidly replicating, and those rapidly replicating cells ingest sugar. Oftentimes, people think that because the PET scan is lighting up where those cells are rapidly replicating, the cancer is actually eating sugar.

That is not the way it works. I have patients who’ve tried to cut sugar completely out of their diets thinking it’s going to help them, and in actuality, it doesn’t help. In some situations, especially when you’re having nausea or feeling uncomfortable or having a stomach upset, sometimes sugar can make you feel better if that is what you’re craving at the time and you’re not really craving other foods.

I strongly recommend you eat a healthy diet. You don’t need to overdose on the sugar, and especially if you have diabetes, make sure you’re managing your sugar. Sugar does not feed cancer, so please do not cut sugar completely out of your diet because it won’t help you treat cancer, nor will it help you prevent cancer.

Another very common myth that I hear is talking about things like superfoods or things that might prevent cancer because they are considered to be antioxidants and kill off cancer cells. We know as oncologists that there are many different types of foods that can actually cause cancer. For example, if you eat a diet high in processed meats or high in red meat or processed foods in general, if you’re eating some of the candies, and some of the things that people use to quit smoking have nicotine and things in them.

We know smoking is very bad for cancer. Alcohol in excess can be very damaging to the liver and the pancreas and can also cause kidney cancer or bladder cancer. Those are all things from your diet that you can remove or avoid to help you stay healthy and prevent diagnosis of cancer.

For things like vitamin supplements — I hear often about vitamin C and about turmeric and other types of foods that might help prevent cancer — there are no data currently that show any of those foods prevent cancer. There is some evidence that turmeric can be an anti-inflammatory, so some people do take turmeric in small doses or in their food as an anti-inflammatory agent, and there’s nothing wrong with that. Again, you don’t want to take too much because too much of anything can be dangerous.

People also ask me about green tea because green teas are seen as a very healthy option for you to be drinking. Green tea can be healthy, and it can be good. It can be a good thing for you to drink occasionally, but what people don’t understand or know is that too much green tea can thin your blood and put you at a higher risk for bleeding.

Any sort of thing that you’re ingesting, make sure that you talk to your doctor so they understand exactly what you’re taking, and if there’s any possibility that it might cause any complications that you may not be aware of.

The other thing I tell all of my patients is that I believe in holistic care. I believe in healthy eating. I believe in diet and exercise as ways to stay healthy. I also believe that you need to make sure that you talk to your care team about what vitamins, what supplements, what you’re putting into your body. Because what some people don’t realize, especially if you’re on any chemotherapy or systemic therapies, some of the supplements that you might take might interact with some of the systemic therapies.

For example, if you’re on a chemotherapy agent and the supplement that you’re taking actually blocks absorption of that chemotherapy agent, it may not be as effective, or it could make it more toxic. You have to be careful that whatever you’re taking, you talk to your doctor and the pharmacy team to make sure that it’s not interacting in a negative way with the medications that you’re taking as prescribed for your cancer.

I think many people don’t realize how much exercise can impact and positively impact your life if you’re going through a cancer diagnosis. We know that exercise helps prevent heart disease and helps keep us healthy overall, but there’s studies that have shown that exercise during and after receiving treatment for your cancer can prolong your life almost as much as some standard therapies.

If your patient is taking standard therapy and feeling a little sluggish, that is completely understandable, but adding exercise into their diet can be a really impactful way to keep healthy and stay alive longer. There are many different ways to take supplements, take holistic care, and take good care of oneself.

Just make sure you’re talking about what is safe and what is not. You would not believe how many patients come to me with supplements or over-the-counter vitamins. I share stories with them of patients who took some of these supplements and, because they aren’t regulated by the FDA, some of those patients actually ended up in liver failure.

I had a patient when I was in training who took a supplement as it was “prescribed” or as it was listed on the bottle. She ended up needing a liver transplant with no other medical problems, and she was very young. Again, many of these supplements can be dangerous if they’re not taken properly and if they’re not monitored by a doctor.

The final thing I want to say that I think is so important is that doctors and patients are a team. We don’t know what happens when the patient goes home at the end of the day. We can give recommendations based on evidence and science, and our goal is to help keep you healthy, stay healthy, and stay alive as long as possible. In order to do that, we need to have an open and honest discussion, there needs to be shared decision-making, and we need to make sure the decisions being made are informed and are based on good science and evidence.

Be careful when there is a celebrity or somebody online trying to sell you a supplement, because oftentimes they have a secondary gain. They might be making money from the supplement, or they might have a brand deal with them. Patients need to be really cautious when people who aren’t their doctor are telling them different supplements and holistic things to take, because they may be selling these things for some secondary gain for themselves that doesn’t actually benefit the patient. It doesn’t mean that they’re bad people. It doesn’t mean that they’re malicious people. What it means is they have a reason for what they’re trying to sell, and your patients just need to make sure that they're thinking very carefully about what goes into their bodies.

Those are very common sources of myths about diet and exercise. I hope that you have a good doctor-patient relationship and are able to talk about these things; come up with exceptional science- and evidence-based, holistic ways to manage medical care; and find great ways to have a partnership with your care team so that the patient feels comfortable with the outcomes.

A version of this article first appeared on Medscape.com.

This transcript has been edited for clarity.

Hi. My name is Dr Shikha Jain. I am a gastrointestinal medical oncologist at the University of Illinois Cancer Center, and also the founder of the nonprofit Women in Medicine. I’m here to talk to you today about some of the myths that we hear around food and diet and how it can impact cancer.

One of the most common myths that I hear in my clinic all the time is that sugar feeds cancer, and I can tell you that that is categorically not true. One of the reasons people sometimes think that is because a scan called a PET scan does capture cells that are rapidly replicating, and those rapidly replicating cells ingest sugar. Oftentimes, people think that because the PET scan is lighting up where those cells are rapidly replicating, the cancer is actually eating sugar.

That is not the way it works. I have patients who’ve tried to cut sugar completely out of their diets thinking it’s going to help them, and in actuality, it doesn’t help. In some situations, especially when you’re having nausea or feeling uncomfortable or having a stomach upset, sometimes sugar can make you feel better if that is what you’re craving at the time and you’re not really craving other foods.

I strongly recommend you eat a healthy diet. You don’t need to overdose on the sugar, and especially if you have diabetes, make sure you’re managing your sugar. Sugar does not feed cancer, so please do not cut sugar completely out of your diet because it won’t help you treat cancer, nor will it help you prevent cancer.

Another very common myth that I hear is talking about things like superfoods or things that might prevent cancer because they are considered to be antioxidants and kill off cancer cells. We know as oncologists that there are many different types of foods that can actually cause cancer. For example, if you eat a diet high in processed meats or high in red meat or processed foods in general, if you’re eating some of the candies, and some of the things that people use to quit smoking have nicotine and things in them.

We know smoking is very bad for cancer. Alcohol in excess can be very damaging to the liver and the pancreas and can also cause kidney cancer or bladder cancer. Those are all things from your diet that you can remove or avoid to help you stay healthy and prevent diagnosis of cancer.

For things like vitamin supplements — I hear often about vitamin C and about turmeric and other types of foods that might help prevent cancer — there are no data currently that show any of those foods prevent cancer. There is some evidence that turmeric can be an anti-inflammatory, so some people do take turmeric in small doses or in their food as an anti-inflammatory agent, and there’s nothing wrong with that. Again, you don’t want to take too much because too much of anything can be dangerous.

People also ask me about green tea because green teas are seen as a very healthy option for you to be drinking. Green tea can be healthy, and it can be good. It can be a good thing for you to drink occasionally, but what people don’t understand or know is that too much green tea can thin your blood and put you at a higher risk for bleeding.

Any sort of thing that you’re ingesting, make sure that you talk to your doctor so they understand exactly what you’re taking, and if there’s any possibility that it might cause any complications that you may not be aware of.

The other thing I tell all of my patients is that I believe in holistic care. I believe in healthy eating. I believe in diet and exercise as ways to stay healthy. I also believe that you need to make sure that you talk to your care team about what vitamins, what supplements, what you’re putting into your body. Because what some people don’t realize, especially if you’re on any chemotherapy or systemic therapies, some of the supplements that you might take might interact with some of the systemic therapies.

For example, if you’re on a chemotherapy agent and the supplement that you’re taking actually blocks absorption of that chemotherapy agent, it may not be as effective, or it could make it more toxic. You have to be careful that whatever you’re taking, you talk to your doctor and the pharmacy team to make sure that it’s not interacting in a negative way with the medications that you’re taking as prescribed for your cancer.

I think many people don’t realize how much exercise can impact and positively impact your life if you’re going through a cancer diagnosis. We know that exercise helps prevent heart disease and helps keep us healthy overall, but there’s studies that have shown that exercise during and after receiving treatment for your cancer can prolong your life almost as much as some standard therapies.

If your patient is taking standard therapy and feeling a little sluggish, that is completely understandable, but adding exercise into their diet can be a really impactful way to keep healthy and stay alive longer. There are many different ways to take supplements, take holistic care, and take good care of oneself.

Just make sure you’re talking about what is safe and what is not. You would not believe how many patients come to me with supplements or over-the-counter vitamins. I share stories with them of patients who took some of these supplements and, because they aren’t regulated by the FDA, some of those patients actually ended up in liver failure.

I had a patient when I was in training who took a supplement as it was “prescribed” or as it was listed on the bottle. She ended up needing a liver transplant with no other medical problems, and she was very young. Again, many of these supplements can be dangerous if they’re not taken properly and if they’re not monitored by a doctor.

The final thing I want to say that I think is so important is that doctors and patients are a team. We don’t know what happens when the patient goes home at the end of the day. We can give recommendations based on evidence and science, and our goal is to help keep you healthy, stay healthy, and stay alive as long as possible. In order to do that, we need to have an open and honest discussion, there needs to be shared decision-making, and we need to make sure the decisions being made are informed and are based on good science and evidence.

Be careful when there is a celebrity or somebody online trying to sell you a supplement, because oftentimes they have a secondary gain. They might be making money from the supplement, or they might have a brand deal with them. Patients need to be really cautious when people who aren’t their doctor are telling them different supplements and holistic things to take, because they may be selling these things for some secondary gain for themselves that doesn’t actually benefit the patient. It doesn’t mean that they’re bad people. It doesn’t mean that they’re malicious people. What it means is they have a reason for what they’re trying to sell, and your patients just need to make sure that they're thinking very carefully about what goes into their bodies.

Those are very common sources of myths about diet and exercise. I hope that you have a good doctor-patient relationship and are able to talk about these things; come up with exceptional science- and evidence-based, holistic ways to manage medical care; and find great ways to have a partnership with your care team so that the patient feels comfortable with the outcomes.

A version of this article first appeared on Medscape.com.

Gulf War veterans continue to report significantly higher rates of chronic physical and mental health conditions than their counterparts who did not deploy, according to a new analysis of data from an ongoing cohort study.

Veterans had higher rates in 22 of 47 (47%) self-reported medical conditions compared with nondeployed veterans of the same era, reported US Department of Veterans Affairs (VA) Director of Surveillance Military Environment Exposures for Health Outcomes Military Exposures Erin K. Dursa, PhD, MPH, et al in the Journal of Occupational and Environmental Medicine.

The conditions include chronic fatigue syndrome (13.7% vs 6.2%, respectively; adjusted odds ratio [aOR], 2.44), fibromyalgia (7.5% vs 4.2%, respectively; aOR, 2.05), and irritable bowel syndrome (20.8% vs 13.1%, respectively; aOR, 1.73), all of which are considered key components of Gulf War Illness (GWI), or Gulf War Syndrome. The differences were statistically significant.

“This is still happening. They're still sick with the very same things they’ve had for 34 to 35 years,” Robert Haley, MD, professor of medicine at the University of Texas Southwestern Medical Center in Dallas, told Federal Practitioner in an interview. Haley, who has studied GWI for decades, was familiar with the findings but not involved in the new research.

The US deployed nearly 700,000 troops during the Gulf War. Many troops began reporting chronic illness following deployment, during which some were exposed to oil well fires, nerve agents, pesticides, depleted uranium, and other hazards. An estimated 150,000 troops became sick, Haley said.

“Our group and a couple others started very quickly finding evidence that it was a real illness,” he said. “It was physical, not psychological.”

According to the VA, GWI encompasses chronic fatigue syndrome, fibromyalgia, functional gastrointestinal disorders, and undiagnosed illnesses with symptoms such as abnormal weight loss, fatigue, cardiovascular signs, and muscle and joint pain.

Seeking an Explanation

Research links GWI to exposure to toxic sarin gas, a nerve agent used by Iraq, according to Haley. “It’s analogous to pesticide poisoning,” he said.

Other exposures may play a role, Haley said, but he believes sarin gas is the “major cause.” Sarin gas damages mitochondria within cells, causing them to produce less energy. The actual mechanism, however, remains unknown.

“We're getting real[ly] close to the answer, but we’re not there yet,” Haley said.

A 2000 study reported survey results from 15,000 Gulf War veterans and 15,000 nondeployed counterparts. The deployed veterans had a “higher prevalence of medical conditions, symptoms, functional impairment, and healthcare utilization than Gulf Era veterans.”

The new data, compiled between 2024 and 2025, represent the Gulf War Era cohort study’s fourth follow-up. Researchers surveyed 6888 Gulf War veterans and 5489 nondeployed veterans from the same era (response rate, 46.8%). The Gulf War veterans were 79.9% male; 73.1% White, 20.0% Black, 4.4% Hispanic, and 2.6% identified as another race or ethnicity. Most served in the Army (64.3%), and most were aged 17-25 (37.5%) or 26-32 (29.5%) years at deployment.

The nondeployed veteran group had similar demographics, although the cohort was older. In addition to chronic fatigue syndrome, fibromyalgia, and irritable bowel syndrome, conditions that were significantly more common in Gulf War veterans than in nondeployed veterans included chronic obstructive pulmonary disease (aOR, 1.62), gastritis (aOR, 1.54), dermatitis (aOR, 1.45), bipolar or manic depression (aOR, 1.45), traumatic brain injury (aOR, 1.43), depression (aOR, 1.38), and alcohol or drug dependence (aOR, 1.36). The differences were statistically significant.

Multiple sclerosis (aOR, 0.42) was significantly less likely to be reported among Gulf War veterans.

The most common conditions reported overall by Gulf War veterans were hypertension (59.9%), sleep apnea (50.8%), arthritis not specified (41.9%), and depression (40.6%).

Affirming Reality

In an interview with Federal Practitioner, Beatrice Golomb, MD, PhD, a professor of medicine at the University of California San Diego and former VA staff physician who studies GWI, noted that researchers adjusted their analyses for body mass index (BMI), although “multiple studies show that weight gain is a metabolic feature of Gulf War Illness.”

This matters, Golomb said, because “if veterans develop increased BMI, and if that increase in BMI then contributes to things like diabetes, heart disease, and other outcomes, then adjusting for BMI will reduce the ability to see the causally-induced problems. For that reason, some problems are likely understated in this article.”

However, Golomb, who was not involved in the study, said the new research “supports findings from earlier studies to a considerable extent.” She added: “It affirms that Gulf War veterans, and those with Gulf War Illness, have elevations in many different health problems. These problems are real and often disabling.”

Lessons for the Clinic

Moving forward, “clinicians should be reminded that these veterans have real health problems, are legitimately affected, often in multiple ways, and deserve to be treated with the honor, respect, compassion, and seriousness they deserve," Golomb said.

In an interview with Federal Practitioner, Kimberly Sullivan, PhD, a research associate professor at Boston University School of Public Health who studies GWI, highlighted a new tool within the VA electronic health record that clinicians can use to screen eligible veterans for it. “This is a big improvement from the past when there was no easy way to track veterans with Gulf War Illness in the medical record, even for care providers trying to identify veterans for treatment studies,” said Sullivan, who was not involved in the new study.

Sullivan added that Gulf War veterans should be screened specifically for chronic fatigue syndrome, fibromyalgia, and irritable bowel syndrome.

The VA’s Health Outcomes Military Exposures program funded the study. The study authors have no disclosures. Haley discloses relationships with the Department of Defense and the VA. Golomb and Sullivan have no disclosures.

Gulf War veterans continue to report significantly higher rates of chronic physical and mental health conditions than their counterparts who did not deploy, according to a new analysis of data from an ongoing cohort study.

Veterans had higher rates in 22 of 47 (47%) self-reported medical conditions compared with nondeployed veterans of the same era, reported US Department of Veterans Affairs (VA) Director of Surveillance Military Environment Exposures for Health Outcomes Military Exposures Erin K. Dursa, PhD, MPH, et al in the Journal of Occupational and Environmental Medicine.

The conditions include chronic fatigue syndrome (13.7% vs 6.2%, respectively; adjusted odds ratio [aOR], 2.44), fibromyalgia (7.5% vs 4.2%, respectively; aOR, 2.05), and irritable bowel syndrome (20.8% vs 13.1%, respectively; aOR, 1.73), all of which are considered key components of Gulf War Illness (GWI), or Gulf War Syndrome. The differences were statistically significant.

“This is still happening. They're still sick with the very same things they’ve had for 34 to 35 years,” Robert Haley, MD, professor of medicine at the University of Texas Southwestern Medical Center in Dallas, told Federal Practitioner in an interview. Haley, who has studied GWI for decades, was familiar with the findings but not involved in the new research.

The US deployed nearly 700,000 troops during the Gulf War. Many troops began reporting chronic illness following deployment, during which some were exposed to oil well fires, nerve agents, pesticides, depleted uranium, and other hazards. An estimated 150,000 troops became sick, Haley said.

“Our group and a couple others started very quickly finding evidence that it was a real illness,” he said. “It was physical, not psychological.”

According to the VA, GWI encompasses chronic fatigue syndrome, fibromyalgia, functional gastrointestinal disorders, and undiagnosed illnesses with symptoms such as abnormal weight loss, fatigue, cardiovascular signs, and muscle and joint pain.

Seeking an Explanation

Research links GWI to exposure to toxic sarin gas, a nerve agent used by Iraq, according to Haley. “It’s analogous to pesticide poisoning,” he said.

Other exposures may play a role, Haley said, but he believes sarin gas is the “major cause.” Sarin gas damages mitochondria within cells, causing them to produce less energy. The actual mechanism, however, remains unknown.

“We're getting real[ly] close to the answer, but we’re not there yet,” Haley said.

A 2000 study reported survey results from 15,000 Gulf War veterans and 15,000 nondeployed counterparts. The deployed veterans had a “higher prevalence of medical conditions, symptoms, functional impairment, and healthcare utilization than Gulf Era veterans.”

The new data, compiled between 2024 and 2025, represent the Gulf War Era cohort study’s fourth follow-up. Researchers surveyed 6888 Gulf War veterans and 5489 nondeployed veterans from the same era (response rate, 46.8%). The Gulf War veterans were 79.9% male; 73.1% White, 20.0% Black, 4.4% Hispanic, and 2.6% identified as another race or ethnicity. Most served in the Army (64.3%), and most were aged 17-25 (37.5%) or 26-32 (29.5%) years at deployment.

The nondeployed veteran group had similar demographics, although the cohort was older. In addition to chronic fatigue syndrome, fibromyalgia, and irritable bowel syndrome, conditions that were significantly more common in Gulf War veterans than in nondeployed veterans included chronic obstructive pulmonary disease (aOR, 1.62), gastritis (aOR, 1.54), dermatitis (aOR, 1.45), bipolar or manic depression (aOR, 1.45), traumatic brain injury (aOR, 1.43), depression (aOR, 1.38), and alcohol or drug dependence (aOR, 1.36). The differences were statistically significant.

Multiple sclerosis (aOR, 0.42) was significantly less likely to be reported among Gulf War veterans.

The most common conditions reported overall by Gulf War veterans were hypertension (59.9%), sleep apnea (50.8%), arthritis not specified (41.9%), and depression (40.6%).

Affirming Reality

In an interview with Federal Practitioner, Beatrice Golomb, MD, PhD, a professor of medicine at the University of California San Diego and former VA staff physician who studies GWI, noted that researchers adjusted their analyses for body mass index (BMI), although “multiple studies show that weight gain is a metabolic feature of Gulf War Illness.”

This matters, Golomb said, because “if veterans develop increased BMI, and if that increase in BMI then contributes to things like diabetes, heart disease, and other outcomes, then adjusting for BMI will reduce the ability to see the causally-induced problems. For that reason, some problems are likely understated in this article.”

However, Golomb, who was not involved in the study, said the new research “supports findings from earlier studies to a considerable extent.” She added: “It affirms that Gulf War veterans, and those with Gulf War Illness, have elevations in many different health problems. These problems are real and often disabling.”

Lessons for the Clinic

Moving forward, “clinicians should be reminded that these veterans have real health problems, are legitimately affected, often in multiple ways, and deserve to be treated with the honor, respect, compassion, and seriousness they deserve," Golomb said.

In an interview with Federal Practitioner, Kimberly Sullivan, PhD, a research associate professor at Boston University School of Public Health who studies GWI, highlighted a new tool within the VA electronic health record that clinicians can use to screen eligible veterans for it. “This is a big improvement from the past when there was no easy way to track veterans with Gulf War Illness in the medical record, even for care providers trying to identify veterans for treatment studies,” said Sullivan, who was not involved in the new study.

Sullivan added that Gulf War veterans should be screened specifically for chronic fatigue syndrome, fibromyalgia, and irritable bowel syndrome.

The VA’s Health Outcomes Military Exposures program funded the study. The study authors have no disclosures. Haley discloses relationships with the Department of Defense and the VA. Golomb and Sullivan have no disclosures.

Gulf War veterans continue to report significantly higher rates of chronic physical and mental health conditions than their counterparts who did not deploy, according to a new analysis of data from an ongoing cohort study.

Veterans had higher rates in 22 of 47 (47%) self-reported medical conditions compared with nondeployed veterans of the same era, reported US Department of Veterans Affairs (VA) Director of Surveillance Military Environment Exposures for Health Outcomes Military Exposures Erin K. Dursa, PhD, MPH, et al in the Journal of Occupational and Environmental Medicine.

The conditions include chronic fatigue syndrome (13.7% vs 6.2%, respectively; adjusted odds ratio [aOR], 2.44), fibromyalgia (7.5% vs 4.2%, respectively; aOR, 2.05), and irritable bowel syndrome (20.8% vs 13.1%, respectively; aOR, 1.73), all of which are considered key components of Gulf War Illness (GWI), or Gulf War Syndrome. The differences were statistically significant.

“This is still happening. They're still sick with the very same things they’ve had for 34 to 35 years,” Robert Haley, MD, professor of medicine at the University of Texas Southwestern Medical Center in Dallas, told Federal Practitioner in an interview. Haley, who has studied GWI for decades, was familiar with the findings but not involved in the new research.

The US deployed nearly 700,000 troops during the Gulf War. Many troops began reporting chronic illness following deployment, during which some were exposed to oil well fires, nerve agents, pesticides, depleted uranium, and other hazards. An estimated 150,000 troops became sick, Haley said.

“Our group and a couple others started very quickly finding evidence that it was a real illness,” he said. “It was physical, not psychological.”

According to the VA, GWI encompasses chronic fatigue syndrome, fibromyalgia, functional gastrointestinal disorders, and undiagnosed illnesses with symptoms such as abnormal weight loss, fatigue, cardiovascular signs, and muscle and joint pain.

Seeking an Explanation

Research links GWI to exposure to toxic sarin gas, a nerve agent used by Iraq, according to Haley. “It’s analogous to pesticide poisoning,” he said.

Other exposures may play a role, Haley said, but he believes sarin gas is the “major cause.” Sarin gas damages mitochondria within cells, causing them to produce less energy. The actual mechanism, however, remains unknown.

“We're getting real[ly] close to the answer, but we’re not there yet,” Haley said.

A 2000 study reported survey results from 15,000 Gulf War veterans and 15,000 nondeployed counterparts. The deployed veterans had a “higher prevalence of medical conditions, symptoms, functional impairment, and healthcare utilization than Gulf Era veterans.”

The new data, compiled between 2024 and 2025, represent the Gulf War Era cohort study’s fourth follow-up. Researchers surveyed 6888 Gulf War veterans and 5489 nondeployed veterans from the same era (response rate, 46.8%). The Gulf War veterans were 79.9% male; 73.1% White, 20.0% Black, 4.4% Hispanic, and 2.6% identified as another race or ethnicity. Most served in the Army (64.3%), and most were aged 17-25 (37.5%) or 26-32 (29.5%) years at deployment.

The nondeployed veteran group had similar demographics, although the cohort was older. In addition to chronic fatigue syndrome, fibromyalgia, and irritable bowel syndrome, conditions that were significantly more common in Gulf War veterans than in nondeployed veterans included chronic obstructive pulmonary disease (aOR, 1.62), gastritis (aOR, 1.54), dermatitis (aOR, 1.45), bipolar or manic depression (aOR, 1.45), traumatic brain injury (aOR, 1.43), depression (aOR, 1.38), and alcohol or drug dependence (aOR, 1.36). The differences were statistically significant.

Multiple sclerosis (aOR, 0.42) was significantly less likely to be reported among Gulf War veterans.

The most common conditions reported overall by Gulf War veterans were hypertension (59.9%), sleep apnea (50.8%), arthritis not specified (41.9%), and depression (40.6%).

Affirming Reality

In an interview with Federal Practitioner, Beatrice Golomb, MD, PhD, a professor of medicine at the University of California San Diego and former VA staff physician who studies GWI, noted that researchers adjusted their analyses for body mass index (BMI), although “multiple studies show that weight gain is a metabolic feature of Gulf War Illness.”

This matters, Golomb said, because “if veterans develop increased BMI, and if that increase in BMI then contributes to things like diabetes, heart disease, and other outcomes, then adjusting for BMI will reduce the ability to see the causally-induced problems. For that reason, some problems are likely understated in this article.”

However, Golomb, who was not involved in the study, said the new research “supports findings from earlier studies to a considerable extent.” She added: “It affirms that Gulf War veterans, and those with Gulf War Illness, have elevations in many different health problems. These problems are real and often disabling.”

Lessons for the Clinic

Moving forward, “clinicians should be reminded that these veterans have real health problems, are legitimately affected, often in multiple ways, and deserve to be treated with the honor, respect, compassion, and seriousness they deserve," Golomb said.

In an interview with Federal Practitioner, Kimberly Sullivan, PhD, a research associate professor at Boston University School of Public Health who studies GWI, highlighted a new tool within the VA electronic health record that clinicians can use to screen eligible veterans for it. “This is a big improvement from the past when there was no easy way to track veterans with Gulf War Illness in the medical record, even for care providers trying to identify veterans for treatment studies,” said Sullivan, who was not involved in the new study.

Sullivan added that Gulf War veterans should be screened specifically for chronic fatigue syndrome, fibromyalgia, and irritable bowel syndrome.

The VA’s Health Outcomes Military Exposures program funded the study. The study authors have no disclosures. Haley discloses relationships with the Department of Defense and the VA. Golomb and Sullivan have no disclosures.

Unlike Black individuals in the general population who experience disparities in medical care, Black veterans with several types of cancer were just as likely to survive as non-Black veterans, according to a recently published systematic review and meta-analysis. For some cancers, Black veterans reported even better survival outcomes.

The analysis, published by Drew Moghanaki, MD, MPH, Chief of Thoracic Oncology, Department of Radiation Oncology, University of California, Los Angeles, and codirector, Veterans Affairs (VA) Greater Los Angeles Lung Precision Oncology Program, et al, in JAMA Network Open, found that Black veterans had better overall survival (OS) than non-Black veterans (hazard ratio [HR], 0.93) and cancer-specific survival (CSS) (HR, 0.94).

Black veterans had better survival rates for bladder, laryngeal, lung, oropharyngeal, prostate, and plasma cell cancers.

“Once there's equal access to cancer care, we no longer see the purported biological differences that people think are linked to race,” Moghanaki said in an interview with Federal Practitioner.

General Population: Racial Gap

“We've known for decades that there are differences in cancer outcomes for Black people in the US vs non-Black people,” Moghanaki said.

While the gaps in cancer mortality rates between Blacks and Whites have decreased over the last 25 years, colorectal cancer mortality remained 21% higher among Black people than White people in 2024, according to a report from the American Association for Cancer Research.

The association also reported that overall cancer mortality is 13% higher among Black men than White men, despite only 3% higher incidence. Separately, breast cancer mortality in Black women is 35% higher than in White women, even though their incidence is 6% lower.

Research suggests these disparities exist “not so much because of biology, but instead because of the structural and socioeconomic differences that many Black Americans live with in this country,” Moghanaki said.

The VA is different, he said, because “once you’re eligible for VA health care benefits, you’re getting essentially the same health care regardless of skin color.”

For the study, the researchers sought to determine whether the advantages of the VA system were reflected in cancer survival outcomes.

Methodology: Reviewing 34 Years of Data

The authors analyzed 39 studies including 603,256 veterans treated for cancer between 1983 and 2017. Study sizes ranged from 117 to 145,678 subjects. On average, 29.0% (range, 8.9%-55.0%) of participants were Black. Some studies specifically compared Black and White veterans, but the overall meta-analysis compared Black veterans with non-Black veterans.

A total of 29 studies had sufficient data for meta-analyses, including 20 (69%) focused on prostate cancer, 2 (7%) each on non-small cell lung cancer (NSCLC) and pancreatic cancer, and 1 each (3%) on head and neck cancers, esophageal cancer, bladder cancer, breast cancer, and myeloma.

Worse Outcomes for Black Veterans Were Rare

Of the 27 studies that examined OS, most (63%) found similar survival rates between Black and non-Black veterans, with 9 reporting higher survival for Black veterans and only 1 reporting higher survival for non-Black veterans. Among the 17 studies that evaluated CSS, those numbers were 13, 3, and 1, respectively.

Among veterans with prostate cancer, the pooled HRs for Blacks vs non-Blacks were 0.94 for OS and 0.90 for CSS. For NSCLC, they were 0.92 and 0.98, respectively.

The study notes that Black veterans may represent “a positively selected subgroup with respect to health, resilience, or other unmeasured factors, a phenomenon that has been described as a ‘healthy Black veteran effect.”

Other limitations include the high number of prostate cancer studies in the meta-analysis, while several leading causes of cancer death in the US (colorectal, pancreatic, breast), were underrepresented or absent. The analysis also included few women.

The differences in outcomes by race between the VA and general population may be due to the VA’s commitment to providing access to a full range of care and support, Moghanaki said.

“Veterans who are eligible for VA health care benefits also receive housing support, transportation benefits, caregiver support, social services, and mental health services that is often important for anyone with a diagnosis of cancer,” he said, before adding, “The VA’s footprint is large and able to ensure access to care regardless of where veterans live.”

In an interview with Federal Practitioner, Electra D. Paskett, PhD, professor of cancer research and director of the Division of Cancer Prevention and Control at The Ohio State University College of Medicine, who was not involved in the study, said the findings show that “equal access to state-of-the-art care in a timely manner produces good outcomes.”

She offered this message to VA clinicians: “Keep doing what you are doing!”

Moghanaki reported relationships with Bristol Myers Squibb Foundation and Varian Medical Systems, and he was the sole recipient of funding for the study from the Stanley Iezman and Nancy Stark Endowment for Thoracic Radiation Oncology Research at the David Geffen School of Medicine/University of California, Los Angeles. Some other authors reported additional disclosures. Paskett reports no disclosures.

Unlike Black individuals in the general population who experience disparities in medical care, Black veterans with several types of cancer were just as likely to survive as non-Black veterans, according to a recently published systematic review and meta-analysis. For some cancers, Black veterans reported even better survival outcomes.

The analysis, published by Drew Moghanaki, MD, MPH, Chief of Thoracic Oncology, Department of Radiation Oncology, University of California, Los Angeles, and codirector, Veterans Affairs (VA) Greater Los Angeles Lung Precision Oncology Program, et al, in JAMA Network Open, found that Black veterans had better overall survival (OS) than non-Black veterans (hazard ratio [HR], 0.93) and cancer-specific survival (CSS) (HR, 0.94).

Black veterans had better survival rates for bladder, laryngeal, lung, oropharyngeal, prostate, and plasma cell cancers.

“Once there's equal access to cancer care, we no longer see the purported biological differences that people think are linked to race,” Moghanaki said in an interview with Federal Practitioner.

General Population: Racial Gap

“We've known for decades that there are differences in cancer outcomes for Black people in the US vs non-Black people,” Moghanaki said.

While the gaps in cancer mortality rates between Blacks and Whites have decreased over the last 25 years, colorectal cancer mortality remained 21% higher among Black people than White people in 2024, according to a report from the American Association for Cancer Research.

The association also reported that overall cancer mortality is 13% higher among Black men than White men, despite only 3% higher incidence. Separately, breast cancer mortality in Black women is 35% higher than in White women, even though their incidence is 6% lower.

Research suggests these disparities exist “not so much because of biology, but instead because of the structural and socioeconomic differences that many Black Americans live with in this country,” Moghanaki said.

The VA is different, he said, because “once you’re eligible for VA health care benefits, you’re getting essentially the same health care regardless of skin color.”

For the study, the researchers sought to determine whether the advantages of the VA system were reflected in cancer survival outcomes.

Methodology: Reviewing 34 Years of Data

The authors analyzed 39 studies including 603,256 veterans treated for cancer between 1983 and 2017. Study sizes ranged from 117 to 145,678 subjects. On average, 29.0% (range, 8.9%-55.0%) of participants were Black. Some studies specifically compared Black and White veterans, but the overall meta-analysis compared Black veterans with non-Black veterans.

A total of 29 studies had sufficient data for meta-analyses, including 20 (69%) focused on prostate cancer, 2 (7%) each on non-small cell lung cancer (NSCLC) and pancreatic cancer, and 1 each (3%) on head and neck cancers, esophageal cancer, bladder cancer, breast cancer, and myeloma.

Worse Outcomes for Black Veterans Were Rare

Of the 27 studies that examined OS, most (63%) found similar survival rates between Black and non-Black veterans, with 9 reporting higher survival for Black veterans and only 1 reporting higher survival for non-Black veterans. Among the 17 studies that evaluated CSS, those numbers were 13, 3, and 1, respectively.

Among veterans with prostate cancer, the pooled HRs for Blacks vs non-Blacks were 0.94 for OS and 0.90 for CSS. For NSCLC, they were 0.92 and 0.98, respectively.

The study notes that Black veterans may represent “a positively selected subgroup with respect to health, resilience, or other unmeasured factors, a phenomenon that has been described as a ‘healthy Black veteran effect.”

Other limitations include the high number of prostate cancer studies in the meta-analysis, while several leading causes of cancer death in the US (colorectal, pancreatic, breast), were underrepresented or absent. The analysis also included few women.

The differences in outcomes by race between the VA and general population may be due to the VA’s commitment to providing access to a full range of care and support, Moghanaki said.

“Veterans who are eligible for VA health care benefits also receive housing support, transportation benefits, caregiver support, social services, and mental health services that is often important for anyone with a diagnosis of cancer,” he said, before adding, “The VA’s footprint is large and able to ensure access to care regardless of where veterans live.”

In an interview with Federal Practitioner, Electra D. Paskett, PhD, professor of cancer research and director of the Division of Cancer Prevention and Control at The Ohio State University College of Medicine, who was not involved in the study, said the findings show that “equal access to state-of-the-art care in a timely manner produces good outcomes.”

She offered this message to VA clinicians: “Keep doing what you are doing!”

Moghanaki reported relationships with Bristol Myers Squibb Foundation and Varian Medical Systems, and he was the sole recipient of funding for the study from the Stanley Iezman and Nancy Stark Endowment for Thoracic Radiation Oncology Research at the David Geffen School of Medicine/University of California, Los Angeles. Some other authors reported additional disclosures. Paskett reports no disclosures.

Unlike Black individuals in the general population who experience disparities in medical care, Black veterans with several types of cancer were just as likely to survive as non-Black veterans, according to a recently published systematic review and meta-analysis. For some cancers, Black veterans reported even better survival outcomes.

The analysis, published by Drew Moghanaki, MD, MPH, Chief of Thoracic Oncology, Department of Radiation Oncology, University of California, Los Angeles, and codirector, Veterans Affairs (VA) Greater Los Angeles Lung Precision Oncology Program, et al, in JAMA Network Open, found that Black veterans had better overall survival (OS) than non-Black veterans (hazard ratio [HR], 0.93) and cancer-specific survival (CSS) (HR, 0.94).

Black veterans had better survival rates for bladder, laryngeal, lung, oropharyngeal, prostate, and plasma cell cancers.

“Once there's equal access to cancer care, we no longer see the purported biological differences that people think are linked to race,” Moghanaki said in an interview with Federal Practitioner.

General Population: Racial Gap

“We've known for decades that there are differences in cancer outcomes for Black people in the US vs non-Black people,” Moghanaki said.

While the gaps in cancer mortality rates between Blacks and Whites have decreased over the last 25 years, colorectal cancer mortality remained 21% higher among Black people than White people in 2024, according to a report from the American Association for Cancer Research.

The association also reported that overall cancer mortality is 13% higher among Black men than White men, despite only 3% higher incidence. Separately, breast cancer mortality in Black women is 35% higher than in White women, even though their incidence is 6% lower.

Research suggests these disparities exist “not so much because of biology, but instead because of the structural and socioeconomic differences that many Black Americans live with in this country,” Moghanaki said.

The VA is different, he said, because “once you’re eligible for VA health care benefits, you’re getting essentially the same health care regardless of skin color.”

For the study, the researchers sought to determine whether the advantages of the VA system were reflected in cancer survival outcomes.

Methodology: Reviewing 34 Years of Data

The authors analyzed 39 studies including 603,256 veterans treated for cancer between 1983 and 2017. Study sizes ranged from 117 to 145,678 subjects. On average, 29.0% (range, 8.9%-55.0%) of participants were Black. Some studies specifically compared Black and White veterans, but the overall meta-analysis compared Black veterans with non-Black veterans.

A total of 29 studies had sufficient data for meta-analyses, including 20 (69%) focused on prostate cancer, 2 (7%) each on non-small cell lung cancer (NSCLC) and pancreatic cancer, and 1 each (3%) on head and neck cancers, esophageal cancer, bladder cancer, breast cancer, and myeloma.

Worse Outcomes for Black Veterans Were Rare

Of the 27 studies that examined OS, most (63%) found similar survival rates between Black and non-Black veterans, with 9 reporting higher survival for Black veterans and only 1 reporting higher survival for non-Black veterans. Among the 17 studies that evaluated CSS, those numbers were 13, 3, and 1, respectively.

Among veterans with prostate cancer, the pooled HRs for Blacks vs non-Blacks were 0.94 for OS and 0.90 for CSS. For NSCLC, they were 0.92 and 0.98, respectively.

The study notes that Black veterans may represent “a positively selected subgroup with respect to health, resilience, or other unmeasured factors, a phenomenon that has been described as a ‘healthy Black veteran effect.”

Other limitations include the high number of prostate cancer studies in the meta-analysis, while several leading causes of cancer death in the US (colorectal, pancreatic, breast), were underrepresented or absent. The analysis also included few women.

The differences in outcomes by race between the VA and general population may be due to the VA’s commitment to providing access to a full range of care and support, Moghanaki said.

“Veterans who are eligible for VA health care benefits also receive housing support, transportation benefits, caregiver support, social services, and mental health services that is often important for anyone with a diagnosis of cancer,” he said, before adding, “The VA’s footprint is large and able to ensure access to care regardless of where veterans live.”

In an interview with Federal Practitioner, Electra D. Paskett, PhD, professor of cancer research and director of the Division of Cancer Prevention and Control at The Ohio State University College of Medicine, who was not involved in the study, said the findings show that “equal access to state-of-the-art care in a timely manner produces good outcomes.”

She offered this message to VA clinicians: “Keep doing what you are doing!”

Moghanaki reported relationships with Bristol Myers Squibb Foundation and Varian Medical Systems, and he was the sole recipient of funding for the study from the Stanley Iezman and Nancy Stark Endowment for Thoracic Radiation Oncology Research at the David Geffen School of Medicine/University of California, Los Angeles. Some other authors reported additional disclosures. Paskett reports no disclosures.

Interviews with a small sample of veterans seeking disability compensation for military sexual trauma (MST) reveal the US Department of Veterans Affairs (VA) claims process may retraumatize victims by invalidating their experiences and forcing them to relive their assaults, according to a new report.

For some victims, “retraumatization and invalidation contributed to perceptions of VA-enacted institutional betrayal, which impacted their trust in and likelihood of using VA health care,” report Aliya R. Webermann, PhD, of VA Connecticut Healthcare System and Yale School of Medicine, et al in the Journal of Trauma & Dissociation.

One participant recalled that having to write about her trauma “was a big trigger. It was hard. When I was typing it, in the back of my mind, that’s all I could remember. It’s like going through this whole thing all over again.” Another described writing her statement as “brutal.”

Clinical psychologist Anne P. DePrince, PhD, a professor at the University of Denver not involved in the research, said in an interview with Federal Practitioner that the findings “add to a growing number of studies showing that institutional policies can be more than just red tape.

“Policies and procedures, and how those are implemented by staff, can have real consequences for survivors of intimate abuse, adding to the psychological burden they bear.”

The Burden of Military Sexual Trauma

According to a 2016 meta-analysis, 15.7% of US service members and veterans have experienced MST when measured as combined sexual assault and harassment. Viewed separately, assault was reported by 13.9%, including 23.6% of women and 1.9% of men, while harassment was reported by 31.2%, including 52.5% of women and 8.9% of men. The VA defines MST as “sexual assault or threatening sexual harassment experienced during military service.” MST has been linked to posttraumatic stress disorder (PTSD), substance misuse, suicidality, and other adverse outcomes, the new study notes.

Veterans are eligible for service-connected disability compensation for any condition, such as PTSD precipitated by MST, the study authors write, but patients must provide evidence of the trauma and show that the MST caused their disability.

A 2024 analysis found that MST-related PTSD claims for disability were more likely to be denied than combat-related PTSD claims (27.6% vs 18.2%, respectively).

‘I Had to Relive All of That Again’

The researchers recruited 15 victims of MST for interviews in 2024 (73% women, 60% White, 60% Army, mean age 52.6 years). Most served prior to 9/11 and lived in a single state.

In the conversations, which addressed the MST-related claims process, participants described being forced to repeat their stories. “When it was time for me to sit down and write, I had to relive all of that again. It was kind of rough,” one participant said.

Four veterans said being asked to recall their traumas was especially difficult when they were already doing so as part of treatment: “Through therapy, I gotta keep telling the same thing over and over, and it gets old . . . isn’t once enough?” said one veteran, while a male veteran said the experience was “like a knife going into your gut all the time.”

Victims Told They Don’t Fit the Mold

Veterans also described stress during the process.

“It would make me shut down,” said one participant about trying to appeal an initial 10% disability rating. “I used to drink a lot. It took a toll not just on me, but on my relationship.”

Two of the 15 veterans were denied disability, and they described reading their files as traumatic.

“When I read what they put, sometimes I feel as if I’m being assaulted all over again,” one said.

Additionally, some veterans “described being confronted when their lives did not follow a simple pattern of behavior before and after their MST,” the authors write.

One female veteran said: “They were like, ‘But you continued to perform so well and do well in class and still be able to be a military rock star.’ People deal with trauma in different ways. I don’t have to do a 180 and s— the bed to show this is impacting me.”

In other comments, veterans spoke about racial divides—the 2024 analysis found Black veterans were more likely to be denied MST-related disability claims than White veterans—“the living hell” of denied claims, and perceptions of the VA as “an institutional adversary that was distrustful and untrustworthy.”

DePrince said the study highlights the importance of preparing trauma survivors for what they will experience in the claims process.

“My team has learned from survivors across multiple studies just how important clear and accurate information is when trying to navigate legal, health, and social service systems,” she said. “Unfortunately, many survivors find it hard to get clear and accurate information about these processes, which adds to the stress of trying to access much-needed care and resources after trauma.”

Clinical psychologist Sheela Raja, PhD, an associate professor at the University of Illinois Chicago who studies how trauma affects survivors, agreed with DePrince in an interview with Federal Practitioner.

“When survivors know what’s coming, they can prepare, and that alone can make a huge difference,” said Raja, who was familiar with the study findings.

Raja, who has written books about trauma and PTSD, called research such as this “essential.” These reports bring “survivors’ voices forward and help us understand not just their experiences, but the symptoms and stress that can come from navigating systems that weren’t designed with trauma in mind.”

The VA funded the study. The authors have no disclosures. DePrince is associate editor of the Journal of Trauma and Dissociation, where the study appeared, but she was not involved in the review of the paper. Raja has no disclosures.

Interviews with a small sample of veterans seeking disability compensation for military sexual trauma (MST) reveal the US Department of Veterans Affairs (VA) claims process may retraumatize victims by invalidating their experiences and forcing them to relive their assaults, according to a new report.

For some victims, “retraumatization and invalidation contributed to perceptions of VA-enacted institutional betrayal, which impacted their trust in and likelihood of using VA health care,” report Aliya R. Webermann, PhD, of VA Connecticut Healthcare System and Yale School of Medicine, et al in the Journal of Trauma & Dissociation.

One participant recalled that having to write about her trauma “was a big trigger. It was hard. When I was typing it, in the back of my mind, that’s all I could remember. It’s like going through this whole thing all over again.” Another described writing her statement as “brutal.”

Clinical psychologist Anne P. DePrince, PhD, a professor at the University of Denver not involved in the research, said in an interview with Federal Practitioner that the findings “add to a growing number of studies showing that institutional policies can be more than just red tape.

“Policies and procedures, and how those are implemented by staff, can have real consequences for survivors of intimate abuse, adding to the psychological burden they bear.”

The Burden of Military Sexual Trauma

According to a 2016 meta-analysis, 15.7% of US service members and veterans have experienced MST when measured as combined sexual assault and harassment. Viewed separately, assault was reported by 13.9%, including 23.6% of women and 1.9% of men, while harassment was reported by 31.2%, including 52.5% of women and 8.9% of men. The VA defines MST as “sexual assault or threatening sexual harassment experienced during military service.” MST has been linked to posttraumatic stress disorder (PTSD), substance misuse, suicidality, and other adverse outcomes, the new study notes.

Veterans are eligible for service-connected disability compensation for any condition, such as PTSD precipitated by MST, the study authors write, but patients must provide evidence of the trauma and show that the MST caused their disability.

A 2024 analysis found that MST-related PTSD claims for disability were more likely to be denied than combat-related PTSD claims (27.6% vs 18.2%, respectively).

‘I Had to Relive All of That Again’

The researchers recruited 15 victims of MST for interviews in 2024 (73% women, 60% White, 60% Army, mean age 52.6 years). Most served prior to 9/11 and lived in a single state.

In the conversations, which addressed the MST-related claims process, participants described being forced to repeat their stories. “When it was time for me to sit down and write, I had to relive all of that again. It was kind of rough,” one participant said.

Four veterans said being asked to recall their traumas was especially difficult when they were already doing so as part of treatment: “Through therapy, I gotta keep telling the same thing over and over, and it gets old . . . isn’t once enough?” said one veteran, while a male veteran said the experience was “like a knife going into your gut all the time.”

Victims Told They Don’t Fit the Mold

Veterans also described stress during the process.

“It would make me shut down,” said one participant about trying to appeal an initial 10% disability rating. “I used to drink a lot. It took a toll not just on me, but on my relationship.”

Two of the 15 veterans were denied disability, and they described reading their files as traumatic.

“When I read what they put, sometimes I feel as if I’m being assaulted all over again,” one said.

Additionally, some veterans “described being confronted when their lives did not follow a simple pattern of behavior before and after their MST,” the authors write.

One female veteran said: “They were like, ‘But you continued to perform so well and do well in class and still be able to be a military rock star.’ People deal with trauma in different ways. I don’t have to do a 180 and s— the bed to show this is impacting me.”

In other comments, veterans spoke about racial divides—the 2024 analysis found Black veterans were more likely to be denied MST-related disability claims than White veterans—“the living hell” of denied claims, and perceptions of the VA as “an institutional adversary that was distrustful and untrustworthy.”

DePrince said the study highlights the importance of preparing trauma survivors for what they will experience in the claims process.

“My team has learned from survivors across multiple studies just how important clear and accurate information is when trying to navigate legal, health, and social service systems,” she said. “Unfortunately, many survivors find it hard to get clear and accurate information about these processes, which adds to the stress of trying to access much-needed care and resources after trauma.”

Clinical psychologist Sheela Raja, PhD, an associate professor at the University of Illinois Chicago who studies how trauma affects survivors, agreed with DePrince in an interview with Federal Practitioner.

“When survivors know what’s coming, they can prepare, and that alone can make a huge difference,” said Raja, who was familiar with the study findings.

Raja, who has written books about trauma and PTSD, called research such as this “essential.” These reports bring “survivors’ voices forward and help us understand not just their experiences, but the symptoms and stress that can come from navigating systems that weren’t designed with trauma in mind.”

The VA funded the study. The authors have no disclosures. DePrince is associate editor of the Journal of Trauma and Dissociation, where the study appeared, but she was not involved in the review of the paper. Raja has no disclosures.

Interviews with a small sample of veterans seeking disability compensation for military sexual trauma (MST) reveal the US Department of Veterans Affairs (VA) claims process may retraumatize victims by invalidating their experiences and forcing them to relive their assaults, according to a new report.

For some victims, “retraumatization and invalidation contributed to perceptions of VA-enacted institutional betrayal, which impacted their trust in and likelihood of using VA health care,” report Aliya R. Webermann, PhD, of VA Connecticut Healthcare System and Yale School of Medicine, et al in the Journal of Trauma & Dissociation.

One participant recalled that having to write about her trauma “was a big trigger. It was hard. When I was typing it, in the back of my mind, that’s all I could remember. It’s like going through this whole thing all over again.” Another described writing her statement as “brutal.”

Clinical psychologist Anne P. DePrince, PhD, a professor at the University of Denver not involved in the research, said in an interview with Federal Practitioner that the findings “add to a growing number of studies showing that institutional policies can be more than just red tape.

“Policies and procedures, and how those are implemented by staff, can have real consequences for survivors of intimate abuse, adding to the psychological burden they bear.”

The Burden of Military Sexual Trauma

According to a 2016 meta-analysis, 15.7% of US service members and veterans have experienced MST when measured as combined sexual assault and harassment. Viewed separately, assault was reported by 13.9%, including 23.6% of women and 1.9% of men, while harassment was reported by 31.2%, including 52.5% of women and 8.9% of men. The VA defines MST as “sexual assault or threatening sexual harassment experienced during military service.” MST has been linked to posttraumatic stress disorder (PTSD), substance misuse, suicidality, and other adverse outcomes, the new study notes.

Veterans are eligible for service-connected disability compensation for any condition, such as PTSD precipitated by MST, the study authors write, but patients must provide evidence of the trauma and show that the MST caused their disability.

A 2024 analysis found that MST-related PTSD claims for disability were more likely to be denied than combat-related PTSD claims (27.6% vs 18.2%, respectively).

‘I Had to Relive All of That Again’

The researchers recruited 15 victims of MST for interviews in 2024 (73% women, 60% White, 60% Army, mean age 52.6 years). Most served prior to 9/11 and lived in a single state.

In the conversations, which addressed the MST-related claims process, participants described being forced to repeat their stories. “When it was time for me to sit down and write, I had to relive all of that again. It was kind of rough,” one participant said.

Four veterans said being asked to recall their traumas was especially difficult when they were already doing so as part of treatment: “Through therapy, I gotta keep telling the same thing over and over, and it gets old . . . isn’t once enough?” said one veteran, while a male veteran said the experience was “like a knife going into your gut all the time.”

Victims Told They Don’t Fit the Mold

Veterans also described stress during the process.

“It would make me shut down,” said one participant about trying to appeal an initial 10% disability rating. “I used to drink a lot. It took a toll not just on me, but on my relationship.”

Two of the 15 veterans were denied disability, and they described reading their files as traumatic.

“When I read what they put, sometimes I feel as if I’m being assaulted all over again,” one said.

Additionally, some veterans “described being confronted when their lives did not follow a simple pattern of behavior before and after their MST,” the authors write.

One female veteran said: “They were like, ‘But you continued to perform so well and do well in class and still be able to be a military rock star.’ People deal with trauma in different ways. I don’t have to do a 180 and s— the bed to show this is impacting me.”

In other comments, veterans spoke about racial divides—the 2024 analysis found Black veterans were more likely to be denied MST-related disability claims than White veterans—“the living hell” of denied claims, and perceptions of the VA as “an institutional adversary that was distrustful and untrustworthy.”

DePrince said the study highlights the importance of preparing trauma survivors for what they will experience in the claims process.

“My team has learned from survivors across multiple studies just how important clear and accurate information is when trying to navigate legal, health, and social service systems,” she said. “Unfortunately, many survivors find it hard to get clear and accurate information about these processes, which adds to the stress of trying to access much-needed care and resources after trauma.”

Clinical psychologist Sheela Raja, PhD, an associate professor at the University of Illinois Chicago who studies how trauma affects survivors, agreed with DePrince in an interview with Federal Practitioner.

“When survivors know what’s coming, they can prepare, and that alone can make a huge difference,” said Raja, who was familiar with the study findings.

Raja, who has written books about trauma and PTSD, called research such as this “essential.” These reports bring “survivors’ voices forward and help us understand not just their experiences, but the symptoms and stress that can come from navigating systems that weren’t designed with trauma in mind.”

The VA funded the study. The authors have no disclosures. DePrince is associate editor of the Journal of Trauma and Dissociation, where the study appeared, but she was not involved in the review of the paper. Raja has no disclosures.

Metabolic modulation may represent a viable therapeutic strategy in pulmonary hypertension (PH), report researchers from the Veterans Affairs Atlanta Healthcare System. Metformin and thiazolidinedione (TZD) were associated with significantly improved survival in their recent retrospective study of 41,670 veterans with PH and diabetes mellitus (DM). Insulin, on the other hand, was associated with increased mortality.

PH is a complex condition that may combine pulmonary vascular disease, heart disease, lung disease, and chronic thromboembolism. More than one-third of veterans with PH also have DM. Veterans are more likely than nonveterans to have chronic cardiopulmonary disease, which may make them particularly susceptible to PH. Moreover, those who served in Iraq and Afghanistan may have respiratory issues that predispose them to PH.

Another study from the same researchers assessed the influence of DM and weight, both potentially modifiable risk factors, on PH outcomes in 110,495 veterans. Veterans with PH survived an average of 3.9 years after PH diagnosis. Roughly one-third had DM, which increased risk of death by 31%. The analysis showed that lower weight and DM were strong risk factors for mortality in PH.

The most striking finding in the current study, according to the researchers, was a consistent reduction of about 20% in mortality risk associated with metformin and a similar association of 18% lower risk with TZD. The contrast with the 28% higher mortality with insulin “likely reflects fundamental differences” in how these medications influence cellular energy metabolism, they reported.

Interactions were observed between drug effects and both renal function and PH comorbidities, with metformin's protective effect enhanced in patients with lower estimated glomerular filtration rate but attenuated in those with lung disease. The associations remained “robust across multiple analytical approaches,” the researchers note.

Hemoglobin A_1c was not associated with outcome, suggesting that these therapies' association with outcome may be irrespective of their glycemic effects. The researchers say this emphasizes the complex interplay between DM and PH pathobiology, known differences in mechanisms of action of antidiabetic medications, and potentially off target impacts of these metabolically active therapies.

Metabolic modulation may represent a viable therapeutic strategy in pulmonary hypertension (PH), report researchers from the Veterans Affairs Atlanta Healthcare System. Metformin and thiazolidinedione (TZD) were associated with significantly improved survival in their recent retrospective study of 41,670 veterans with PH and diabetes mellitus (DM). Insulin, on the other hand, was associated with increased mortality.

PH is a complex condition that may combine pulmonary vascular disease, heart disease, lung disease, and chronic thromboembolism. More than one-third of veterans with PH also have DM. Veterans are more likely than nonveterans to have chronic cardiopulmonary disease, which may make them particularly susceptible to PH. Moreover, those who served in Iraq and Afghanistan may have respiratory issues that predispose them to PH.

Another study from the same researchers assessed the influence of DM and weight, both potentially modifiable risk factors, on PH outcomes in 110,495 veterans. Veterans with PH survived an average of 3.9 years after PH diagnosis. Roughly one-third had DM, which increased risk of death by 31%. The analysis showed that lower weight and DM were strong risk factors for mortality in PH.

The most striking finding in the current study, according to the researchers, was a consistent reduction of about 20% in mortality risk associated with metformin and a similar association of 18% lower risk with TZD. The contrast with the 28% higher mortality with insulin “likely reflects fundamental differences” in how these medications influence cellular energy metabolism, they reported.

Interactions were observed between drug effects and both renal function and PH comorbidities, with metformin's protective effect enhanced in patients with lower estimated glomerular filtration rate but attenuated in those with lung disease. The associations remained “robust across multiple analytical approaches,” the researchers note.

Hemoglobin A_1c was not associated with outcome, suggesting that these therapies' association with outcome may be irrespective of their glycemic effects. The researchers say this emphasizes the complex interplay between DM and PH pathobiology, known differences in mechanisms of action of antidiabetic medications, and potentially off target impacts of these metabolically active therapies.

Metabolic modulation may represent a viable therapeutic strategy in pulmonary hypertension (PH), report researchers from the Veterans Affairs Atlanta Healthcare System. Metformin and thiazolidinedione (TZD) were associated with significantly improved survival in their recent retrospective study of 41,670 veterans with PH and diabetes mellitus (DM). Insulin, on the other hand, was associated with increased mortality.

PH is a complex condition that may combine pulmonary vascular disease, heart disease, lung disease, and chronic thromboembolism. More than one-third of veterans with PH also have DM. Veterans are more likely than nonveterans to have chronic cardiopulmonary disease, which may make them particularly susceptible to PH. Moreover, those who served in Iraq and Afghanistan may have respiratory issues that predispose them to PH.

Another study from the same researchers assessed the influence of DM and weight, both potentially modifiable risk factors, on PH outcomes in 110,495 veterans. Veterans with PH survived an average of 3.9 years after PH diagnosis. Roughly one-third had DM, which increased risk of death by 31%. The analysis showed that lower weight and DM were strong risk factors for mortality in PH.

The most striking finding in the current study, according to the researchers, was a consistent reduction of about 20% in mortality risk associated with metformin and a similar association of 18% lower risk with TZD. The contrast with the 28% higher mortality with insulin “likely reflects fundamental differences” in how these medications influence cellular energy metabolism, they reported.

Interactions were observed between drug effects and both renal function and PH comorbidities, with metformin's protective effect enhanced in patients with lower estimated glomerular filtration rate but attenuated in those with lung disease. The associations remained “robust across multiple analytical approaches,” the researchers note.

Hemoglobin A_1c was not associated with outcome, suggesting that these therapies' association with outcome may be irrespective of their glycemic effects. The researchers say this emphasizes the complex interplay between DM and PH pathobiology, known differences in mechanisms of action of antidiabetic medications, and potentially off target impacts of these metabolically active therapies.

A novel wearable wrist device was feasible and effective for identifying exposure to respiratory viruses in children with asthma, based on new data presented at the American Thoracic Society 2026 International Conference.

Upper respiratory infections are the main trigger of asthma exacerbations in children, and documented racial and ethnic disparities in upper respiratory infections likely contribute to similar disparities in asthma exacerbations, noted Darlene Bhavnani, PhD, MPH, of The University of Texas at Austin, et al in their abstract.

“Understanding differences in personal exposure to upper respiratory viruses in children with asthma may help to inform these differences in the risk of viral infection and viral-associated asthma exacerbations,” Bhavnani said.

The researchers hypothesized that the use of a wearable passive air sampler could monitor respiratory virus exposure as a way to identify children at increased risk for asthma exacerbations.

Wrist devices to measure respiratory virus exposure are an emerging technology and have not been tested in children, the researchers noted. In their study, the researchers identified 25 children aged 6 to 17 years with persistent asthma who were enrolled in the TexHALE study. Participants were given a Fresh Air Clip to station in their homes and were asked to wear a wristband with a Fresh Air Clip for about 5 consecutive days. The median age of the participants was 12 years, and 64% were male.

At the end of the study period, families reported the number of days the wristband was worn, and the researchers used droplet digital polymerase chain reaction tests to quantify exposure to rhinovirus, respiratory syncytial virus (RSV), influenza A, and influenza B.

A total of 24 clips and 24 wristbands were distributed; 23 clips and all 24 wristbands were recovered for analysis. A total of 22 participants (92%) wore the wristband over a median of 6 days. Overall, approximately one-third of the wristbands (33%) tested positive for any respiratory virus, defined as > 6 copies of viral RNA, with 5 positive tests for rhinovirus, 5 for influenza B, 2 for RSV, and none for influenza A. None of the stationary home-based clips tested positive for any respiratory virus.

The researchers were not sure what to expect from the study, as personal exposure to upper respiratory viruses has not been well studied in children, said Bhavnani.

“One third of the children in our pilot study were exposed to one or more upper respiratory viruses in their personal environments, which is a substantial portion of the population studied,” she noted. “Given that viral exposure is the first step in the pathway leading to a viral infection and viral-associated asthma exacerbations, understanding differences in viral exposure could help us to learn more about how to prevent viral infection and viral-associated asthma exacerbations in children with asthma,” she said.

The study was limited by the small sample size, and larger studies are needed. However, the finding the one-third of wristbands and zero stationary clips tested positive for upper respiratory viruses suggests that clips stationed in homes may not be optimal to detect household exposures, or and that exposure outside the home may be more important for monitoring exposure to respiratory viruses in this population, and the results support the feasibility of the devices, the researchers wrote.

“Fresh Air Clips in the form of wearables can be used to understand differences in personal viral exposure and to target interventions that ultimately, would reduce the burden of viral infection and viral-associated asthma exacerbations,” Bhavnani said.

New Role for New Technology

“New technology now allows us to quantitate exposure to specific respiratory viruses on wearable and stationary devices,” said Tim Joos, MD, who practices internal medicine and pediatrics at a community health center in Seattle.

The current study findings suggest that the majority of the exposure to respiratory viruses occurs outside the home, said Joos, who was not involved in the study. Consequently, technology that can detect community exposure could be useful, although the role it may play in public health and clinical practice is yet to be determined, Joos said.

The wristbands and clips were easy to deploy and recover, which supports their value, and potential applications include testing the effectiveness of infection control strategies such as social distancing, masking, and isolation in lowering viral exposures, Joos noted.

The study received no outside funding but was supported by core funds from the Dell Medical School at the University of Texas at Austin. The researchers had no financial conflicts to disclose. Joos had no financial conflicts to disclose.

A version of this article first appeared on Medscape.com.

A novel wearable wrist device was feasible and effective for identifying exposure to respiratory viruses in children with asthma, based on new data presented at the American Thoracic Society 2026 International Conference.

Upper respiratory infections are the main trigger of asthma exacerbations in children, and documented racial and ethnic disparities in upper respiratory infections likely contribute to similar disparities in asthma exacerbations, noted Darlene Bhavnani, PhD, MPH, of The University of Texas at Austin, et al in their abstract.

“Understanding differences in personal exposure to upper respiratory viruses in children with asthma may help to inform these differences in the risk of viral infection and viral-associated asthma exacerbations,” Bhavnani said.

The researchers hypothesized that the use of a wearable passive air sampler could monitor respiratory virus exposure as a way to identify children at increased risk for asthma exacerbations.

Wrist devices to measure respiratory virus exposure are an emerging technology and have not been tested in children, the researchers noted. In their study, the researchers identified 25 children aged 6 to 17 years with persistent asthma who were enrolled in the TexHALE study. Participants were given a Fresh Air Clip to station in their homes and were asked to wear a wristband with a Fresh Air Clip for about 5 consecutive days. The median age of the participants was 12 years, and 64% were male.

At the end of the study period, families reported the number of days the wristband was worn, and the researchers used droplet digital polymerase chain reaction tests to quantify exposure to rhinovirus, respiratory syncytial virus (RSV), influenza A, and influenza B.

A total of 24 clips and 24 wristbands were distributed; 23 clips and all 24 wristbands were recovered for analysis. A total of 22 participants (92%) wore the wristband over a median of 6 days. Overall, approximately one-third of the wristbands (33%) tested positive for any respiratory virus, defined as > 6 copies of viral RNA, with 5 positive tests for rhinovirus, 5 for influenza B, 2 for RSV, and none for influenza A. None of the stationary home-based clips tested positive for any respiratory virus.

The researchers were not sure what to expect from the study, as personal exposure to upper respiratory viruses has not been well studied in children, said Bhavnani.

“One third of the children in our pilot study were exposed to one or more upper respiratory viruses in their personal environments, which is a substantial portion of the population studied,” she noted. “Given that viral exposure is the first step in the pathway leading to a viral infection and viral-associated asthma exacerbations, understanding differences in viral exposure could help us to learn more about how to prevent viral infection and viral-associated asthma exacerbations in children with asthma,” she said.

The study was limited by the small sample size, and larger studies are needed. However, the finding the one-third of wristbands and zero stationary clips tested positive for upper respiratory viruses suggests that clips stationed in homes may not be optimal to detect household exposures, or and that exposure outside the home may be more important for monitoring exposure to respiratory viruses in this population, and the results support the feasibility of the devices, the researchers wrote.

“Fresh Air Clips in the form of wearables can be used to understand differences in personal viral exposure and to target interventions that ultimately, would reduce the burden of viral infection and viral-associated asthma exacerbations,” Bhavnani said.

New Role for New Technology

“New technology now allows us to quantitate exposure to specific respiratory viruses on wearable and stationary devices,” said Tim Joos, MD, who practices internal medicine and pediatrics at a community health center in Seattle.

The current study findings suggest that the majority of the exposure to respiratory viruses occurs outside the home, said Joos, who was not involved in the study. Consequently, technology that can detect community exposure could be useful, although the role it may play in public health and clinical practice is yet to be determined, Joos said.

The wristbands and clips were easy to deploy and recover, which supports their value, and potential applications include testing the effectiveness of infection control strategies such as social distancing, masking, and isolation in lowering viral exposures, Joos noted.

The study received no outside funding but was supported by core funds from the Dell Medical School at the University of Texas at Austin. The researchers had no financial conflicts to disclose. Joos had no financial conflicts to disclose.

A version of this article first appeared on Medscape.com.

A novel wearable wrist device was feasible and effective for identifying exposure to respiratory viruses in children with asthma, based on new data presented at the American Thoracic Society 2026 International Conference.

Upper respiratory infections are the main trigger of asthma exacerbations in children, and documented racial and ethnic disparities in upper respiratory infections likely contribute to similar disparities in asthma exacerbations, noted Darlene Bhavnani, PhD, MPH, of The University of Texas at Austin, et al in their abstract.

“Understanding differences in personal exposure to upper respiratory viruses in children with asthma may help to inform these differences in the risk of viral infection and viral-associated asthma exacerbations,” Bhavnani said.

The researchers hypothesized that the use of a wearable passive air sampler could monitor respiratory virus exposure as a way to identify children at increased risk for asthma exacerbations.

Wrist devices to measure respiratory virus exposure are an emerging technology and have not been tested in children, the researchers noted. In their study, the researchers identified 25 children aged 6 to 17 years with persistent asthma who were enrolled in the TexHALE study. Participants were given a Fresh Air Clip to station in their homes and were asked to wear a wristband with a Fresh Air Clip for about 5 consecutive days. The median age of the participants was 12 years, and 64% were male.

At the end of the study period, families reported the number of days the wristband was worn, and the researchers used droplet digital polymerase chain reaction tests to quantify exposure to rhinovirus, respiratory syncytial virus (RSV), influenza A, and influenza B.

A total of 24 clips and 24 wristbands were distributed; 23 clips and all 24 wristbands were recovered for analysis. A total of 22 participants (92%) wore the wristband over a median of 6 days. Overall, approximately one-third of the wristbands (33%) tested positive for any respiratory virus, defined as > 6 copies of viral RNA, with 5 positive tests for rhinovirus, 5 for influenza B, 2 for RSV, and none for influenza A. None of the stationary home-based clips tested positive for any respiratory virus.

The researchers were not sure what to expect from the study, as personal exposure to upper respiratory viruses has not been well studied in children, said Bhavnani.

“One third of the children in our pilot study were exposed to one or more upper respiratory viruses in their personal environments, which is a substantial portion of the population studied,” she noted. “Given that viral exposure is the first step in the pathway leading to a viral infection and viral-associated asthma exacerbations, understanding differences in viral exposure could help us to learn more about how to prevent viral infection and viral-associated asthma exacerbations in children with asthma,” she said.

The study was limited by the small sample size, and larger studies are needed. However, the finding the one-third of wristbands and zero stationary clips tested positive for upper respiratory viruses suggests that clips stationed in homes may not be optimal to detect household exposures, or and that exposure outside the home may be more important for monitoring exposure to respiratory viruses in this population, and the results support the feasibility of the devices, the researchers wrote.

“Fresh Air Clips in the form of wearables can be used to understand differences in personal viral exposure and to target interventions that ultimately, would reduce the burden of viral infection and viral-associated asthma exacerbations,” Bhavnani said.

New Role for New Technology

“New technology now allows us to quantitate exposure to specific respiratory viruses on wearable and stationary devices,” said Tim Joos, MD, who practices internal medicine and pediatrics at a community health center in Seattle.

The current study findings suggest that the majority of the exposure to respiratory viruses occurs outside the home, said Joos, who was not involved in the study. Consequently, technology that can detect community exposure could be useful, although the role it may play in public health and clinical practice is yet to be determined, Joos said.

The wristbands and clips were easy to deploy and recover, which supports their value, and potential applications include testing the effectiveness of infection control strategies such as social distancing, masking, and isolation in lowering viral exposures, Joos noted.

The study received no outside funding but was supported by core funds from the Dell Medical School at the University of Texas at Austin. The researchers had no financial conflicts to disclose. Joos had no financial conflicts to disclose.

A version of this article first appeared on Medscape.com.

Disruptions caused by the COVID-19 pandemic led to an estimated 619 missed cases of colorectal cancer (CRC) diagnoses among US veterans, and those whose cases were caught had larger tumors and more malignant bowel obstructions compared with a prepandemic period, a new longitudinal study finds.

The decline in diagnoses during the pandemic (March 2020-October 2023) represented a 5% decrease in anticipated cases compared with the prepandemic period (January 2017-February 2020) reported Veterans Health Administration (VHA) researchers in the Journal of Gastrointestinal Surgery.

Meanwhile, the percentage of cancers > 4 cm increased from 48.9% to 57.3% from the prepandemic to pandemic periods, and the percentage of patients with malignant bowel obstructions at presentation nearly doubled from 2.7% to 5.3%. 

“The COVID-19 pandemic resulted in a significant initial decrease in rates of colon cancer diagnosis, with a slow return to baseline,” Louise Davies, MD, MS, a head-and-neck surgeon at the University of Wisconsin-Madison and senior author of the study told Federal Practitioner. “The length of time it took for things to return to normal surprised us. Patterns of detection did not return to more normal baselines until 2023.”

The Pandemic’s Toll on Colonoscopies

While mortality and diagnosis rates have fallen significantly over the past 3 decades, an estimated 158,850 colorectal cancer cases will be diagnosed in the US in 2026, and 55,230 patients will die. Within the VHA, an estimated 4000 new cases of colorectal cancer are diagnosed annually. 

The pandemic disrupted medical care across the board, and colonoscopies were no exceptions. “There are various estimates that there were anywhere from 2 to 3 million missed exams,” said Timothy Pawlik, MD, PhD, MBA, MPH, a surgical oncologist and professor at The Ohio State University Wexner Medical Center, in an interview. 

“At the height of the pandemic, all nonurgent procedures were put on hold,” explained Pawlik, who was not involved in the new study. “I suspect that a number of procedures were missed because different institutions and GI practices simply weren't providing that service at that time. In addition, I'm sure there was some reticence among patients to seek care even after the procedures were restarted and reoffered, especially at a hospital.”

Inside the VHA Data

The researchers found that 22,256 VHA patients were diagnosed with CRC during the study period (mean age, 71 years; 95.6% male; 72.1% White, 19.3% Black, and 6.4% Hispanic). 

In a subset of 1087 patients, the percentage with an American Society of Anesthesiologists class ≥ 3 rose from 74.4% before the pandemic to 78.9% during it. 

In light of the study findings, “clinicians should encourage their eligible patients to get screened for colon cancer, especially if they delayed screening as a result of the pandemic,” Davies said. 

Why Colonoscopy Delays Matter

Pawlik, the Ohio State University Wexner Medical Center surgical oncologist, said even small delays in colonoscopies can be important. 

“There are data suggesting that even a delay beyond 6 to 12 months can significantly increase the risk of advanced-stage cancer. Longer delays of a year, which were associated with the pandemic, definitely increase the risk of presenting with later stages of disease and potentially have a meaningful impact on your prognosis and survival.”

However, he noted that the study findings are limited because the results don’t clarify when patients were due for colonoscopies. 

Still, in the big picture, the research “emphasizes the importance of timely colonoscopy compliance with national guidelines for screening of colon cancer,” he said. 

Lessons About At-Home Tests

Pawlik added that the research also highlights that in times of limited access such as pandemics, there can be value to pivoting to home-based screening methods.

Study coauthor Douglas Robertson, MD, MPH, national deputy director of the Colorectal Cancer Screening Program with the US Department of Veterans Affairs National Gastroenterology and Hepatology Program, said the pandemic spurred a shift toward fecal immunochemical testing (FIT) via mail. 

The VA is now mailing > 40,000 FIT tests per month to veterans. “This program was an outgrowth of and response to the pandemic and would enhance VA’s readiness to maintain CRC screening efforts should something similar occur in the future,” Robertson said in an interview.

The Department of Veterans Affairs funded the study. Davies, Robertson, and the other study authors have no disclosures. Pawlik is co-editor-in-chief of the Journal of Gastrointestinal Surgery and has no other disclosures. 

Disruptions caused by the COVID-19 pandemic led to an estimated 619 missed cases of colorectal cancer (CRC) diagnoses among US veterans, and those whose cases were caught had larger tumors and more malignant bowel obstructions compared with a prepandemic period, a new longitudinal study finds.

The decline in diagnoses during the pandemic (March 2020-October 2023) represented a 5% decrease in anticipated cases compared with the prepandemic period (January 2017-February 2020) reported Veterans Health Administration (VHA) researchers in the Journal of Gastrointestinal Surgery.

Meanwhile, the percentage of cancers > 4 cm increased from 48.9% to 57.3% from the prepandemic to pandemic periods, and the percentage of patients with malignant bowel obstructions at presentation nearly doubled from 2.7% to 5.3%. 

“The COVID-19 pandemic resulted in a significant initial decrease in rates of colon cancer diagnosis, with a slow return to baseline,” Louise Davies, MD, MS, a head-and-neck surgeon at the University of Wisconsin-Madison and senior author of the study told Federal Practitioner. “The length of time it took for things to return to normal surprised us. Patterns of detection did not return to more normal baselines until 2023.”

The Pandemic’s Toll on Colonoscopies

While mortality and diagnosis rates have fallen significantly over the past 3 decades, an estimated 158,850 colorectal cancer cases will be diagnosed in the US in 2026, and 55,230 patients will die. Within the VHA, an estimated 4000 new cases of colorectal cancer are diagnosed annually. 

The pandemic disrupted medical care across the board, and colonoscopies were no exceptions. “There are various estimates that there were anywhere from 2 to 3 million missed exams,” said Timothy Pawlik, MD, PhD, MBA, MPH, a surgical oncologist and professor at The Ohio State University Wexner Medical Center, in an interview. 

“At the height of the pandemic, all nonurgent procedures were put on hold,” explained Pawlik, who was not involved in the new study. “I suspect that a number of procedures were missed because different institutions and GI practices simply weren't providing that service at that time. In addition, I'm sure there was some reticence among patients to seek care even after the procedures were restarted and reoffered, especially at a hospital.”

Inside the VHA Data

The researchers found that 22,256 VHA patients were diagnosed with CRC during the study period (mean age, 71 years; 95.6% male; 72.1% White, 19.3% Black, and 6.4% Hispanic). 

In a subset of 1087 patients, the percentage with an American Society of Anesthesiologists class ≥ 3 rose from 74.4% before the pandemic to 78.9% during it. 

In light of the study findings, “clinicians should encourage their eligible patients to get screened for colon cancer, especially if they delayed screening as a result of the pandemic,” Davies said. 

Why Colonoscopy Delays Matter

Pawlik, the Ohio State University Wexner Medical Center surgical oncologist, said even small delays in colonoscopies can be important. 

“There are data suggesting that even a delay beyond 6 to 12 months can significantly increase the risk of advanced-stage cancer. Longer delays of a year, which were associated with the pandemic, definitely increase the risk of presenting with later stages of disease and potentially have a meaningful impact on your prognosis and survival.”

However, he noted that the study findings are limited because the results don’t clarify when patients were due for colonoscopies. 

Still, in the big picture, the research “emphasizes the importance of timely colonoscopy compliance with national guidelines for screening of colon cancer,” he said. 

Lessons About At-Home Tests

Pawlik added that the research also highlights that in times of limited access such as pandemics, there can be value to pivoting to home-based screening methods.

Study coauthor Douglas Robertson, MD, MPH, national deputy director of the Colorectal Cancer Screening Program with the US Department of Veterans Affairs National Gastroenterology and Hepatology Program, said the pandemic spurred a shift toward fecal immunochemical testing (FIT) via mail. 

The VA is now mailing > 40,000 FIT tests per month to veterans. “This program was an outgrowth of and response to the pandemic and would enhance VA’s readiness to maintain CRC screening efforts should something similar occur in the future,” Robertson said in an interview.

The Department of Veterans Affairs funded the study. Davies, Robertson, and the other study authors have no disclosures. Pawlik is co-editor-in-chief of the Journal of Gastrointestinal Surgery and has no other disclosures. 

Disruptions caused by the COVID-19 pandemic led to an estimated 619 missed cases of colorectal cancer (CRC) diagnoses among US veterans, and those whose cases were caught had larger tumors and more malignant bowel obstructions compared with a prepandemic period, a new longitudinal study finds.

The decline in diagnoses during the pandemic (March 2020-October 2023) represented a 5% decrease in anticipated cases compared with the prepandemic period (January 2017-February 2020) reported Veterans Health Administration (VHA) researchers in the Journal of Gastrointestinal Surgery.

Meanwhile, the percentage of cancers > 4 cm increased from 48.9% to 57.3% from the prepandemic to pandemic periods, and the percentage of patients with malignant bowel obstructions at presentation nearly doubled from 2.7% to 5.3%. 

“The COVID-19 pandemic resulted in a significant initial decrease in rates of colon cancer diagnosis, with a slow return to baseline,” Louise Davies, MD, MS, a head-and-neck surgeon at the University of Wisconsin-Madison and senior author of the study told Federal Practitioner. “The length of time it took for things to return to normal surprised us. Patterns of detection did not return to more normal baselines until 2023.”

The Pandemic’s Toll on Colonoscopies

While mortality and diagnosis rates have fallen significantly over the past 3 decades, an estimated 158,850 colorectal cancer cases will be diagnosed in the US in 2026, and 55,230 patients will die. Within the VHA, an estimated 4000 new cases of colorectal cancer are diagnosed annually. 

The pandemic disrupted medical care across the board, and colonoscopies were no exceptions. “There are various estimates that there were anywhere from 2 to 3 million missed exams,” said Timothy Pawlik, MD, PhD, MBA, MPH, a surgical oncologist and professor at The Ohio State University Wexner Medical Center, in an interview. 

“At the height of the pandemic, all nonurgent procedures were put on hold,” explained Pawlik, who was not involved in the new study. “I suspect that a number of procedures were missed because different institutions and GI practices simply weren't providing that service at that time. In addition, I'm sure there was some reticence among patients to seek care even after the procedures were restarted and reoffered, especially at a hospital.”

Inside the VHA Data

The researchers found that 22,256 VHA patients were diagnosed with CRC during the study period (mean age, 71 years; 95.6% male; 72.1% White, 19.3% Black, and 6.4% Hispanic). 

In a subset of 1087 patients, the percentage with an American Society of Anesthesiologists class ≥ 3 rose from 74.4% before the pandemic to 78.9% during it. 

In light of the study findings, “clinicians should encourage their eligible patients to get screened for colon cancer, especially if they delayed screening as a result of the pandemic,” Davies said. 

Why Colonoscopy Delays Matter

Pawlik, the Ohio State University Wexner Medical Center surgical oncologist, said even small delays in colonoscopies can be important. 

“There are data suggesting that even a delay beyond 6 to 12 months can significantly increase the risk of advanced-stage cancer. Longer delays of a year, which were associated with the pandemic, definitely increase the risk of presenting with later stages of disease and potentially have a meaningful impact on your prognosis and survival.”

However, he noted that the study findings are limited because the results don’t clarify when patients were due for colonoscopies. 

Still, in the big picture, the research “emphasizes the importance of timely colonoscopy compliance with national guidelines for screening of colon cancer,” he said. 

Lessons About At-Home Tests

Pawlik added that the research also highlights that in times of limited access such as pandemics, there can be value to pivoting to home-based screening methods.

Study coauthor Douglas Robertson, MD, MPH, national deputy director of the Colorectal Cancer Screening Program with the US Department of Veterans Affairs National Gastroenterology and Hepatology Program, said the pandemic spurred a shift toward fecal immunochemical testing (FIT) via mail. 

The VA is now mailing > 40,000 FIT tests per month to veterans. “This program was an outgrowth of and response to the pandemic and would enhance VA’s readiness to maintain CRC screening efforts should something similar occur in the future,” Robertson said in an interview.

The Department of Veterans Affairs funded the study. Davies, Robertson, and the other study authors have no disclosures. Pawlik is co-editor-in-chief of the Journal of Gastrointestinal Surgery and has no other disclosures. 

TOPLINE:

In a population-based study, human papillomavirus (HPV) vaccination in England was associated with a 100% reduction in mortality due to cervical cancer between 2020 and 2024 among women aged 20-24 years who were mostly vaccinated at the age of 12-13 years.

METHODOLOGY:

• Researchers conducted a population-based study using cervical cancer mortality data of women aged 20-24, 25-29, and 30-34 years from the National Disease Registration Service and Office for National Statistics in England from 2000 to 2024.
• The analysis included women from the first eligible birth cohort (born from September 1990 to August 1991) who were targeted by England's school-based HPV vaccination programme introduced in September 2008 for girls aged 12-13 years, with a catch-up programme for girls aged 14-18 years implemented in 2008-2010.
• HPV vaccination coverage by birth cohort was obtained from annual reports of the UK Health Security Agency and used to estimate the proportion of women vaccinated for each age group and calendar year.
• The relative risk reduction (RRR) in mortality among vaccinated women compared with expected rates in the absence of vaccination, assuming no herd immunity, was evaluated.

TAKEAWAY:

• Among women aged 20-24 years between 2020 and 2024 with approximately 88%-91% vaccination coverage, no deaths occurred compared with 23.1 expected deaths on the basis of the observed average rate from 2000 to 2014, corresponding to a reduction in mortality of 100% (95% CI, 84%-100%).
• Among vaccinated women, the RRR in mortality due to cervical cancer was estimated at 100% (P = .0008) in those aged 20-24 years, 100% (P < .0001) in those aged 25-29 years, and 63% (P = .094) in those aged 30-34 years.
• Mortality reductions of 80% (95% CI, 51%-94%) were observed in women aged 20-24 years during 2015-2019 and 69% (95% CI, 55%-79%) were observed in those aged 25-29 years during 2020-2024.
• Up until the end of 2024, the HPV vaccination programme in England was associated with a reduction of approximately 199.6 deaths due to cervical cancer (95% CI, 125.0-274.2) among cohorts offered vaccination.

IN PRACTICE:

The authors concluded that "we found a substantial reduction in cervical cancer mortality in women aged 20-29 years that was associated with high uptake of HPV vaccination." "This observation further supports the benefit of HPV vaccination in reducing not only the incidence of but also the mortality from a cancer that is globally still the second most common cause of cancer death in women younger than 65 years," they added. SOURCE: The study was led by Peter Sasieni, PhD, Centre for Cancer Screening, Prevention and Early Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England. It was published online on June 17, 2026, in The Lancet.

LIMITATIONS:

The analysis relied on population-level vaccination coverage data instead of individual-level status; the researchers had access to mortality data in 5-year age groups only rather than single-year cohorts, and the study assumed no herd protection among unvaccinated women within birth cohorts.

DISCLOSURES:

The study was funded by the Cancer Research UK. One author reported serving as a lead investigator of a trial examining the HPV vaccine Gardasil 9 that was partially supported by a research grant from the Investigator-Initiated Studies Program of Merck Sharp & Dohme. Additional disclosures are listed in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

A version of this article first appeared on Medscape.com.

TOPLINE:

In a population-based study, human papillomavirus (HPV) vaccination in England was associated with a 100% reduction in mortality due to cervical cancer between 2020 and 2024 among women aged 20-24 years who were mostly vaccinated at the age of 12-13 years.

METHODOLOGY:

• Researchers conducted a population-based study using cervical cancer mortality data of women aged 20-24, 25-29, and 30-34 years from the National Disease Registration Service and Office for National Statistics in England from 2000 to 2024.
• The analysis included women from the first eligible birth cohort (born from September 1990 to August 1991) who were targeted by England's school-based HPV vaccination programme introduced in September 2008 for girls aged 12-13 years, with a catch-up programme for girls aged 14-18 years implemented in 2008-2010.
• HPV vaccination coverage by birth cohort was obtained from annual reports of the UK Health Security Agency and used to estimate the proportion of women vaccinated for each age group and calendar year.
• The relative risk reduction (RRR) in mortality among vaccinated women compared with expected rates in the absence of vaccination, assuming no herd immunity, was evaluated.

TAKEAWAY:

• Among women aged 20-24 years between 2020 and 2024 with approximately 88%-91% vaccination coverage, no deaths occurred compared with 23.1 expected deaths on the basis of the observed average rate from 2000 to 2014, corresponding to a reduction in mortality of 100% (95% CI, 84%-100%).
• Among vaccinated women, the RRR in mortality due to cervical cancer was estimated at 100% (P = .0008) in those aged 20-24 years, 100% (P < .0001) in those aged 25-29 years, and 63% (P = .094) in those aged 30-34 years.
• Mortality reductions of 80% (95% CI, 51%-94%) were observed in women aged 20-24 years during 2015-2019 and 69% (95% CI, 55%-79%) were observed in those aged 25-29 years during 2020-2024.
• Up until the end of 2024, the HPV vaccination programme in England was associated with a reduction of approximately 199.6 deaths due to cervical cancer (95% CI, 125.0-274.2) among cohorts offered vaccination.

IN PRACTICE:

The authors concluded that "we found a substantial reduction in cervical cancer mortality in women aged 20-29 years that was associated with high uptake of HPV vaccination." "This observation further supports the benefit of HPV vaccination in reducing not only the incidence of but also the mortality from a cancer that is globally still the second most common cause of cancer death in women younger than 65 years," they added. SOURCE: The study was led by Peter Sasieni, PhD, Centre for Cancer Screening, Prevention and Early Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England. It was published online on June 17, 2026, in The Lancet.

LIMITATIONS:

The analysis relied on population-level vaccination coverage data instead of individual-level status; the researchers had access to mortality data in 5-year age groups only rather than single-year cohorts, and the study assumed no herd protection among unvaccinated women within birth cohorts.

DISCLOSURES:

The study was funded by the Cancer Research UK. One author reported serving as a lead investigator of a trial examining the HPV vaccine Gardasil 9 that was partially supported by a research grant from the Investigator-Initiated Studies Program of Merck Sharp & Dohme. Additional disclosures are listed in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

A version of this article first appeared on Medscape.com.

TOPLINE:

In a population-based study, human papillomavirus (HPV) vaccination in England was associated with a 100% reduction in mortality due to cervical cancer between 2020 and 2024 among women aged 20-24 years who were mostly vaccinated at the age of 12-13 years.

METHODOLOGY:

• Researchers conducted a population-based study using cervical cancer mortality data of women aged 20-24, 25-29, and 30-34 years from the National Disease Registration Service and Office for National Statistics in England from 2000 to 2024.
• The analysis included women from the first eligible birth cohort (born from September 1990 to August 1991) who were targeted by England's school-based HPV vaccination programme introduced in September 2008 for girls aged 12-13 years, with a catch-up programme for girls aged 14-18 years implemented in 2008-2010.
• HPV vaccination coverage by birth cohort was obtained from annual reports of the UK Health Security Agency and used to estimate the proportion of women vaccinated for each age group and calendar year.
• The relative risk reduction (RRR) in mortality among vaccinated women compared with expected rates in the absence of vaccination, assuming no herd immunity, was evaluated.

TAKEAWAY:

• Among women aged 20-24 years between 2020 and 2024 with approximately 88%-91% vaccination coverage, no deaths occurred compared with 23.1 expected deaths on the basis of the observed average rate from 2000 to 2014, corresponding to a reduction in mortality of 100% (95% CI, 84%-100%).
• Among vaccinated women, the RRR in mortality due to cervical cancer was estimated at 100% (P = .0008) in those aged 20-24 years, 100% (P < .0001) in those aged 25-29 years, and 63% (P = .094) in those aged 30-34 years.
• Mortality reductions of 80% (95% CI, 51%-94%) were observed in women aged 20-24 years during 2015-2019 and 69% (95% CI, 55%-79%) were observed in those aged 25-29 years during 2020-2024.
• Up until the end of 2024, the HPV vaccination programme in England was associated with a reduction of approximately 199.6 deaths due to cervical cancer (95% CI, 125.0-274.2) among cohorts offered vaccination.

IN PRACTICE:

The authors concluded that "we found a substantial reduction in cervical cancer mortality in women aged 20-29 years that was associated with high uptake of HPV vaccination." "This observation further supports the benefit of HPV vaccination in reducing not only the incidence of but also the mortality from a cancer that is globally still the second most common cause of cancer death in women younger than 65 years," they added. SOURCE: The study was led by Peter Sasieni, PhD, Centre for Cancer Screening, Prevention and Early Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, England. It was published online on June 17, 2026, in The Lancet.

LIMITATIONS:

The analysis relied on population-level vaccination coverage data instead of individual-level status; the researchers had access to mortality data in 5-year age groups only rather than single-year cohorts, and the study assumed no herd protection among unvaccinated women within birth cohorts.

DISCLOSURES:

The study was funded by the Cancer Research UK. One author reported serving as a lead investigator of a trial examining the HPV vaccine Gardasil 9 that was partially supported by a research grant from the Investigator-Initiated Studies Program of Merck Sharp & Dohme. Additional disclosures are listed in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

A version of this article first appeared on Medscape.com.