The National Institutes of Health has launched its first agencywide Strategic Plan for Autoimmune Disease Research, a five-year initiative aimed at accelerating research into diseases that affect an estimated 50 million Americans and cost more than $100 billion annually.

Autoimmune disorders occur when the immune system, designed to protect the body from viruses, bacteria and other threats, mistakenly attacks healthy tissues. Nearly every part of the body can be affected, including the skin, joints, heart, lungs and nervous system.

The result is often chronic and debilitating illness as most autoimmune diseases have no permanent cure and require lifelong management. While treatments continue to improve, many patients still rely on the long-term use of immunosuppressive therapies to manage their disease.

One of the key features of autoimmune diseases is that they disproportionately affect women, who account for more than 70% of patients worldwide, a distinction the NIH initiative will explore.

At Cedars-Sinai, scientists and clinicians with the Kao Autoimmunity Institute are working to understand how biological sex influences immune responses and disease risk. In lupus, for example, 90% of the patients are women and investigators are trying to understand what factors drive that enormous disparity and what could improve treatment.

Autoimmune disease and lupus investigator Caroline Jefferies, PhD, scientific director of the Center for Research in Women’s Health Science at Cedars-Sinai, and rheumatologist Mariko Ishimori, MD, associate director of the Clinical and Translational Research Center, sat down with the Cedars-Sinai Newsroom to discuss how sex differences can shape lupus risk, symptoms and patient care.

Why do autoimmune diseases affect women more often than men?

Jefferies: Differences in sex chromosomes, hormones and environmental exposures all influence the immune system. Some genes involved in regulating immune responses are located on the X chromosome. Although females typically have two X chromosomes, one is usually switched off in each cell. Certain immune-related genes, however, can escape that inactivation process and remain active, which may contribute to a heightened immune response and help explain why autoimmune diseases are more common in women.

How does the immune system function differently in women compared to men?

Jefferies: Women generally mount stronger immune responses than men, resulting in faster responses to viruses and better responses to vaccines. This was especially evident during the COVID-19 pandemic, when men experienced higher mortality and more severe disease. But that significant antiviral advantage also may contribute to the higher rates of inflammatory and autoimmune diseases seen in women, including lupus.

Why is lupus a key example of sex differences in autoimmune disease?

Jefferies: About 9 out of 10 lupus patients are women, and lupus was one of the first autoimmune diseases linked to overactivation of antiviral immunity. Decades ago, researchers discovered that interferons—proteins released when the body detects viruses—were elevated in lupus patients. Interferons drive immune cell activation, antibody production and cell death, all of which can contribute to the development of autoimmunity and illness.

Does lupus present differently in women and men, and can those differences affect diagnosis or treatment?

Ishimori: Women are far more likely to develop lupus, especially during their reproductive years, when the ratio of women to men with the disease is about 9 to 1.

Lupus symptoms can vary widely, but women commonly experience fatigue, joint pain, swelling, rashes and oral ulcers. Men may be more likely to develop inflammation around the heart or lungs, or organ-threatening disease affecting the kidneys or heart. Because there is no definitive blood test, or single symptom, that confirm lupus, delays in diagnosis can occur. Men may face additional delays because lupus is generally considered more common in women and may be less likely to be considered in the differential diagnosis in men.

Are there stages in a woman’s life when autoimmune symptoms may change or become more noticeable?

Ishimori: During pregnancy, the immune system adapts to tolerate a growing fetus while continuing to protect the mother. Some women with autoimmune disease experience flares during pregnancy, while others do not. Patients with known autoimmune disease are generally encouraged to achieve good disease control before conception because well-controlled disease is associated with fewer pregnancy complications. Several weeks after delivery, there may be an increased risk of disease flare or even a first presentation of autoimmune disease as the immune system readjusts.

Around menopause, some autoimmune symptoms can overlap with changes naturally associated with that stage of life, which can sometimes complicate diagnosis of a specific disorder.

What should women do if they think they may have an autoimmune disease?

Ishimori: Autoimmune symptoms often persist over time, although they may come and go. Because infections and other illnesses can sometimes cause similar symptoms, it’s important to look at the bigger picture. Keeping track of symptoms—such as fevers, rashes or patterns of joint pain—can help patients have more informed conversations with their doctors. Patients should feel comfortable asking what conditions are being considered, what tests are being ordered and whether autoimmune disease could be a possible explanation for their symptoms.

How could a better understanding of sex differences change autoimmune disease treatment?

Jefferies: One of the biggest gaps in our knowledge is understanding how sex chromosomes and sex hormones influence the immune system across different tissues and organs. A better understanding of those mechanisms could eventually help researchers develop more targeted treatments for organ-specific complications of lupus, including heart and lung disease. Ultimately, that is why we do this work—to help patients, many of them women, live healthier lives.

Read more from Cedars-Sinai Stories and Insights: Cultivated Care for Autoimmune Diseases

Smidt Heart Institute cardiologist Janet Wei, MD, is one of the authors of a maternal health report from the National Academies of Sciences, Engineering, and Medicine, a nonprofit organization that reviews published research and provides advice to the U.S. government. Wei, associate professor of Cardiology and Biomedical Sciences, sat down with the Cedars-Sinai Newsroom to explain how pregnancy affects women’s hearts.   

How does pregnancy increase cardiovascular risk?

Pregnancy acts as a stress test for the heart and can uncover, or even worsen, problems like high blood pressure and diabetes. During pregnancy, the heart must work harder to support a growing fetus, and cardiac stress often continues after delivery.

Cardiovascular disease is the leading cause of pregnancy-related death in the U.S., yet most of these deaths are preventable. The National Academies of Sciences, Engineering, and Medicine report on maternal health highlights that although 57% of cardiovascular-related deaths occur between seven days and one year postpartum, preventive care is often focused on the prenatal and immediate postpartum period.

What are two takeaways from the report?

The committee reviewed published medical research and gathered input from a wide range of stakeholders, including clinicians, professional societies, advocacy organizations and patients.

Several takeaways became clear. The report recommends, for example, that clinicians treat pregnant women with chronic hypertension so that their blood pressure is reduced to less than 140/90 millimeters of mercury.  This is because consistently elevated blood pressure during pregnancy can cause pregnancy complications and increase a woman’s risk for developing cardiovascular disease.

The new guidelines also recommended that clinicians caring for patients with postpartum hypertension or other hypertensive disorders give their patients home blood pressure monitors and use a program that allows the patients to report their readings. This way, clinicians can adjust treatment and set clear thresholds for action. 

Cedars-Sinai is already doing this through a postpartum blood pressure monitoring program that sends patients home with a blood pressure cuff and allows them to transmit readings to their care teams. (Kimberly Gregory, MD, MPH, director of the Division of Maternal-Fetal Medicine at Cedars-Sinai, served as an adviser to the National Academies committee that created the maternal health report.)

How often should women visit a doctor in the year after giving birth?

How frequently a woman should see her doctor during the postpartum period depends on her cardiovascular risk. 

Not every woman can easily see a doctor or health specialist—especially in rural areas or when cost is a concern. Therefore, the National Academies report recommends the Health Resources and Services Administration use its telehealth, rural health and maternal health programs to reduce geographic, financial and system barriers to preventive cardiovascular services.

What can pregnant women do to protect heart health?

The National Academies created a resource for women that includes the following advice:

Share your history. Tell your healthcare team your family history of heart disease, especially early heart attacks or strokes, and your pregnancy history, including any past complications.

Keep postpartum follow-up appointments on your calendar. It’s important not to miss these appointments because risk for complications continues through the first year after delivery.

Take warning signs seriously—trust your instincts. If something feels wrong during pregnancy or after birth, seek care right away and tell providers that you’re pregnant or that you gave birth recently.

Read more from Cedars-Sinai Stories and Insights: High Blood Pressure—What Women Need to Know

The early-stage international study, published in the journal Nature Medicine, focused on removing a harmful protein from a mother’s blood.

Preeclampsia is marked by high blood pressure that can quickly become life-threatening. In its most severe early form—before 34 weeks of pregnancy—physicians frequently must deliver babies prematurely to protect the mother, even though early delivery can pose significant risks for the infant. The method tested by investigators was found to safely extend pregnancy, giving babies more time to develop before birth.

“Even a few extra days in the womb can make a meaningful difference in outcomes for premature infants,” said co-corresponding study author Ananth Karumanchi, MD, professor of Medicine, director of the Renovascular Research Center and the Medallion Chair in Vascular Biology at Cedars-Sinai. “We found a way to potentially buy that time safely. Our approach could shift how we manage very early preeclampsia.”

The approach focuses on a protein called sFlt-1, which is produced by the placenta and known to damage blood vessels and drive preeclampsia symptoms. Investigators engineered a specialized immune protein that binds to sFlt-1 and incorporated it into a blood-filtering device. Using a process called extracorporeal apheresis—similar to kidney dialysis—they were able to filter the mother’s blood and remove excess sFlt-1 without affecting other essential blood components.

The treatment was evaluated in 16 women. Their blood pressure improved, their babies continued to grow normally during treatment, and they remained pregnant for an average of 10 additional days—more than double the time seen in untreated patients.

“Right now, the only way to cure preeclampsia and protect the life and health of the mother is to deliver the baby,” said Sarah Kilpatrick, MD, PhD, an expert in maternal-fetal medicine and chair of the Department of Obstetrics and Gynecology at Cedars-Sinai. “That puts very premature infants at high risk. This approach could give clinicians more flexibility in managing these high-risk cases.”

Researchers say the treatment is notable also because it removes a harmful factor rather than introducing new drugs, potentially reducing the risk of side effects. However, they note that despite the small study’s positive results, the treatment is experimental and needs to be tested in larger clinical trials.

“Our goal was to directly target one of the root causes of preeclampsia,” said the study’s co-corresponding author Ravi Thadhani, MD, MPH, executive vice president of Clinical Affairs, chief medical officer for Cedars-Sinai Medical Center and Cedars-Sinai Health System. “By lowering sFLt-1, we were able to stabilize patients and extend pregnancy—a meaningful and exciting step forward.”

Additional Cedars-Sinai authors include Agnes Lo.

Other authors include Thomas F. Hiemstra, Manu Vatish, Holger Stepan, Ana Sofia Cerdeira, Jeremy Brockelsby, Tim James, Massimiliano Lia, Alissa Cornelis, Elena Krause, Martin R. Spath, Berthold Grüttner, Polina Todorova, Henning Hagmann, Kristen R. Yeung, Bei Xu, Scott Heffernan, Suzanne Pears, Richard Waugh, John Thompson, Jim Iliopoulos, Neroli Sunderland, Murray Killingsworth, Angela Makris, Annemarie Hennessy, Adelene Y. Tan, Paul Kussie, Yuchiao Chang, Linda Hanssens, Stefan Miltenyi and Thomas Benzing.

Funding: This work was supported by Miltenyi Biomedicine and Aggamin Pharmaceuticals.

Competing Interests: R.T. and S.A.K. are co-inventors on multiple biomarker patents related to preeclampsia that have been out-licensed to several companies (Thermo Fisher Scientific, Beckman Coulter, Siemens and Roche) and report financial interest in Aggamin Pharmaceuticals and serving as a consultant to Comanche Biopharma. R.T. and S.A.K. are named as co-inventors on a provisional patent held by Cedars-Sinai Medical Center on a novel lateral-flow diagnostic assay for use in preeclampsia and related conditions. A.H. is an advisor to Comanche Biopharma. A.Y.T. and P.K. are employees of Aggamin.

Pharmaceuticals. L.H. is an employee of, and S.M. is the founder of, Miltenyi Biomedicine. All other authors disclose no conflicts. These financial interests have been disclosed in accordance with journal policies.

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Cedars-Sinai maternal-fetal medicine specialists have developed a postpartum blood pressure monitoring program that is receiving high marks from patients and addressing health risks faced by women during and after childbirth.

Hypertensive disorders of pregnancy, including preeclampsia, are a leading cause of serious postpartum complications and hospital readmissions. The risk of serious cardiovascular problems can persist well beyond delivery, making structured follow-up during and after the postpartum period critical.

“The postpartum period is a vulnerable time for patients with pregnancy-related hypertension, and too often it’s when care becomes fragmented,” said program leader Sonya Fabricant, MD, a maternal-fetal medicine fellow at Cedars-Sinai. “This program was designed to provide structure, continuity and support when patients return home and still need close follow-up.”

Support Begins at Home in Postpartum Hypertension Program

Nearly 500 women have enrolled in the Postpartum Hypertension Program and have received blood pressure cuffs to use at home. For two weeks, patients record blood pressure readings through a secure patient portal integrated into their electronic medical record. This allows the care team to review results in a timely manner and respond when readings require attention.

“Our program isn’t just about numbers,” Fabricant said. “It’s about making sure patients understand what their blood pressure readings mean, feel supported and know someone is paying attention and ready to intervene if needed.”

Improving Long-Term Cardiovascular Follow-Up

A central goal of the Postpartum Hypertension Program is to improve follow-up with healthcare providers who can evaluate and manage long-term cardiovascular risk.

Among patients receiving care within the Cedars-Sinai system, 72% had a physician visit within six months after giving birth, and 83% of those enrolled in the program followed up with a specialist by 12 months.

“Hypertensive disorders of pregnancy are not limited to pregnancy itself—they are an early marker of future cardiovascular risk,” said Sarah J. Kilpatrick, MD, PhD, chair of the Department of Obstetrics and Gynecology at Cedars-Sinai, who oversaw the creation of the monitoring initiative. “Programs like this help ensure patients stay connected to care and prioritize their own health after childbirth when mothers are more likely to focus on the newborn and their families.”

High Marks From Patients

Patient surveys consistently highlighted the program’s impact on emotional wellbeing during the postpartum transition, according to Fabricant. Participants frequently reported feeling less anxious after discharge and more confident managing their blood pressure at home.

“What we heard repeatedly from patients was how reassuring it was to know their blood pressure was being closely followed during a stressful time,” Fabricant said. “That reassurance helped many patients stay engaged in their care during early postpartum recovery.”

Read more from Cedars-Sinai Stories and Insights: A High-Risk Pregnancy Lifeline

Cedars-Sinai has received a $30 million gift from the Cayton Goldrich Family Foundation to establish the Cedars-Sinai Cayton BRCA Center, a first-of-its-kind in Southern California. The state-of-the-art center will concentrate on the research, diagnosis and comprehensive treatment of illnesses linked to mutations in the genes known as BRCA1 and BRCA2.

These genes, when functioning properly, help repair damaged DNA to prevent tumors from forming. However, mutations in the genes can significantly increase the risk of certain inherited cancers, including breast, ovarian, prostate and pancreatic malignancies.

“We can help prevent harmful BRCA mutations from being passed down from carriers to their children and grandchildren and work toward ending the cycle of inherited cancer risk,” said foundation trustee Barry Cayton.

Trustee Andrea Goldrich Cayton added, “Our family has personally been affected by BRCA gene mutations, so we feel especially compelled to make a transformative mark in the healthcare space linked to holistic BRCA research and care.”

The Cayton and Goldrich families are longtime supporters of Cedars-Sinai. In 2019, the Goldrich Family Foundation donated $10 million to establish the Jona Goldrich Center for Alzheimer's and Memory Disorders at Cedars-Sinai. The center was named for the late patriarch of the Goldrich family, who was a Holocaust survivor and prominent Los Angeles real estate developer and philanthropist.

“Cedars-Sinai is truly humbled and honored by our continued visionary partnership with the Cayton Goldrich Family Foundation,” said Peter L. Slavin, MD, president and CEO of Cedars-Sinai and the David and Meredith Kaplan Presidential Chair. “They embody humanitarianism and hold a strong belief in science’s ability to transform healthcare and improve human life.”

About 1 in 400 people in the U.S. carry a BRCA mutation. Males are less likely to be tested for the mutations, and female carriers are more likely to be diagnosed with breast cancer. BRCA mutations increase cancer risk in both genders, but the specific forms of cancer and rates of diagnoses differ.

Some population groups are more prone to BRCA mutations, including people of Eastern European Jewish, Korean, Mexican, and African American ancestries. Currently, there is no comprehensive BRCA clinical and research center in Los Angeles to serve high-risk communities. Cedars-Sinai leaders said the new center will play a major role in advancing research, education and clinical innovation.

“The Cedars-Sinai Cayton BRCA Center will offer patients personalized guidance and timelines for their care, including risk-reducing procedures, genetic testing, specialized screenings and reproductive medicine services to help break the cycle of genetic cancer risk,” said Shlomo Melmed, MB, ChB, executive vice president of Medicine and Health Sciences, dean of the Medical Faculty and the Helene A. and Philip E. Hixon Distinguished Chair in Investigative Medicine. “We will develop a hub of translational discovery science devoted to eradicating the cellular underpinnings of BRCA mutations.”

Read more on the Cedars-Sinai Blog: 7 Tips to Reduce Your Breast Cancer Risk

The scientific meeting brings together gynecologic experts from around the world to share the latest in complex benign gynecology and women’s health. Cedars-Sinai presentations span a range of topics including endometriosis, fibroids, pelvic pain, fertility preservation and surgical interventions that reduce bleeding and enhance recovery.

Cedars-Sinai MIGS Experts Available for Interviews

Kelly Wright, MD, director of the Division of Minimally Invasive Gynecologic Surgery and vice chair of Gynecology, is available to discuss MIGS research, innovation and gynecologic disorders. She is presenting findings about fertility-sparing treatment for a rare reproductive system disorder and sustainability in gynecologic operating rooms.

Liron Bar-El, MD, who specializes in complex gynecologic surgery and endometriosis care, can discuss methods to improve surgical team coordination in laparoscopic hysterectomy for efficiency and patient benefit. Bar-El will be honored at the meeting with an award from the Foundation of the AAGL (American Association of Gynecologic Laparoscopists) for innovative research in MIGS education and training.

Raanan Meyer, MD, director of Cedars-Sinai’s Minimally Invasive Gynecologic Surgery Research Program, is presenting a study that compared postoperative complication rates in traditional hysterectomy versus laparoscopic. Meyer will also share the results of a study that found patients with endometriosis-like pain, but no confirmed diagnosis, have a higher risk for depression than those with documented disease.

Kacey Hamilton, MD, who specializes in complex gynecologic surgery, ultrasound, and endometriosis, has done research evaluating outcomes of hysterectomy modalities. She will share a study of techniques for managing hemorrhaging during second-trimester pregnancy surgery that can be used in other gynecologic procedures.

Rebecca Schneyer, MD, has been honored for research that identified racial disparities in gynecological care. At the conference, she is available to discuss new population health research examining age-related trends in endometriosis disease severity and surgical complexity.

Camelita Thrift, MD, with the division of Minimally Invasive Gynecologic Surgery, and affiliated with the Cedars-Sinai Health Sciences University, is available to discuss her presentation on the role race and ethnicity play in endometriosis severity, delays in diagnosis and access to surgical care.

Media Contact

To arrange interviews, contact Laura Coverson at 310-562-1112 or Laura.Coverson@cshs.org.

“In the morning, we will host a clinician track on best practices for treating women with IBD,” Khanna said. “In the afternoon, patients and families are invited to a dedicated session covering pregnancy, fertility, nutrition, mental health and more. There is also time for patients and providers to connect.”

An estimated 3 million people in the U.S. have inflammatory bowel disease, according to the Centers for Disease Control and Prevention. The disorder produces chronic and often destructive inflammation in the digestive tract. The two most common forms of IBD are Crohn’s disease and ulcerative colitis. While some cases can be mild and manageable, many IBD patients are faced with a constellation of health problems including severe diarrhea, malnutrition, dangerous blood clots, and extensive and painful scarring.

IBD occurs in men and women at about the same rate, but the disease can leave women facing unique health challenges. There can be difficult decisions about proceeding with certain drug therapies while trying to conceive or during pregnancy and menopause. 

“For women living with IBD, simply knowing that their needs are recognized and that there is a community and program designed for them can be incredibly empowering,” Khanna said.

The Cedars-Sinai Newsroom interviewed Khanna about how IBD impacts the health and wellbeing of women, including finding a good healthcare provider and effective therapies available to them.

In what ways can IBD impact women and men differently?

While inflammatory bowel disease occurs at about the same rate in both sexes, women often present differently. After age 30, Crohn’s disease is more common in women than in men. We also see sex-specific patterns: Women are more likely to have Crohn’s limited to the colon, less extensive ulcerative colitis, and more frequent extraintestinal conditions, such as eye inflammation and skin disorders. Recognizing these differences is critical for timely diagnosis and effective management.

Are there differences in diagnosis, disease course or treatment protocols for women?

The diagnostic workup for IBD is the same regardless of sex and typically involves colonoscopy, imaging, lab testing. However, the course of the illness can vary. Women may experience flares around hormonal changes, such as those occurring during menstruation or pregnancy.

Treatment approaches are generally the same for men and women, but side effects can differ. For example, women are more likely to develop drug-induced lupus with certain biologic therapies. Providers must stay alert to sex-based responses to various treatments for IBD. For women of childbearing age, therapy selection must consider whether a medication is safe in pregnancy. Most of them are, but not all.

Does IBD impact a woman’s reproductive life, including menstruation, fertility and pregnancy?

Absolutely. Many women report worsening symptoms during menstruation due to hormone fluctuations. Fertility can be reduced in women with active inflammation or prior pelvic surgery, although more research is needed on that front. Pregnancy outcomes are best when disease is in remission for at least three to six months before conception. Interestingly, we have found that some women with IBD may actually experience improvement in symptoms during pregnancy.

Most IBD medications can be safely continued during pregnancy, particularly when the disease is under control. Methotrexate, an immunosuppressant medication, should be avoided. There are other classes of medications, such as JAK inhibitors, whose safety and use should be discussed with your provider. At Cedars-Sinai, our IBD Pregnancy and Fertility Clinic brings gastroenterology and obstetrics together so women receive coordinated care.

Do women find it challenging to get an accurate IBD diagnosis? What advice would you offer?

Many women do face delays. They may see multiple providers before reaching a gastroenterologist who recognizes their symptoms as inflammatory bowel disease. My advice is to advocate for yourself. If you are not being heard, seek a second opinion, ideally at a dedicated IBD center. A colonoscopy and appropriate testing are essential to confirm the condition.

How do IBD patients benefit from a multidisciplinary approach to care?

One young woman in her 20s came to me after years of aggressive Crohn’s disease. She had seen specialists across the country, endured multiple treatments, and was facing another surgery. She broke down in tears, telling me she felt abandoned by her doctors. I reassured her and then brought her case to our weekly IBD meeting where top experts could collaborate on her care. That sense of not being given up on, and of building a trusted partnership with a care team, can be life-changing for patients living with a chronic illness.

The Women and IBD conference will take place at Cedars-Sinai on Saturday, Sept. 13. Attendance is free but registration is required. Those interested in attending can email groupibdwomensprogram@cshs.org to register and receive more information.

Read more on the Cedars-Sinai Blog: A Good Grip on Crohn’s Disease

Traditional cervical cancer screening is done during a pelvic exam. As an alternative, the U.S. Preventive Services Task Force published new draft guidance in December stating that women may self-collect vaginal samples for HPV testing at their clinician’s office. Experts believe this could improve screening rates and detect more cases of cervical precancers and cancers.

“I think this testing is going to make it much easier for women to ensure they are up to date with cervical cancer screening, said Caroline Goldzweig, MD, chief medical officer of Cedars-Sinai Medical Network. “Many women see primary care physicians who may not routinely perform pelvic exams, and having to make a separate visit to a gynecologist can be a barrier for patients. Cervical cancer is so preventable, given what we now know about how to manage early abnormalities, that every case is a tragedy.” 

January is Cervical Cancer Awareness Month, and gynecological oncologist BJ Rimel, MD, medical director of the Cancer Clinical Trials Office at Cedars-Sinai Cancer, sat down with the Cedars-Sinai Newsroom to discuss this new option.

First, what is the difference between HPV and high-risk HPV?

HPV is the most common sexually transmitted infection (STI) in the U.S. HPV is transmitted through skin-to-skin contact, usually during sex with someone who has the virus. There are more than 200 types of HPV, but not all cause cancer. Certain types, which we call high-risk HPV, can avoid the body’s immune system and linger, causing damage to cells that can then cause those cells to become cancerous.

How does this type of self-collection work?

The kits currently approved by the Food and Drug Administration are for collection in a clinician’s office, so most people would likely receive them from their primary care provider. The patient is given an instruction sheet and a collection swab to be inserted into the vagina. Then the patient goes into the restroom to collect their sample. The patient returns the sample to the clinician, who sends it to the lab for evaluation. It isn’t at all complicated. If you can insert a tampon, you can do this.

What are the potential benefits for patients?

These tests make HPV screening much easier for patients who cannot—or do not want to—make it in to see a gynecologist for whatever reason. Maybe they don’t have access to a gynecologist, or have experienced trauma that makes a pelvic exam especially difficult, or their schedule is so busy that their visit keeps getting put off.

If they make it in to see their primary caregiver, they can do one of these HPV tests right there. If they get a negative result—meaning HPV is not present—they will not need another test for cervical cancer for 5 years. If they get a positive result, they need to prioritize seeing a gynecologist for further screening. I think these tests will increase screening and help us identify people with high-risk HPV and prevent deaths from cervical cancer.

Is there a similar test to detect high-risk HPV in men?

No. Currently, there is no standard medical test for high-risk HPV, which can also lead to penile, anal and oral cancers, in men. However, there are other tests that can detect HPV-caused cancer in men.

Why is HPV screening so important?

Caught early, cervical cancer is completely curable. Cervical cancer caught late is very difficult and often impossible to cure. Pap tests give us a fantastic ability to test for precancerous changes to the cervix, which we can then eliminate to prevent cancer.

HPV, it turns out, is the predictor of those precancerous changes, and precancer doesn’t usually develop unless HPV is present.

We have very good vaccines against HPV available and we strongly recommend that children are vaccinated beginning at age 9. For those not vaccinated as children, we recommend that teens, young adults, and even some adults up to age 45 receive the HPV vaccine in consultation with their doctors. For people who are infected with high-risk HPV, we can recommend things to help improve immune responsiveness. For example, smoking and HPV are a very high-risk combination, so if we know someone is infected, we will advise them to quit right away.

What do we know about how accurate the tests are?

The kits were approved by the FDA in May for self-collection in a clinician’s office, and we know that they work very well. They are similar to the tests gynecologists use to screen patients for high-risk HPV. Eventually, self-collection from home could become an option.

Are there potential downsides to self-collection?

The potential downsides are fairly small. If people take this test and do not visit a gynecologist, they aren’t being assessed for other gynecologic conditions that might need to be treated. During a pelvic exam, we can detect large masses. We can detect painful areas. We can detect nodules. We can answer questions that the patient may have about something that may be painful or “off” or itchy or discolored, and we miss all of that information with a self-swab. For example, I will never find an early vaginal melanoma if I never look for one.

That being said, for some patients these tests will be highly valuable, and I’m hopeful that they will become widely available in primary care offices.

Read more on the Cedars-Sinai Blog: HPV Vaccine Recommendations Changed—Is It Right for You?

A Cedars-Sinai-led technology startup has been awarded a $3 million federal grant to develop a first-of-its-kind, affordable, home-based fingerstick test for early detection of preeclampsia, a potentially deadly pregnancy complication.

The startup, Gravidas Diagnostics Inc., won support from the Advanced Research Projects Agency for Health (ARPA-H) to address the condition that is typically diagnosed after 20 weeks of pregnancy, with most cases occurring near the due date.

ARPA-H, part of the United States Department of Health and Human Services, is an investment agency that was created by the U.S. Congress in 2022. The goal: to invest in and support high-impact medical research that could potentially create sustainable and equitable health solutions for critical areas of need, such as women’s and maternal-fetal health.

"This award is a significant milestone for Gravidas,” said Nirdesh K. Gupta, PhD, chief executive officer of Gravidas and managing partner of the Cedars-Sinai Intellectual Property Company. “It will enable us to develop a rapid, accurate test that can be easily administered at home, reassuring patients and allowing clinicians to identify high-risk pregnancies and proactively provide lifesaving care before the onset of symptoms.”

Preeclampsia is a serious pregnancy complication that is typically diagnosed after 20 weeks of pregnancy, with most cases occurring near the due date. The usual signs of preeclampsia are high blood pressure, excess protein in urine, and swelling. If left untreated, preeclampsia can lead to organ damage and, rarely, death. In the U.S., preeclampsia is estimated to occur in up to 7% of all pregnancies and is one of the leading causes of maternal death and severe morbidity, with Black women being 60% more likely to develop preeclampsia compared with white women.

“Pregnant women with risk factors and limited access to routine obstetric care will be the largest beneficiaries of this home-based test. This innovative solution has the potential to reduce racial disparities in adverse pregnancy outcomes, particularly among Black women,” said Sarah J. Kilpatrick, MD, PhD, a nationally renowned expert in maternal-fetal medicine and chair of the Department of Obstetrics and Gynecology at Cedars-Sinai.

Currently, there are no home-based tests available that can accurately detect preeclampsia early in pregnancy. Gravidas’ innovative, low-cost fingerstick test, which uses technology born out of groundbreaking research funded and pioneered by Anders Berg, MD, PhD, vice-chair of Clinical Pathology at Cedars-Sinai, and Ananth Karumanchi, MD, professor of Medicine and director of the Renovascular Research Center at Cedars-Sinai, aims to change that.

“Preeclampsia can only be treated by delivering the baby,” said Karumanchi, whose laboratory pioneered the discovery of the protein being used in the home test. “A rapid, easy-to-use, home-administered test prescribed by a physician can help to rule out imminent risk or to detect preeclampsia early and start necessary interventions to manage hypertension and reduce pregnancy-related complications.”

In 2022, prior to receiving this ARPA-H award, investigators at Cedars-Sinai published a multicenter study with over 1,000 patients, utilizing a blood test to assess the ratio between two key proteins—known as serum soluble fms-like tyrosine kinase 1 to placental growth factor ratio (sFlt‐1/PlGF)—in the bloodstream that predicted worsening of preeclampsia in hospitalized patients. The study, led by Cedars-Sinai investigators, resulted in Food and Drug Administration approval for use of the hospital-based blood test in the U.S. The home-based fingerstick test for preeclampsia will measure sFIt-1 in the bloodstream using colorimetric assay.

Given the increasing numbers of preeclampsia cases nationwide, the decision to create a home-based test for pregnant individuals to use and screen for the condition was the natural next step.

“Gravidas is working to ensure the test is widely accessible, cost-effective, equitable and easy for patients to use in the comfort of their own homes and other settings outside of the hospital,” said Berg, chief technology officer at Gravidas.

“The development of this home-based test for preeclampsia is a testament to Cedars-Sinai’s commitment to harnessing promising technology to build affordable solutions to address major areas of clinically unmet need, especially women’s reproductive health, and to help improve overall patient outcomes,” said Jeffrey A. Golden, MD, director of the Burns and Allen Research Institute and executive vice dean for Research and Education at Cedars-Sinai.

Read more on the Cedars-Sinai Blog: Cedars-Sinai Introduces Dutch Health-Tech Startups to US Markets

The study is funded by an $8 million grant from the highly respected Leducq Foundation and is one of only four awarded this year as part of the foundation’s 2024 International Networks of Excellence Program, which promotes collaborative global research in cardiovascular and neurovascular diseases.

Karumanchi—an expert on hypertension, or high blood pressure, during pregnancy—is the first Leducq Foundation grant recipient at Cedars-Sinai. He will work with an international network of investigators to identify how problems with the placenta—the organ in the uterus that connects mother and baby during pregnancy—can cause heart defects in newborns and lead to heart and blood vessel issues in the mother. The research team also aims to discover new treatments for these conditions.

“Heart disease is typically studied by looking at the heart, blood vessels, cholesterol and blood pressure,” said Karumanchi, the study’s principal investigator. “Thanks to the generous support of the Leducq Foundation, we can explore the origins of heart disease from a different perspective. Previous studies have linked placenta problems with cardiovascular diseases, including congenital heart disease, but scientists haven’t fully understood why. This new funding will help close that research gap.”

Didier Stainier, PhD, from the Max Planck Institute for Heart and Lung Research in Germany, will co-lead the team of placental and developmental biologists, physician-scientists, cardiovascular biologists and epidemiologists from the University of Pennsylvania, the University of Calgary in Canada, Centro Nacional de Investigaciones Cardiovasculares in Spain and the University of Bristol in England.

“Dr. Karumanchi has assembled an exceptional global investigative team of experts from various fields to tackle this important research and ultimately find new ways to understand and treat placenta-related heart diseases,” said Jeffrey A. Golden, MD, executive vice dean of Research and Education and director of the Burns and Allen Research Institute. “Having Cedars-Sinai at the helm of this collaboration speaks to our leadership in this pioneering field of placenta-related cardiovascular disease.”

Recently, Karumanchi identified a biomarker to help diagnose and predict preeclampsia, a hypertension-related disorder and one of the most common pregnancy complications, which also is thought to occur because of problems with the placenta.

Now, new genetic and molecular research tools are allowing Karumanchi and the international team to study the placenta in far greater detail. Growing collections of human tissue and blood samples from mothers and babies with heart problems will enable scientists to make progress in understanding the role of the placenta in maternal and fetal cardiovascular health and disease.

“What an incredible honor to receive this award from the Leducq Foundation,” Karumanchi said. “It’s recognition that our research team has a promising idea with exciting potential implications. We look forward to uncovering new ways to better understand, prevent and treat certain heart diseases.” 

Read more on the Cedars-Sinai Blog: Five Things We Know About the Placenta—and a Few We Wish We Did

, show that women with PCOS and high levels of androgen hormones have lower pregnancy and live birth rates as compared with women with PCOS without high levels of androgens. Miscarriage rates were not different between the two groups of women.

“Polycystic ovary syndrome is not just one disease entity, but a disease spectrum—and one that affects an estimated 10% of women of childbearing age,” said Jessica Chan, MD, associate professor of Obstetrics and Gynecology at Cedars-Sinai and first author of the study. “As it may take longer to conceive with the type of PCOS that includes high levels of androgens, these patients may be advised to start trying to conceive sooner or to seek fertility care more expeditiously.”

Although more research is needed to understand the different forms the disease can take, investigators hope these findings will help clinicians guide women with different types of PCOS regarding pregnancy and live birth expectations.

Additional Cedars-Sinai authors include Margareta Pisarska, MD. Other authors include Richard S. Legro, MD, Esther Eisenberg, MD, and Nanette Santoro, MD.

Funding was provided by the CREST grant R25 HD075737SRI/Bayer Innovation Grant. 

Follow Cedars-Sinai Academic Medicine on LinkedIn for more on the latest basic science and clinical research from Cedars-Sinai.

Inequities in pain medication treatment received postpartum, after giving birth, were found in a Cedars-Sinai study of 18,000 women. The disparities were observed even among patients reporting the highest pain levels.

The retrospective cohort study was published in The Joint Commission Journal on Quality and Patient Safety.

Both opioid and non-opioid pain medications given to patients were examined. Investigators wanted to see if the lower opioid doses reported in some studies finding racial and ethnic differences in peripartum pain management could be due to those patients receiving other kinds of drugs for their discomfort.

“Even after adjusting our analysis to include non-opioid medications, Black and Hispanic patients who reported the highest pain scores received lower doses of opioid-containing medication. The fact that they also received non-opioid drugs could not explain the lower opioid treatment they received when compared with white patients,” said Naomi Greene, PhD, principal investigator of the study and research assistant professor of  Obstetrics and Gynecology.

Pain associated with labor and delivery can make it challenging for women to care for themselves and their newborns. Investigators looked at many variables available in the electronic medical records of the patients who delivered at Cedars-Sinai over a three-year period, 2019−2021. White, Black, Asian and Hispanic women were part of the large cohort.

“We attempted to identify factors that might have mitigated the apparent differences, such as the number of pain assessments, use of epidurals, the amount of non-opioid medication, maternal age, the number of pregnancies, and body mass index. But none of these factors could account for the racial and ethnic disparities in the amount of effective opioid pain management given to them,” said Sarah J. Kilpatrick, MD, PhD, the Helping Hand of Los Angeles Chair in Obstetrics and Gynecology and senior author of the paper.

Investigators emphasize that further study is needed to identify what factors might explain the persistent racial and ethnic disparities in pain management that could point to potential interventions to eliminate the inequities.

“This study adds to the growing body of literature on peripartum pain medication disparity. While confirming previous findings, we added to it by showing that the amount of non-opioid medication used could not explain those disparities in opiate-based therapy given to patients in pain,” Greene said.

It is likely that pain perception and assessments are affected by a complex set of factors, the study authors noted.

“Healthcare provider beliefs, attitudes, and biases concerning pain rating in patients of different races and ethnicities are part of the challenge. Exploring this would necessitate a prospective intervention, such as a survey distributed to nurses and doctors to assess these beliefs and biases. Also, beyond recording a number for a pain score, we need to find ways to allow patients to directly assess their satisfaction with the pain management they are receiving,” Kilpatrick said.

Read more on the Cedars-Sinai Blog: Equitable, Personalized Care for Women and Children of Color

In a special conversation to mark Women’s Health Month, maternal-fetal medicine specialist Melissa Wong, MD, spoke with the Cedars-Sinai Newsroom about specific AI applications developed at Cedars-Sinai and being used to improve maternal health outcomes and gynecological cancer screening. Wong is also director of Informatics and Artificial Intelligence Strategies for the Department of Obstetrics and Gynecology.

What are some significant results of using AI to improve pregnancy and childbirth outcomes?

Two important studies looked at the leading causes of death during pregnancy and childbirth: preeclampsia and postpartum hemorrhage.

We know that low-dose aspirin can reduce the risk of developing preeclampsia, a dangerous hypertensive complication of pregnancy that can cause serious illness or death. Black pregnant women are particularly vulnerable to being overlooked for aspirin treatment. Our study found that using artificial intelligence to identify patients at risk for preeclampsia—and then automate the decision-making about prescribing the aspirin—led to an increase in appropriate aspirin treatment and also eliminated the racial disparity in care.

In another study using an application of AI, machine learning, we developed an algorithm that can help predict which patients are at an increased risk for severe complications from bleeding after childbirth. The key was to analyze data at many different points of a patient’s labor and delivery—from underlying medical conditions to the kind of anesthesia the mother received. Our next step is to see if the algorithm can help predict hemorrhages in real time and allow for intervention and saving lives.

What future uses of AI for OB-GYN care are being considered?

In the area of gynecological care, we are wrapping up a study that could improve the evaluation of the Pap smear used to check for cervical cancer. We do hundreds of Paps a week in our health system. The results are most meaningful when you can put them in the context of the patient’s history. We’ve developed an AI application using ChatGPT that performs a contextual analysis of results, produces a recommendation for next steps, if needed, and even generates a letter to the patient about the results.

Gestational diabetes and hypertension during pregnancy are two conditions we believe could also benefit from AI interventions to identify trends and patterns in patient-submitted data and recommend interventions.

In the case of diabetes, about 80% of the patients submitting data from their glucose monitors are probably doing well or just need straightforward adjustments to their insulin. But our expert diabetes educator still has to analyze all of the data, even if only 20% of the patients will require direct intervention with medication or nutrition counseling to get them back on track. AI could help us focus on the smaller group of patients who need more complex and nuanced support, more expeditiously.

As for managing high blood pressure during pregnancy, this is often a new skill patients learn in pregnancy or postpartum. It’s also a complicated one. Trying to distinguish between a somewhat worrisome reading and one where you need to call your provider asap is not intuitive. A good AI model could send an alert when subtle pattern changes signal a need for medication modifications or urgent attention by the patient and provider.

What is the approach to AI innovation at Cedars-Sinai?

I feel incredibly fortunate to be here, not just because we are at the forefront of investigating the use of artificial intelligence across a wide variety of specialties and procedures, but because we do it with implementation in mind. There is a lot of AI research in the U.S. but not much that goes beyond the lab. At Cedars-Sinai, the goal is to research the myriad possible applications, and then when we’ve refined and tested them, to “turn it on,” so to speak. We are highly motivated to implement what we have developed and to help improve the delivery of care and the health of our patients.

What is the primary goal of harnessing AI for healthcare?

It’s about how AI can help healthcare providers free up their brains and their time to focus on delivering the best possible care. It can be a remarkable tool that brings us front and center with the patient again and moves us away from the kind of work that AI and machine learning do more effectively, quickly and accurately.

Whether a provider is in a healthcare desert with limited resources or at an academic medical center, the best applications of artificial intelligence will have a democratizing impact—reducing healthcare inequalities and providing care that could be more personalized across a broad spectrum of patient populations.

Read more from the Cedars-Sinai Blog: How Women Can Strengthen Their Health at Any Age

Using spatial analysis of tissue samples, Cedars-Sinai investigators have identified patterns that could predict whether patients with the most common type of ovarian cancer will experience early relapse after treatment. These patterns, detailed in a study published in the peer-reviewed journal

“Using spatial protein analysis, we looked not only at the types of cells within and around a tumor, but also at their relative positions and how they interact,” said Alex Xu, PhD, a research scientist at Cedars-Sinai Cancer and the Board of Governors Regenerative Medicine Institute at Cedars-Sinai and first author of the study.

Investigators’ analysis of ovarian cancer tissue samples identified patterns consistently associated with patients whose cancer relapsed soon after treatment, Xu said.

“Spatial analysis is the next frontier in tissue biomarker development and our group has demonstrated the importance of spatial analysis in several cancer types,” said Akil Merchant, MD, a senior author of the study and director of the Spatial Molecular Profiling Core facility at Cedars-Sinai Cancer.

High-grade serous ovarian carcinoma is the deadliest form of ovarian cancer, and ovarian cancers are particularly challenging because they are difficult to detect, Xu said. Frequently, patients with these tumors respond to initial treatment with surgery and chemotherapy but the cancer recurs.

In this study, investigators looked at tissue samples from 42 patients who had ovarian cancer—both primary tumors and tumors that recurred after patients’ initial treatment—using a technology called imaging mass cytometry, which reveals the spatial protein content of the tissue. The investigators’ main findings centered around plasma cells, a crucial part of the tumor immune response.

“Our findings suggest that plasma cells are a clinically important factor determining a patient’s time to relapse,” Xu said. “Previous research into their role has been contradictory, with some studies suggesting their presence predicted negative outcomes while others suggested positive outcomes.”

Here investigators found that outcomes were associated with the location of the plasma cells, and their relationship to adjacent cells types.

“Plasma cells were associated with good patient outcomes when lymphoid aggregates, which are structures that include T and B cells, were also abundant in the area immediately surrounding the tumor,” Xu said. “This could be because the plasma cells were part of these organized structures that facilitated communication between these immune cells, thus improving their ability to attack the tumor.”

Plasma cells were linked with poor patient outcomes when cells called cancer-associated fibroblasts, which are known to interfere with the activity of immune cells, were plentiful, which suggested that fibroblasts may be preventing plasma cells from communicating with other immune cells.  

“These different microenvironments could account for sometimes differing reports about the role of plasma cells in patient prognosis,” said Dan Theodorescu, MD, PhD, director of Cedars-Sinai Cancer and the PHASE ONE Distinguished Chair. “This avenue of investigation could help us identify biomarkers, or even precision therapies, that improve outcomes for patients with this particularly deadly cancer.”

Other Cedars-Sinai authors participating in the study include Marcela Haro and Ann E. Walts.

Additional authors participating in the study include Ye Hu, Joshi John, Beth Y. Karlan, and Sandra Orsulic.

Funding: SO was supported by the NIH grant R01 CA208753, the United States Department of Veterans Affairs Merit Awards VA-ORD I01 BX004974 and I01 BX006020, the Office of the Assistant Secretary of Defense for Health Affairs through the Ovarian Cancer Research Program Award No. W81XWH2210631, and the Sandy Rollman Ovarian Cancer Foundation. SO and AMX were supported by the NIH National Center for Advancing Translational Science (NCATS) UCLA CTSI Grant Number UL1TR001881.

Read more on the Cedars-Sinai Blog: Ovarian Cancer—The Whispering Cancer

Addressing the complexity of causes behind poor health outcomes for Black mothers requires commitment, investment and innovation to produce meaningful, measurable change.

“Ensuring equitable outcomes for our patients is a priority at the highest level of Cedars-Sinai. Black Maternal Health Week raises awareness about birthing inequities that exist, and the multidisciplinary work required to close the gap,” said Christina Harris, MD, Cedars-Sinai vice president and chief health equity officer.

“But the work of preventing harm and saving Black lives is a continuous process that is not confined to one week. It is 24 hours a day, seven days a week, every week and every year. That is the level of commitment that is required,” Harris said.

Cedars-Sinai initiatives to improve Black maternal health include lowering the rates of a common cause of death during childbirth, funding community partners, providing mandatory anti-discrimination education and bridging the gap in maternal mental health care.

Community Conversations

Throughout the year, Cedars-Sinai partners with BlackDoctor.org for a series of Community Conversations that address a wide range of health and public health concerns. This month’s conversation will focus on Black maternal mental health.

According to the American Counseling Association, Black women face an increased risk of perinatal mood and anxiety disorders, including depression and post-traumatic stress disorder. On April 10, “Shining a Light on Black Maternal Mental Health” will feature a panel of healthcare experts discussing the importance of early diagnosis and access to support and effective treatment. The conversation will include an inspirational Black mom who shares her journey of recovery from serious postpartum depression. 

AI Plus Aspirin Eliminates Racial Disparities in Preeclampsia Treatment

"Whenever we focus on eliminating racial or ethnic disparities in care, we ultimately end up increasing the quality of care for everybody,” said maternal-fetal medicine specialist Melissa Wong, MD.

Aspirin can reduce the risk of developing preeclampsia, a dangerous hypertensive complication of pregnancy that can lead to serious complications and even death. But Black pregnant women are particularly vulnerable to being overlooked for aspirin treatment.  

A study led by Wong found that using artificial intelligence to automate decision-making about prescribing low-aspirin—and to identify patients at risk for preeclampsia—resulted in an increase in appropriate aspirin treatment and eliminated the racial disparity in care.

Perinatal Antidiscrimination Initiative

“Not being heard, or having assumptions made about you or your condition, can be a critical barrier to getting good medical care. I've found there are differences in how people perceive respect, or disrespect, based on race and ethnicity," explains Kimberly Gregory, MD, MPH, director of Maternal-Fetal Medicine and vice chair of Women's Healthcare Quality and Performance Improvement in the Department of Obstetrics and Gynecology.

“Always Listening and Learning with You”—ALLY—is a phrase developed by the Cedars-Sinai perinatal unit to characterize an effective approach to patient advocacy and health equity.

The principal of “allyship” is the foundation of annual department compliance training on unconscious bias. The course demonstrates the value of inclusive terminology, offers opportunities to explore how to advocate for  patients and colleagues and emphasizes the critical role staff members play in improving the experiences of patients.

Black Maternal Mental Health

“Black women are twice as likely to experience perinatal mood and anxiety disorders, including postpartum depression, than their white counterparts. They are also less likely to receive treatment,” said clinical psychologist Eynav Accortt, PhD, director of the Reproductive Psychology Program.

Cedars-Sinai investigators are recruiting participants for an NIH funded study aimed at addressing those disparities. The Resources, Inspiration, Support, Empowerment (R.I.S.E.) for Black Maternal Mental Health study tests a mobile health web application designed to help manage stress in pregnancy.

Black women living anywhere in the U.S. who are 12-32 weeks pregnant and at least 18 years old can participate in the study. Click here for more information.

Community Partners

Cedars-Sinai also partners with trusted community organizations committed to improving Black maternal and infant health.

Since 2022, Cedars-Sinai has committed over $3.5 million to 14 organizations which focus on reaching perinatal and postnatal Black women in Los Angeles County, across the continuum of care. Grantees include highly respected partners such as the California Black Women’s Health Project, which provides health education and other resources meant to build empowering relationships within the community of Black pregnant and parenting women they serve.

“Striving for health equity among all populations has long been a goal of Cedars-Sinai. These organizations are key partners in that mission. The grants—and opportunities to combine resources for the good of public health—are an important way we can contribute to improving Black maternal health and well-being,” Harris said.

Read more on the Cedars-Sinai Blog: Equitable, Personalized Care for Women and Children of Color                           

When Elisa Schoenfeld, a child development specialist, learned she had tested positive for a BRCA gene mutation, she knew it raised her risk for breast and ovarian cancer. She and her daughter, Amira, who received similar genetic test results, visited the BRCA Ovarian Previvor Clinic at Cedars-Sinai. That visit set the two on unique, personalized paths to managing their ovarian cancer risk.

“Our previvor clinic is here to empower people who have tested BRCA1 or BRCA2 positive to make informed choices about their health,” said BJ Rimel, MD, the gynecological oncologist who oversees the clinic, part of Cedars-Sinai Cancer and the Department of Obstetrics and Gynecology. “Patients receive regular ovarian cancer screenings and information about prevention options based on their level of risk, personal preferences and future plans for fertility.”

Elisa, who is 56, was tested for BRCA gene variants five years ago because she has a family history of cancer. Her results showed what is called a “variant of uncertain significance.” 

“This was a variant that they didn't know about. Most of these variants are considered to be negative, meaning no increased cancer risk,” Elisa said. “Five years later, my genetic counselor at Cedars-Sinai called to tell me that my particular variant was studied more and is now reclassified as positive.”

Amira, a 34-year-old speech-language pathologist who lives in Los Angeles, was recently tested and also had a variant of uncertain significance.

“The BRCA genes are massive and have many variants,” Rimel said. “Some are harmless—like a typo where you can still read the word—and produce a normal protein. Some produce a nonfunctional protein that increases cancer risk. There are others we aren’t yet certain about, but as we do more testing, we can reclassify those variants as either benign or risk-increasing and let those patients know.”

Rimel, who is also medical director of the Cancer Clinical Trials Office at Cedars-Sinai Cancer, recommends genetic testing through a healthcare provider for people of Eastern European Jewish descent—the group with the highest concentration of BRCA mutations—as well as any woman with a parent, aunt, uncle or child diagnosed with breast or pancreatic cancer before age 50, or ovarian cancer at any age.

She also encourages participation in the Gilda Radner Hereditary Cancer Program to help investigators learn more about the risks associated with being BRCA positive.

“The BRCA Ovarian Previvor Clinic and the Gilda Radner Hereditary Cancer Program are an important part of our service to the local community and to the broader patient and research community throughout the country,” said Dan Theodorescu, MD, PhD, director of Cedars-Sinai Cancer and the PHASE ONE Foundation Distinguished Chair. “They represent two of the many ways that we are leveraging precision medicine to improve treatment and save lives.”

The average woman’s risk for developing ovarian cancer during her lifetime is about 1.7%, according to Rimel. But that risk rises to 26% for women with a BRCA2 mutation and 45% for women with a BRCA1 mutation. Because of this, Elisa’s genetic counselor sent her information about the Cedars-Sinai previvor clinic, and she and Amira decided to make an appointment.

“We were the first mother and daughter to visit the clinic together,” Elisa said. “We both received really helpful information and I decided to have a hysterectomy and have my ovaries removed.”

Separately, Elisa also chose to have a double mastectomy and reconstruction. After discussions with Rimel, Amira visits the clinic every six months but likely won’t take further action until her late 30s or 40s.

“At this point in my life, I'm not looking to do anything as significant as what my mom did,” Amira said. “Dr. Rimel shared information about removal of my ovaries and fallopian tubes, but she doesn’t recommend it yet. For now, I feel like I’m doing everything I can to keep tabs on this in the best way possible. It gives me peace of mind and I feel confident in the advice I am receiving.”

The twice-monthly BRCA Ovarian Previvor Clinic is open to BRCA1- and BRCA2-positive patients who are between 30 years old, when ovarian cancer risk begins to rise, and 50, when health experts recommend that all BRCA-positive patients have their ovaries removed.

The hourlong appointment offers ovarian cancer-focused screening including a medical and family history, review of genetic tests, transvaginal ultrasound and pelvic exam. The final step is a blood draw that includes testing for an ovarian cancer tumor marker called CA-125, as well as other tests that might be needed based on findings from the exams. Most patients visit the clinic every six months.

“The goal of each visit is to pinpoint early warning signs that suggest a patient has developed ovarian cancer, and to help these patients as they journey through their reproductive years with conversations about their plans and about managing their risk,” Rimel said.

Patients can choose fertility-preserving options, such as egg freezing prior to removal of their fallopian tubes and ovaries, or they can join a clinical trial investigating whether removal of the fallopian tubes alone is enough to reduce a patient’s cancer risk.

Patients who do not wish to preserve their fertility can discuss removal of the fallopian tubes and ovaries during the recommended interval of ages 35-40 for BRCA1 carriers and 40-45 for BRCA2 carriers. Patients continue to visit the clinic for screenings until their ovaries have been removed, and Rimel stresses that each patient’s individual risk and preferences are taken into account.

“Our goal is for patients in clinic, as they reach that interval age, not to feel pressured to make choices about their reproduction at that moment, but to have the information they need to help them make these decisions, and an open and established dialog with supportive caregivers who can guide them,” Rimel said.

Amira and Elisa Schoenfeld each benefited from this guidance.

“The clinic was great,” Elisa said. “Everyone there makes you feel comfortable—and like you’re doing the right thing by staying ahead of your health.”

Read more on the Cedars-Sinai Blog: Ovarian Cancer—The Whispering Cancer

It is one of the most common and painful disorders, affecting more than 6 million women in the United States. Endometriosis is often difficult to diagnose and effectively treat. But Cedars-Sinai experts find patients can now benefit from minimally invasive procedures, medications and integrative medicine.

Endometriosis occurs when cells similar to the uterine lining are found growing in the wrong places, most commonly in the ovaries or fallopian tubes or in the abdominal cavity. Sometimes the errant endometrial tissue can migrate to the bladder, rectum and vagina. More than 11% of women have the disorder, according to the Office on Women’s Health in the U.S. Department of Health and Human Services.

Cedars-Sinai endometriosis experts Matthew Siedhoff, MD, a minimally invasive gynecological surgeon and vice chair, Department of Obstetrics and Gynecology, and Kelly Wright, MD, director of Minimally Invasive Gynecological Surgery, answer some of the most common questions about the condition and offer guidance on finding effective treatment and support for the challenges many women face.   

Dr. Siedhoff, what are common, and uncommon, symptoms of endometriosis?

Classic symptoms of endometriosis include pain with periods, noncyclic pelvic pain, pain with intercourse, and infertility. Very painful periods in adolescence can be an early warning sign of the disease, and it is sometimes associated with other symptoms such as vomiting or loose stool. Bowel and bladder dysfunction, migraines, fatigue and pain throughout the body can also be associated with endometriosis. However, some patients are completely asymptomatic, and the condition is diagnosed almost accidentally when it can be seen on imaging done for other reasons, such as an infertility workup.

Dr. Wright, why is endometriosis so difficult to diagnose?

There are no good noninvasive tests for endometriosis, and it doesn’t always show up on imaging studies. Since the condition can present in a variety of ways, patients can be passed from specialist to specialist before it is finally considered as a possible diagnosis. It can then be hard for a patient to find a physician familiar with the nuances and complexities involved in effectively treating the disease. In too many cases, the road from initial symptoms to a diagnosis of endometriosis can take seven to 10 years.

The symptoms of endometriosis, such as pain, sexual dysfunction and infertility, can be difficult to talk about during medical visits. Some providers don’t actively inquire about these symptoms, relying on patients to volunteer them. Sometimes clinicians minimize the symptoms a patient shares telling them that what they are experiencing is normal for a woman. And sometimes they are told that their physical complaints are psychological or all in their head.

Dr. Siedhoff, what are the current best practices for effectively diagnosing and treating endometriosis?

Endometriosis can sometimes be diagnosed by imaging or physical exam, but most of the time, laparoscopic, or minimally invasive, surgery is required to definitively confirm the diagnosis. If a provider suspects endometriosis based on a patient’s clinical presentation, it is perfectly reasonable to start treatment without surgical confirmation. If initial nonsurgical treatments aren’t working, that’s often a sign it’s time to consider surgery.

It’s important that patients see a surgeon with considerable experience in endometriosis surgery. Less experienced surgeons sometimes superficially treat endometriosis lesions by burning them away, a procedure called fulguration. This approach may help the patient a little, but actually cutting out the tissue results in greater pain reduction, decreases the risk the endometriosis will recur and produces better fertility outcomes.

Dr. Wright, is minimally invasive surgical removal of endometriosis a complicated procedure?

Finding how far the disease has spread and removing it often requires working around delicate structures, such as the intestines, kidneys, bladder, blood vessels and nerves. The severity of the patient’s endometriosis—and where the lesions will be found—can be difficult to predict before surgery, so it’s important to have a skilled surgeon prepared to remove the tissue regardless the location. Also, in younger women, the appearance of endometriosis can be subtle and requires an experienced eye to identify it and remove it.

The good news is that minimally invasive gynecological surgery is associated with less postoperative pain, faster recovery and lower infection rates. Our team at Cedars-Sinai is highly experienced and dedicated to improving the health and quality of life for patients who have been suffering with endometriosis.

Dr. Siedhoff, what is the best advice you can give frustrated patients trying to get help and relief?

First of all, don’t give up. There is effective treatment available. Often their condition will be one that is managed rather than cured. It usually takes some time to find the right treatment plan, and it may involve a variety of specialists, including gynecological surgeons, urologists, reproductive endocrinologists, gastroenterologists and integrative medicine specialists. But our patients do improve, and sometimes dramatically.  

Endometriosis Patient Resources

Endometriosis can sometimes lead to feelings of isolation, hopelessness and depression. Emotional support and practical strategies for managing endometriosis can help people navigate the anxiety, stress, loneliness and pain. Here are support programs available to Cedars-Sinai patients.

Endometriosis Peer Support Network: Patients can connect directly with volunteers who have had their own extensive endometriosis journeys and understand the emotional, psychological and healthcare challenges women face. For more information, contact Caryn Lindsey, LCSW, at 310-423-2412 or by email at caryn.lindsey@cshs.org. There is no fee.

Endometriosis Support Group: Connect with others who are facing challenges living with an endometriosis diagnosis. Currently, the group meeting is virtual. Register here. The fee is $15.

Empowered Relief (chronic pain management class): A single-session, two-hour class providing patients with in-depth knowledge about chronic pain and effective pain management.  Register here. The fee is $30.

Read more on the Cedars-Sinai Blog: You’re Not Alone: Coping With Endometriosis

, director of Nursing Research and Quality Improvement and assistant professor of Biomedical Sciences at Cedars-Sinai, joined the International Transplant Nurses Society (ITNS) as a speaker at the group’s inaugural presentation for the Commission on the Status of Women at the United Nations.

“It’s a high honor to participate at the level of the U.N.,” Coleman said. “But specifically, to highlight the work that is being done to bring awareness to the disparities that exist between men and women in the transplant space.”

The commission’s theme this year was “Accelerating Efforts Toward Gender Equality to Achieve Universal Health Coverage.” Coleman and her fellow ITNS speakers discussed the key challenges faced by women in transplantation as they work to create a global transplant community focused on diversity, equity and inclusion.

There are a number of barriers to women receiving equitable care, according to Coleman.

“So often, women are busy and put their partners or their families before their own health, creating an initial delay in treatment,” Coleman said. “In the event that they do get to their provider, the challenge becomes the provider hearing and believing their symptoms in order to treat them with the appropriate level of care.”

Additionally, Coleman says that women, and particularly women of color, are generally underrepresented in clinical research studies.

“We are immensely proud to have Dr. Coleman represent Cedars-Sinai in front of the U.N.,” said David Marshall, JD, DNP, RN, senior vice president and chief nursing executive at Cedars-Sinai. “Her commitment to diversity, equity and inclusivity in all patient care makes her an outstanding choice to bring this topic to an international stage.”

Coleman joined Cedars-Sinai in 1987 as a clinical nurse specialist in Cardiac Surgery. Her research spans bench to bedside to community—with work on genomic transplant disparities, family caregivers, and church-based preventive blood pressure education. She earned a master’s degree from the Yale University School of Nursing and a doctorate from the UCLA School of Nursing.

Read more from Cedars-Sinai Catalyst: Bolstering Excellence in Nursing

Women who received standard recommended immunizations during their pregnancy were more likely to accept the COVID-19 vaccine, according to new research from Cedars-Sinai. Investigators also identified disparities in vaccination linked to race and insurance status.

The findings on COVID-19 vaccine uptake during pregnancy are published in the Journal of Infection.

“We found that patients were more likely to accept COVID-19 vaccination if they were Asian, had private health insurance, and had received the recommended pregnancy vaccinations for Tdap (tetanus-diphtheria-acellular pertussis) and the flu,” said corresponding author Laura Ha, MD, a maternal-fetal medicine fellow in the Department of Obstetrics and Gynecology.

Maternal age and weight, in addition to race, also played a role in vaccine hesitancy.

“Pregnant women who were Black, under 35 years of age, not obese or had public insurance were less likely to accept COVID-19 vaccination,” Ha said.

In this retrospective cohort study, investigators examined the medical records of 7,857 patients who delivered at Cedars-Sinai in Los Angeles between December 2020 and March 2022. Immunizations received during pregnancy were among the health variables evaluated.

In May 2022, when the last of the cohort was included in the study, 78% of the U.S. adult population had received at least one dose of the COVID-19 vaccine, according to the Centers for Disease Control and Prevention. However, the rate among pregnant women was much lower; just 42% were vaccinated in spite of the recommendation of healthcare organizations, including the American College of Obstetricians and Gynecologists.

“COVID-19 infection is associated with an increased risk of severe illness and death in pregnant patients. The vaccine decreases the risk of hospitalization and death from the virus, which is why we recommend that pregnant patients get vaccinated,” said  Mariam Naqvi, MD, a maternal-fetal medicine specialist and co-author of the study.

The research also supports the growing body of evidence on the safety of the COVID-19 vaccine for mothers and their newborns.

Our findings were consistent with existing data showing that receiving the COVID-19 vaccine during pregnancy does not increase the risk of preterm birth, low birthweight, low Apgar scores, or admission to the neonatal intensive care unit,” Ha said. The Apgar score is a test given to newborns soon after birth. It assesses the baby's heart rate, muscle tone, and other signs to see if extra medical care or emergency care is needed.

Investigators urge continued research on COVID-19 vaccination in pregnant women to ensure equitable and widespread vaccine distribution and to provide safety data that could improve vaccine acceptance and perinatal outcomes.

Read more on the Cedars-Sinai Blog: COVID-19 Vaccine and Pregnancy

at Cedars-Sinai found that women who developed signs of elevated blood pressure during pregnancy were more likely to have residual evidence of abnormal heart structure and function up to a decade after the pregnancy.

“This study helps to clarify that, for some women, pregnancy is not just a ‘stress test’ that unmasks underlying cardiovascular risks,” said Susan Cheng, MD, MPH, the Erika J. Glazer Chair in Women’s Cardiovascular Health and Population Science, director of the Institute for Research on Healthy Aging in the Department of Cardiology in the Smidt Heart Institute, and senior author of the study. “This risk may also affect the heart years after pregnancy.”

The study, recently published in the peer-reviewed journal Hypertension, looked at more than 5,000 Hispanic/Latina women with at least one prior pregnancy and identified those who had hypertensive disorders of pregnancy, such as gestational hypertension, preeclampsia or eclampsia.

“This study confirms the results of others and demonstrates that women who experience a hypertensive disorder during their pregnancy are more likely to have lasting changes in the structure and function of their hearts than women who have normal blood pressure during their pregnancy,” said Natalie Bello, MD, MPH, director of Hypertension Research in the Smidt Heart Institute and co-author of the study. “Further, this work shows that only a portion of the abnormalities in the heart are explained by the woman’s current blood pressure.”

After accounting for other cardiovascular risk factors that might otherwise lead to early signs of heart disease, researchers found that the approximately 14% of study participants who had developed hypertensive disorders during pregnancy had several persistent heart-related issues found on cardiac imaging. These included greater heart-wall thickness, more frequent abnormal left-ventricle geometry and lower ejection fraction when compared to women who also had a prior pregnancy but without any related hypertensive disorder.

Although they make up a large and growing population of the United States, historically, Hispanic/Latina women have been underrepresented in medical studies. Using data from the Hispanic Community Health Study/Study of Latinos—a multicenter community-based study—investigators were able to engage this diverse population in their research. However, study authors say that given the underlying diversity of Hispanic/Latinx people, the findings of this study are not likely to be specific to any particular ethnicity, race or national origin.

“Cedars-Sinai has long invested in women’s heart health research, and this newest, critical study deepens our understanding of who is most at risk for hypertensive disorders in pregnancy,” said Christine M. Albert, MD, MPH, who is chair of the Department of Cardiology in the Smidt Heart Institute and holds the Lee and Harold Kapelovitz Distinguished Chair in Cardiology and was not involved in this study.

Read more from Cedars-Sinai Discoveries Magazine: Bridging the Data Gap on Hypertension During Pregnancy 

Huntington Health has added numerous highly respected and deeply rooted local physicians through the affiliation, enhancing and expanding local access to expert care and services in Pasadena and the San Gabriel Valley. Among these: cancer; cardiac, vascular and thoracic surgery; obstetrical and gynecological care; pediatric subspecialty services; and otolaryngology (ear, nose and throat).

“We chose to affiliate with Cedars-Sinai for many reasons, including their commitment to grow care at a local level to build healthy, strong communities,” said Lori J. Morgan, MD, MBA, president and CEO of Huntington Health. “Under this guiding principle, we’ve come a long way in two short years.”

Thomas M. Priselac, president and CEO of Cedars-Sinai Health System, credits the commitment of teams at both organizations for the affiliation’s early achievements.

“When we welcomed Huntington Health into the Cedars-Sinai family in August 2021, we were excited about the many opportunities to collaborate, as well as the opportunity to share resources and expertise,” Priselac said. “It is very gratifying that we already have up-and-running collaborations and new information-technology platforms in place that are benefiting patients.”

The accomplishments of the affiliation include:

• Patient care/patient experience—Huntington Health launched CS-Link, a secure, electronic medical records system that enables patients to communicate with their doctors, schedule appointments and access their personal health information. A newly created software system—designed to enhance and simplify the billing/payment experience for patients—also has been implemented.
   
• Cancer care—Huntington Cancer Center, an affiliate of Cedars-Sinai Cancer, has seen tremendous growth in dedicated personnel and services. Additional physicians have joined Huntington Health to expand the already expert roster of skilled clinicians who provide comprehensive cancer care—from diagnosis through surgery and recovery. There are expanded capabilities for infusion for chemotherapy and direct access to Cedars-Sinai Cancer clinical trials.
   
• Cardiac, vascular and thoracic surgery—Expert surgeons have joined the Cardiac, Vascular and Thoracic Surgery Program at Huntington Health to offer a wide range of lifesaving and life-enhancing surgeries to local patients. New, innovative treatment options include robotic valve repair, coronary artery bypass grafting, aortic root and arch surgery, surgical treatment of arrhythmias and minimally invasive thoracic surgery, making this a state-of-the-art program in the San Gabriel Valley. Cedars-Sinai is pleased that cardiac surgeon Robbin Cohen, MD, has joined the faculty and serves as director of the Cardiac Surgery Program at Huntington Health and professor of Cardiac Surgery in the Department of Cardiac Surgery at Cedars-Sinai.  
  
  These surgeons enable San Gabriel Valley residents to access the full spectrum of coordinated care offered by the Smidt Heart Institute at Cedars-Sinai. Cedars-Sinai is best in California and #2 in the U.S. for Cardiology, Heart & Vascular Surgery, according to U.S. News & World Report's "Best Hospitals 2023-24" rankings.
   
• Otolaryngology—Cedars-Sinai’s nationally recognized Otolaryngology Program is now available to adult and pediatric patients throughout the San Gabriel Valley who have conditions affecting the ear, nose and throat.
   
• OB-GYN—Fair Oaks Women’s Health, one of the most respected and longstanding obstetrical and gynecological practices in the San Gabriel Valley, joined Cedars-Sinai in May. With six specialists, it will provide patients access to an even greater network of specialized care.
   
• Pediatric care—Huntington Health’s Neonatal Intensive Care Unit and pediatric physicians now have access to Cedars-Sinai pediatric subspecialists via teleconsultations. The affiliation also enables direct transfers to Cedars-Sinai Guerin Children’s for the most complicated conditions. Outpatient pediatric care in endocrinology and cardiology is also now available at Huntington Health.

“We are so pleased with the progress this partnership has made over the past two years, and I’m confident that these strides point to continued success in the years ahead,” Priselac said.

Read more on the Cedars-Sinai Blog: Heart Disease | When to Get a Second Opinion

Formerly known as the California Pregnancy-Associated Mortality Review (CA-PARM), the committee conducts in-depth investigations of deaths during—and up to one year after— pregnancy. The goal is to identify the causes of maternal loss of life, and any contributing factors, in order to develop evidence-based recommendations for prevention.

CA-PARM was established in 2006 by the California Department of Public Health, in partnership with the California Maternal Quality Care Collaborative, where Gregory has also served.

“We couldn't be more excited about Dr. Gregory's appointment to lead CA-PARC. Her leadership experience with the state committee, a distinguished career as a maternal-fetal medicine specialist, and her critical research on maternal health outcomes and disparities make her perfectly suited for this role,” said Amanda Williams, MD, MPH, the Clinical Innovation Advisor at the California Maternal Quality Care Collaborative.

Gregory is the director of Maternal-Fetal Medicine and vice chair of Women's Healthcare Quality and Performance Improvement in the Department of Obstetrics and Gynecology at Cedars-Sinai.  

“Death associated with pregnancy is a tragic event, impacting families and communities. Each woman who died while pregnant, or in the postpartum period, deserves a thorough and respectful review of what contributed to their death. It is my honor to serve as chair of CA-PARC and to work with a team who is thoughtful and diligent with this sensitive review process. We are dedicated to work that may keep others from dying from preventable causes,” said Gregory, who holds the Helping Hand of Los Angeles–Miriam Jacobs Chair, Maternal-Fetal Medicine.

Gregory joined Cedars-Sinai in 1992, after receiving her medical degree from the Drew/UCLA Medical Education Program and completing her residency in obstetrics and gynecology at Beth Israel Deaconess Medical Center in Boston. She went on to earn a master’s degree in public health from Harvard University before completing a fellowship in maternal-fetal medicine at LAC+USC Medical Center.

A major focus of Gregory’s research over the past decade has been examining the hospital childbirth experience from the mother’s perspective. Her goal is for hospitals to provide a safer and more meaningful experience for women in their care, addressing concerns that range from better pain management to breastfeeding policies.

“Dr. Gregory has been steadfastly committed to improving obstetric outcomes for women for her entire career. She is a compassionate physician whose dedication to providing her patients the best possible care also drives her innovative research to identify and reduce racial and ethnic disparities that can impact the healthcare women of color receive. She wants every pregnant patient to receive the best possible care available,” said Sarah Kilpatrick, MD, PhD, the Helping Hand of Los Angeles Chair of Obstetrics and Gynecology at Cedars-Sinai.

Read more on the Cedars-Sinai Blog: Equitable, Personalized Care for Women and Children of Color

concluded that further research is needed to clarify the reasons for this disparity.

“We’ve known for years that Black women with endometrial cancer have lower survival rates than white women, largely because they are more likely to have an aggressive subtype and to be diagnosed at an advanced stage,” said Kristin Taylor, MD, assistant professor of Obstetrics and Gynecology at Cedars-Sinai and lead author of the study. “But our study found this disparity persists even when we compare patients with the lowest-risk form diagnosed at the earliest possible stage.”

Taylor and fellow investigators reviewed data on more than 23,000 Black and white women from the National Cancer Institute’s SEER database, which collects data from registries in 18 geographic areas in the U.S. All of the patients had the earliest-stage, least-aggressive endometrial cancer—a type called stage 1A low-grade endometrioid endometrial carcinoma.

“Low-grade endometrioid tumors account for about 80% of endometrial cancers, and most of these are stage 1 at diagnosis,” said Taylor. “For these patients, standard treatment is hysterectomy, and many should be cured without the need for radiation or chemotherapy.”

The SEER data showed that the vast majority of patients, both Black and white, were treated with hysterectomy and had high overall survival rates. However, while just 1% of white women did not receive hysterectomies, 3% of Black women in the study didn’t receive this lifesaving surgery.

“We had hoped that when we looked only at the lowest-risk patients, the disparity between Black and white women would disappear, but it did not,” Taylor said. “It’s disappointing.”

Residing in the South, being insured with Medicaid, and residing in a county with low median income were also associated with not receiving surgery.

Study investigators said doctors might recommend against hysterectomy for women—both Black and white—with underlying health conditions that increase risk of surgical complications. Doctors might also offer women of childbearing age a fertility-sparing hormone treatment that lets them temporarily postpone surgery, Taylor said.

However, a slightly higher—though not statistically significant—number of Black women than white women refused surgery when their doctors recommended it, the study found.

“Although there was no data collected on the reason for refusal,” Taylor said, “there is likely an element of mistrust of the medical community that contributes to this difference.”

One factor that might help account for this disparity is structural racism, Taylor said. She pointed to historical policies that caused more Black people to be of lower socioeconomic status, and thus more likely to be uninsured or underinsured and have less access to quality healthcare. She also noted prior medical experimentation on Black people (e.g., the Tuskegee syphilis study) as recently as a few decades ago.

“Even though they might not always be in our conscious memory, I think that the downstream effects of those insults from decades ago get passed on culturally, particularly in the South. Among my own family, I see geographical differences in how members perceive their relationships with their doctors,” said Taylor, who was born in the South but grew up in Illinois.

Taylor said that further studies should be conducted to delve into the roles of these social factors.

“Disparities in survival that persist even among patients with the same stage and subtype of cancer must be investigated and addressed,” said Dan Theodorescu, MD, PhD, director of Cedars-Sinai Cancer and the PHASE One Distinguished Chair. “Dr. Taylor’s work is an example of the many ways investigators at Cedars-Sinai Cancer are working to understand these disparities and bring the highest level of care to all of the diverse patient groups we serve.”

Going forward, Taylor and team plan to address some limitations of the current study by looking at a different dataset.

“One major limitation with the SEER database is that socioeconomic factors are recorded at the county level, which is so broad,” Taylor said. “We're essentially repeating this study using the California Cancer Registry, which gives information including median income, education level, insurance status, primary language and immigration status at the neighborhood level. We'll have a much richer, more granular view of the lives of these patients, which should be really informative.”

Another planned study goes in a completely different direction.

“Some data suggest that there are different genetic pathways, even within this narrow subset of tumors, that could be driving disparities between outcomes in Black and white women,” Taylor said. “We’re hoping to develop models in the lab derived from the tumors of Black and white women with this subtype of cancer to look for biologic differences that could help inform treatments for each population.”

Read more on the Cedars-Sinai Blog: Uterine Cancer: What Women Need to Know