It takes a village: Chimpanzee babies do better when their moms have social connections

A new Duke University study shows that chimpanzee moms with stronger social ties are more likely to raise surviving babies, even without help from kin.

Duke University

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New study shows that chimpanzee moms with stronger social ties are more likely to raise surviving babies, even without help from kin. 

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Credit: Photo courtesy of Madua Musa

DURHAM, N.C. — In chimpanzee communities, strong social ties can be a matter of life and death not just for the adults who form them, but for their kids, too.

A new federally-funded study of wild eastern chimpanzees (Pan troglodytes schweinfurthii) from Gombe National Park shows that female chimpanzees who were more socially integrated with other females in the year before giving birth were more likely to raise surviving offspring.

The findings, published online on June 18 in iScience, show that these survival benefits hold for females even in the absence of close kin. Contrary to many other species, chimpanzee females are the dispersing sex, usually leaving their maternal group at sexual maturity and establishing themselves in a new social group away from their kin. 

“In species where females live in groups with their sisters and mothers, it’s less surprising that female sociality is beneficial,” said Joseph Feldblum, assistant research professor of evolutionary anthropology at Duke and lead author on the study. “But female chimps don’t usually have that. They are also less gregarious than males, so the fact that forming strong social connections still matters is striking.”

To test the connection between friendships and offspring survival, researchers analyzed more than three decades of behavioral data from 37 mothers and their 110 offspring. They focused on association and grooming — how often females spent time near each other or engaged in social grooming behavior — in the year before birth, to avoid including social behavior from the post-birth period, during which it would be difficult to establish the causal relationship between infant loss and social behavior.

Females who were more socially connected had a considerably better chance of raising their babies through to their first year — the period of highest infant mortality. A female with a sociality score twice the community average had a 95% chance her infant would survive the first year. One who was halfway below average saw that chance drop to 75%. The effect persisted through age five, which is roughly the age of weaning. 

The research team then tested whether having close female kin in the group — like a sister or mother — accounted for the survival benefit. The answer was “no.” They also tested if the key was having bonds with males, who could potentially offer protection. The answer was also “no.” What mattered the most was having social connections with other females, regardless of kinship. 

“That tells us it’s not just about being born into a supportive family,” said Feldblum. “These are primarily social relationships with non-kin.”

The authors noted that the mechanism of the survival benefit remains unresolved, although there are several possibilities. Social females might receive less harassment from other females, more help defending food patches or protecting their young, or their offspring could be less likely to be killed by another group member. Social connections might also have helped these females stay in better condition — maybe better fed and less stressed — through pregnancy, giving their offspring a better chance from the get-go.

And it’s not just about the year before birth. Social females stayed social after their babies were born — a sign of stable relationships, not short-term alliances. “Our results don’t prove causation, but they point to the value of being surrounded by others who support you, or at least tolerate you,” said Feldblum.

“We humans are remarkably collaborative and cooperative. We cooperate at scales that are pretty much unique in the animal kingdom,” he said. “Human females who don’t have access to kin — for example because they moved to a new city or village — are still able to form strong bonds that can benefit them. Studying these social dynamics in chimpanzees can help us understand how we evolved to be the social, cooperative species we are today.”

  

Using over 30 years of data from Gombe National Park, new study found that the best predictor for infant survival isn’t rank, male allies or proximity to family, but rather social integration with other females.

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Photo courtesy of Maggie Hoffman

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REFERENCE: Joseph T. Feldblum, Kara K. Walker, Margaret A. Stanton, Elizabeth V. Lonsdorf, Deus C. Mjungu, Carson M. Murray, Anne E. Pusey, Socially integrated female chimpanzees have lower offspring mortality, iScience, 2025, 112863, https://doi.org/10.1016/j.isci.2025.112863.

FUNDING: Data collection was supported by the Jane Goodall Institute, construction of the long-term database was supported by grants from the NSF (DBS-9021946, SBR-9319909, BCS-0452315, IOS-1052693, IOS-1457260), the Harris Steel Group, the Windibrow Foundation, the University of Minnesota, and Duke University.

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Journal

iScience

DOI

10.1016/j.isci.2025.112863 

Method of Research

Data/statistical analysis

Subject of Research

Animals

Article Title

Socially integrated female chimpanzees have lower offspring mortality

Article Publication Date

28-Jun-2025

 

Striking increase in obesity observed among  American youth between 2011 and 2023

American College of Physicians

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Below please find summaries of new articles that will be published in the next issue of Annals of Internal Medicine. The summaries are not intended to substitute for the full articles as a source of information. This information is under strict embargo and by taking it into possession, media representatives are committing to the terms of the embargo not only on their own behalf, but also on behalf of the organization they represent.   
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1. Striking increase in obesity observed among youth between 2011 and 2023

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-00389

URL goes live when the embargo lifts             

A brief research report evaluated obesity among U.S. children and adolescents from 2011 to August 2023 and compared changes before and during the COVID-19 pandemic. The study found that the overall prevalence for obesity increased for all groups from January 2011 to August 2023. The increase was most pronounced among Black youth. While the pandemic presented obesity risk factors including the loss of safe spaces for physical activity, increased food insecurity, and heightened stress linked to family economic hardship, the authors found no overall increase in obesity after accounting for secular trends. The findings are published in Annals of Internal Medicine. 

 

Researchers from the Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center in Boston, MA studied serial cross-sectional data from the 2011 to August 2023 survey cycles of the NHANES (National Health and Nutrition Examination Survey). The participants studied were 17,507 children (ages 2 to 11 years) and adolescents (ages 12 to 19 years). The researchers calculated the unadjusted prevalence of obesity and severe obesity overall, as well as by age and self-reported race and ethnicity. They also estimated changes during the COVID-19 pandemic (August 2021 to August 2023) relative to the prepandemic period (January 2011 to March 2020). The researchers found the overall prevalence of obesity increased from 20.3% in January 2011 to March 2020 to 22.0% in August 2021 to August 2023. By the end of the study period (August 2021-August 2023), the prevalence of obesity was highest among Black (from 22.4% to 35.8%), Mexican American (from 26.4% to 28.1%), and Other Hispanic (from 24.0% to 25.9%) youth. Currently, more than in 1 in 3 Black youth, more than 1 in 4 Hispanic youth, nearly 1 in 5 White youth, and 1 in 10 Asian youth meet the criteria for obesity.

 

Media contacts: For an embargoed PDF, please contact Gabby Macrina at gmacrina@acponline.org. To contact corresponding author Rishi K. Wadhera, MD, MPP, MPhil, please email Katherine Brace at Katie.Brace@bilh.org.    

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2. Risk for microscopic colitis in older adults not associated with medications like statins and NSAIDs

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-00268

URL goes live when the embargo lifts             

A series of six target trial emulations were conducted to examine the potential causal effects of previously implicated medications on risk for microscopic colitis (MC) in older adults. The study found no evidence of a causal relationship between most previously suspected medications and the risk of MC. The results differ from numerous prior studies showing a consistent association between certain pharmacological treatments and MC. The study is published in Annals of Internal Medicine.

 

Researchers from Massachusetts General Hospital, Karolinska Institutet, and colleagues studied data from Swedish adults aged 65 or older between 2006 and 2017 with no history of inflammatory bowel disease or MC. They linked this cohort of older adults in Sweden to the ESPRESSO study, which contains data on gastrointestinal (GI)-related biopsies from all 28 pathology departments in Sweden from January 1965 until April 2017. They used these observational data to emulate six target trials of six suspected medications and MC risk among older adults: nonsteroidal anti-inflammatory drugs (NSAIDs), proton-pump inhibitors (PPIs), statins, angiotensin-converting enzyme inhibitors (ACE-I), angiotensin receptor blockers (ARBs), and selective serotonin receptor inhibitors (SSRIs). For NSAIDS, statins, and PPIs, they compared initiation of the medications versus no initiation. For ACE-I and ARB, they compared the initiation of each medication to the initiation of a calcium-channel blocker (CCB). For SSRIs, they compared the initiation of an SSRI with initiation of Mirtazapine. The primary outcome was histologic diagnosis of MC derived from the ESPRESSO cohort. The researchers found that the 12- and 24- months cumulative incidences of MC were less than 0.5% under all treatment strategies, with risk differences close to null for all treatment strategies except SSRIs. For SSRI vs mirtazapine initiation, the estimated 12- and 24-month risk differences were .04 and .06 percentage points. The researchers suggest that the apparent increased risk of MC with SSRI use as reported in previous studies could be due to surveillance bias. They suggest that clinicians should carefully balance the intended benefits of these medication classes against the very low likelihood of a causal relationship with MC.

 

Media contacts: For an embargoed PDF, please contact Gabby Macrina at gmacrina@acponline.org. To contact corresponding author Hamed Khalili, MD, MPH, please email Tori Roberts at vroberts1@mgb.org.        

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3. Catheter ablation reduces risk for stroke, mortality, and heart failure, demonstrating advantage over surgical ablation

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-00253

URL goes live when the embargo lifts             

A systematic review and meta-analysis aimed to determine the effect of ablation on stroke, death and hospitalization for heart failure (HF). The review found that catheter ablation reduces stroke risk at 30 days as well as mortality and heart failure hospitalization. Surgical ablation had an uncertain benefit, except for stroke. The study is published in Annals of Internal Medicine.

 

Researchers from Washington University in St. Louis and colleagues studied data from 63 randomized controlled trials of catheter or surgical ablation versus no ablation with a total of 11,161 participants. The primary end point was the rate of ischemic strokes that occurred more than 30 days after randomization or initiation of treatment. Secondary outcomes included rates of ischemic stroke at or before 30 days, total all-cause mortality, and total HF hospitalizations. Of the 63 trials included, 39 compared catheter ablation versus control therapy. The analysis found that catheter ablation reduced the relative risk of ischemic stroke after 30 days. However, the rates of ischemic stroke at or before 30 days were higher with catheter ablation. Versus medical therapy. Catheter ablation also reduced all-cause mortality after 30 days, total risk of ischemic stroke, total mortality, and HF hospitalization. Surgical ablation reduced the risks for ischemic stroke and stroke from any cause but had uncertain benefits for other outcomes. The results suggest that catheter ablation provides durable benefits, especially in patients with HF.

 

Media contacts: For an embargoed PDF, please contact Gabby Macrina at gmacrina@acponline.org. To contact corresponding author Brian F. Gage, MD, MSc please email Julia Sandvoss at jsandvoss@wustl.edu.

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4. ACP issues recommendations for optimizing risk adjustment, encouraging adoption of standardized methods and the interoperability of health care data

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-00280

URL goes live when the embargo lifts             

In a new policy paper published in Annals of Internal Medicine, the American College of Physicians (ACP) says optimizing risk adjustment would improve health equity. ACP offers recommendations for improving this component of health care financing and reimbursement through proactive measures that promote a more equitable and effective modern health care system.

 

To enhance the fairness and effectiveness of health care financing systems, in the paper, ACP recommends that health care programs and sectors use standardized methods of risk adjustment, so all health care entities understand how it works and how decisions are made. This would prevent discrepancies in how patient needs are evaluated and funded and would encourage unbiased use of resources. ACP encourages the interoperability of health care data and investment in health information technology to adopt common data standards, which would promote accurate risk adjustment and prevent the siloing of health data. Health care entities should collaborate to enact policy changes that prevent patient data used in adjusting risk from being reset annually.

 

Additionally, physicians, patient advocacy groups, and public and private payers should participate in routine evaluations and feedback that integrates valid and reliable metrics into risk adjustment models. ACP also calls for a strategic effort to limit opportunities to “game” the system by aligning economic incentives with the goal of high-quality, patient-focused care.

 

In a key recommendation, ACP advocates for research to develop validated methods for measuring the cost of caring for patients who experience health care disparities and inequities and maintains that it is essential that all risk adjustment approaches do not reinforce or perpetuate stereotypes. Patients experiencing health care disparities and non-medical drivers of health often face higher barriers to accessing care, which can lead to worsened health conditions and increased health care needs over time. This recommendation aims to foster a more holistic understanding of health.

 

Finally, advanced analytics and machine learning have the potential to revolutionize risk adjustment by providing access to more accurate data and predictive analytics. They should be used to improve upon risk adjustment models and methodologies. Prospective and current risk adjustment models have strengths that can be leveraged through hybrid models, enabling a more comprehensive view of health over time and better capturing patient complexities.

 

Media contacts: For an embargoed PDF, please contact Gabby Macrina at gmacrina@acponline.org. To speak with someone at ACP, please contact Jacquelyn Blaser at jblaser@acponline.org.        

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Also new this issue:

Licensing Internationally Trained Physicians: Advisory Commission Leaders Share Initial Progress

Humayun J. Chaudhry, DO, MS; John R. Combes, MD; Eric S. Holmboe, MD; Katie L. Templeton, JD; George M. Abraham, MD, MPH

Ideas and Opinions

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-00936

 

Does Anyone Remember the German Measles?

Bruce Farber, MD

Ideas and Opinions

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-01726  

 

GRADE Certainty Ratings: Thresholds Rather Than Categories of Contextualization

Monica Hultcrantz, et al.

Research and Reporting Methods

Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-25-00548

 

Low-income patients experience greatest financial burden from US health insurance claim denials

UMass Amherst research shows inequities are “systemic,” recommends simplifying billing rules and creating more user-friendly ways to contest denials

University of Massachusetts Amherst

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Michal Horný is an assistant professor of health policy and management in the UMass Amherst School of Public Health and Health Sciences.

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Credit: UMass Amherst

Low-income patients—and their healthcare providers—are less likely to challenge denials of their health insurance claims than those with household incomes above $50,000, according to University of Massachusetts Amherst research.  

In addition, when the low-income patients or their providers do fight these denials of payment for “free” preventive care or “shoppable” medical services, the outcomes are less successful than those of higher income patients. 

“People with higher income are more likely to have a denied claim reversed and consequently their cost sharing reduced,” says Michal Horný, assistant professor of health policy and management in the School of Public Health and Health Sciences. 

The findings, published in the journal Health Affairs, are the latest in Horný’s ongoing research into health insurance disparities across demographic and socioeconomic dimensions.  

In an earlier paper published in JAMA Network Open, Horný and co-authors found that low-income patients were 43% more likely than high-income patients to have their health insurance claims denied for such preventive care as cancer, diabetes, cholesterol and depression screenings, as well as contraception administration and wellness visits. And historically marginalized racial and ethnic groups were roughly twice as likely as non-Hispanic whites to incur denials.  

“Our new findings further exacerbate the disparity that we established initially,” Horný says. “We added the next step that not only are low-income people most likely to experience a denial, but they’re least likely to have it contested.” 

The new research also found that historically marginalized groups were generally less likely to contest denials. However, when they—or their healthcare providers—did, they were more likely than non-Hispanic whites to be successful in their challenges to get their denials reversed. Still, the mean reduction in cost-sharing was lower among Black and Hispanic people than among whites. 

“It is possible that minority patients were more likely to experience barriers to initiating a claim resubmission or reprocessing, including having access only to under-resourced healthcare providers, explicit or implicit bias, or structural racism,” the paper states. “It is also possible that some minority patients chose to contest only claim denials that were unequivocally wrong, and thus contesting them had a high chance of success.”  

Horný did not find any association between education level and the likelihood of contesting denied claims or being successful in those challenges. 

Horný and team—including Alex Hoagland, a health economist at the University of Toronto—reviewed data from 51,299 denied claims of medical services provided to U.S. adults with private health insurance between 2017 and 2019, most of which were linked to demographic information on the patients. About two in five denials result from incorrect billing by the healthcare provider or processing errors by health insurers. 

The researchers did not have access to who initiated the challenge of the claim denials. “When we launched this research, our mindset was that this is driven by the patient—that after receiving a letter from the insurer that the health plan is not going to pay for it, the patient would call the insurer and try to get the decision reversed,” Horný says. “But we realized that it actually can be driven by healthcare providers as well, because for healthcare providers it’s much easier to get money from a big company than from chasing many small amounts from many patients.” 

Horný says there’s a need for rules and regulations to combat the systemic inequities the research documents. He hypothesizes that low-income people don’t have the flexibility in their jobs and lives to spend hours on the phone contesting a denial. 

“We need regulators to demand health insurance companies be more user-friendly and allow people to contest a claim by filling out an online form 24/7, whenever they have the time to do it,” he says. 

To make it easier for under-resourced healthcare providers (often the ones low-income and marginalized groups visit), Horný recommends universal billing codes among payers to simplify the claims process and reduce errors by both the providers and insurers. 

“Our findings documented considerable administrative burden even for common, high-value health services, where unexpected bills continue to persist with an outsize effect on minoritized groups,” the paper notes. 

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Journal

Health Affairs

DOI

10.1377/hlthaff.2024.01277 

Method of Research

Data/statistical analysis

Subject of Research

People

Article Title

Claim Denials: Low-Income Patients From Disadvantaged Racial And Ethnic Groups Experienced The Largest Burdens

Article Publication Date

2-Jun-2025

 

New study reveals 33% gap in transplant access for UK’s poorest children

New research, presented at the ESOT Congress 2025, reveals persistent inequalities in children’s access to life-saving kidney transplants across the UK

Beyond

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(Tuesday 1 July 2025, London, United Kingdom) New research, presented at the ESOT Congress 2025, reveals persistent inequalities in children’s access to life-saving kidney transplants across the UK. The study highlights how ethnicity, socioeconomic status, and gender significantly influence a child's likelihood of receiving a transplant.1

Researchers from the University of Bristol analysed national data from the UK Renal Registry and NHS Blood & Transplant, focusing on patients under 18 years who started kidney replacement therapy between 1996 and 2020.2 Their findings reveal concerning disparities in access to transplant waitlists and to both deceased and living donor kidney transplants.3

Early on in their treatment, children from Black and Asian communities, girls, and those living in extremely low-income areas are frequently less likely to be placed on the transplant waitlist or receive a transplant. Compared to children from wealthier families, children from the lowest-income families have a 33% lower chance of being placed on the waiting list. Similarly, girls have a 12% lower chance of being added to the waitlist than boys.

“We were particularly struck by how early these disparities appear in the transplant process,” said Dr. Alice James, lead author of the study. “It’s not just about who gets a transplant, but who even gets considered in the first place.”

Once children are waitlisted, disparities related to gender and income tend to reduce, but disadvantages for children from Black backgrounds persist. “Those from Black ethnic backgrounds face systemic disadvantages even after being placed on the waitlist, including fewer living donor opportunities,” Dr. James explained. “This suggests that equity isn’t achieved by waitlisting alone.”

These disparities can have profound consequences. Delays or lack of access to transplantation, especially pre-emptive transplants, prolong children’s reliance on dialysis, which is associated with increased morbidity, poorer growth outcomes, cognitive delays, and reduced quality of life.4

International comparisons show that these issues are not unique to the UK. Similar disparities in paediatric kidney transplant access have been documented in the United States, Canada, and Australia, particularly among Indigenous and ethnic minority populations.5,6,7

To address these entrenched disparities in paediatric kidney transplantation, the research team is calling for urgent, system-wide action, including earlier referrals, culturally tailored education, and stronger family support. Training clinicians to recognise and address unconscious bias is also critical.8

Ongoing research is exploring how clinicians make decisions and gaining deeper insight into families’ experiences, with the goal of identifying and resolving the root causes of inequity.9 “Our goal now is to move from simply identifying these inequities to actually doing something about them,” Dr. James emphasised. “That includes clinician education, family outreach, and reforms that centre fairness in every step of the transplant pathway.”

 

END

 

Note to editors:

A reference to the ESOT Congress 2025 must be included in all coverage and/or articles associated with this study.

For more information or to arrange an expert interview, please contact Luke Paskins on press@esot.org.

About the study author:

Dr. Alice James is a researcher at the University of Bristol Medical School, focusing on paediatric nephrology and healthcare equity. Her work aims to improve transplant access and outcomes for children across diverse backgrounds.

About ESOT:

The European Society for Organ Transplantation (ESOT) was founded 40 years ago and is dedicated to the pursuit of excellence in organ transplantation. Facilitating a wealth of international clinical trials and research collaborations over the years, ESOT remains committed to its primary aim of improving patient outcomes in transplantation. With a community of over 8000 members from around the world, ESOT is an influential international organisation and the facilitator of the biennial congress which hosts approximately 3500 experts who come to meet to explore and discuss the latest scientific research.

References:

1. James A., Bailey P., Plumb L. Investigating Inequalities in Access to Paediatric Kidney Transplantation. Presented at ESOT Congress 2025; 1st July 2025; London, United Kingdom.
2. Hole B., Magadi W., Plumb L., Lyon S. (2023) UK Kidney Association Disparities Sub-report: Ethnicity disparities in patients with kidney failure in England and Wales.
3. Wong E., Medcalf J. UK Renal Registry (2024): Inequity of access to the UK kidney transplant waiting list.
4. Lullmann O., van der Plas E., Harshman L. (2023) Pediatric Transplantation. Understanding the impact of pediatric kidney transplantation on cognition: A review of the literature.
5. Patzer, R. E., Amaral, S., Klein, M., Kutner, N., Perryman, J. P., & McClellan, W. M. (2012). Racial disparities in pediatric access to kidney transplantation: Does socioeconomic status play a role? American Journal of Transplantation, 12(2), 369–378. https://doi.org/10.1111/j.1600-6143.2011.03888.x 
6. Chaturvedi, S., Ullah, S., LePage, A. K., & Hughes, J. T. (2021). Rising incidence of end-stage kidney disease and poorer access to kidney transplant among Australian Aboriginal and Torres Strait Islander children and young adults. Kidney International Reports, 6(6), 1704–1710. 
7. El-Dassouki, N., Wong, D., Toews, M., Gill, J., Edwards, B., Orchanian-Cheff, A., ... & Mysyk, A. (2021). Barriers to accessing kidney transplantation among populations marginalized by race and ethnicity in Canada: A scoping review Part 1—Indigenous communities in Canada. Canadian Journal of Kidney Health and Disease.
8. Hardeman, R. R., et al. (2022). JAMA Health Forum. Mandating Implicit Bias Training for Health Care Professionals: A Step Toward Equity in Health Care.
9. Ibrahim, H. N., et al. (2022) Pediatric Transplantation. Bias in decision-making and access to pediatric kidney transplantation: Need for qualitative studies

 

Breast cancer risk in younger women may be influenced by hormone therapy

NIH study could help to guide clinical recommendations for hormone therapy use among women under 55 years old

NIH/Office of the Director

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Scientists at the National Institutes of Health (NIH) have found that two common types of hormone therapy may alter breast cancer risk in women before age 55. Researchers discovered that women treated with unopposed estrogen hormone therapy (E-HT) were less likely to develop the disease than those who did not use hormone therapy. They also found that women treated with estrogen plus progestin hormone therapy (EP-HT) were more likely to develop breast cancer than women who did not use hormone therapy. Together, these results could help to guide clinical recommendations for hormone therapy use among younger women.

 

The two hormone therapies analyzed in the study are often used to manage symptoms related to menopause or following hysterectomy (removal of uterus) or oophorectomy (removal of one or both ovaries). Unopposed estrogen therapy is recommended only for women who have had a hysterectomy because of its known association with uterine cancer risk.

 

“Hormone therapy can greatly improve the quality of life for women experiencing severe menopausal symptoms or those who have had surgeries that affect their hormone levels,” said lead author Katie O’Brien, Ph.D., of NIH’s National Institute of Environmental Health Sciences (NIEHS). “Our study provides greater understanding of the risks associated with different types of hormone therapy, which we hope will help patients and their doctors develop more informed treatment plans.”

 

The researchers conducted a large-scale analysis that included data from more than 459,000 women under 55 years old across North America, Europe, Asia, and Australia. Women who used E-HT had a 14% reduction in breast cancer incidence compared to those who never used hormone therapy. Notably, this protective effect was more pronounced in women who started E-HT at younger ages or who used it longer. In contrast, women using EP-HT experienced a 10% higher rate of breast cancer compared to non-users, with an 18% higher rate seen among women using EP-HT for more than two years relative to those who never used the therapy.

 

According to the authors, this suggests that for EP-HT users, the cumulative risk of breast cancer before age 55 could be about 4.5%, compared with a 4.1% risk for women who never used hormone therapy and a 3.6% risk for those who used E-HT. Further, the association between EP-HT and breast cancer was particularly elevated among women who had not undergone hysterectomy or oophorectomy. That highlights the importance of considering gynecological surgery status when evaluating the risks of starting hormone therapy, the researchers noted.

 

“These findings underscore the need for personalized medical advice when considering hormone therapy,” said NIEHS scientist and senior author Dale Sandler, Ph.D. “Women and their health care providers should weigh the benefits of symptom relief against the potential risks associated with hormone therapy, especially EP-HT. For women with an intact uterus and ovaries, the increased risk of breast cancer with EP-HT should prompt careful deliberation.”

 

The authors noted that their study is consistent with previous large studies that documented similar associations between hormone therapy and breast cancer risk among older and postmenopausal women. This new study extends those findings to younger women, providing essential evidence to help guide decision-making for women as they go through menopause.

Reference: O’Brien, K., et al. “Hormone therapy use and young-onset breast cancer: a pooled analysis of prospective cohorts included in the Premenopausal Breast Cancer Collaborative Group.” Lancet Oncol 2025; 26: 911–23.

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About the National Institute of Environmental Health Sciences (NIEHS): NIEHS supports research to understand the effects of the environment on human health and is part of the National Institutes of Health. For more information on NIEHS or environmental health topics, visit www.niehs.nih.gov or subscribe to a news list.

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

NIH...Turning Discovery Into Health®

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Journal

The Lancet Oncology

Article Title

Hormone therapy use and young-onset breast cancer: a pooled analysis of prospective cohorts included in the Premenopausal Breast Cancer Collaborative Group

Article Publication Date

30-Jun-2025

 

Strategies for staying smoke-free after rehab

Flinders University

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Professor Billie Bonevski, FHMRI, Flinders University

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For people recovering from substance use disorders, quitting smoking remains one of the most difficult—but most crucial—steps toward long-term health.

New research from Flinders University reveals that providing consistent support and access to a range of nicotine replacement therapies (NRTs) can help people in recovery take that vital step.

A first-of-its-kind trial to compare vapes with combination nicotine replacement therapy (cNRT) - patches, gum, and lozenges - in people leaving smoke-free drug and alcohol rehab facilities was published today in the prestigious journal, The Lancet Public Health.

“Quitting smoking is never easy—but for people emerging from detox, it can be even harder,” says lead author Professor Billie Bonevski, Dean (Research) and Director of Flinders Health and Medical Institute (FHMRI).

“People recovering from substance use are more than twice as likely to smoke as the general population—and far more likely to suffer and die from tobacco-related illness.

“Yet, despite the overwhelming health burden, effective quit strategies tailored for those navigating addiction recovery have been in too short a supply.”

Tobacco smoking among people with substance use disorder (SUD) is a leading cause of health burden, with the prevalence of smoking more than double (84%) that of people without SUD (31%).

People with SUD also tend to experience complex comorbidities, including respiratory ill-health associated with smoking, and mental health challenges.

The study tracked more than 360 adults leaving detox facilities who were randomly given either a 12-week supply of vapes or a combination of nicotine gum, lozenge, inhalator and mouth spray. Both groups were also given Quitline behavioural smoking-cessation counselling.

At the nine-month follow-up, around 10% of people in both groups reported abstaining from smoking – a notable achievement in a cohort where long-term quit rates are typically near zero.

“Our findings underscore the importance of offering comprehensive support to people in drug and alcohol services who want to quit smoking,” says Professor Bonevski.

“This isn’t about one therapy outperforming another—it’s about building a system that gives people the best chance to succeed.

“What matters most is ensuring that people in recovery have access to a range of proven tools, because all nicotine replacement options appear to help.

“That means integrating smoking cessation into addiction treatment, providing tailored support, and ensuring that all effective nicotine therapies are readily available.”

The research contributes to a growing body of evidence that quitting smoking should be a key component of addiction recovery and that with the right support, it is possible.

“We need to treat tobacco dependence with the same urgency and support we give to other substances,” she says.

“Helping people in recovery quit smoking can save lives—and now we know there’s more than one way to do it.”

The paper, ‘Nicotine e-cigarettes for smoking cessation following discharge from smokefree inpatient alcohol and other drug withdrawal services: A pragmatic randomized controlled trial’, by Billie Bonevski, Jane Rich, Dan I Lubman, Catherine Segan, Amanda Baker, Ron Borland, Chris Oldmeadow, Coral Gartner, Natalie Walker, Adrian Dunlop, Mark Daglish, Christopher Bullen, Linda Bauld, David Jacka, Joshua B B Garfield, Rose McCrohan, Ashleigh Guillaumier and Victoria Manning was published in The Lancet Public Health journal.

Post embargo link: https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(25)00101-X/fulltext 

Acknowledgments: Authors thank the National Health and Medical Research Council of Australia for funding the trial with a Project Grant (GNT1160245). Authors also thank trial participants, the many study-related staff at the withdrawal service trial sites and coordinating trial centre, and the Quitline Victoria staff who contributed to the conduct of this trial.

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Journal

The Lancet Public Health

Method of Research

Randomized controlled/clinical trial

Subject of Research

People

Article Title

Nicotine e-cigarettes for smoking cessation following discharge from smoke-free inpatient alcohol and other drug withdrawal services: a pragmatic two-arm, single-blinded, parallel-group, randomised controlled trial

Article Publication Date

30-Jun-2025

COI Statement

CB declares grants for research from the New Zealand Ministry of Health, Health New Zealand, Health Research Council, Wake Forest University, and Education New Zealand, and support for travel to scientific meetings from Kenvue Asia, University of Edinburgh, and the Society for Research on Nicotine and Tobacco, for which he has served as President and Board member. All other authors declare no competing