It’s possible that I shall make an ass of myself. But in that case one can always get out of it with a little dialectic. I have, of course, so worded my proposition as to be right either way (K.Marx, Letter to F.Engels on the Indian Mutiny)
Tuesday, September 30, 2025
Study explores use of religion and spirituality to help patients cope with stress of radiation therapy for gynecologic cancers
Researchers identify the most meaningful questions to help clinicians open conversations about spirituality with patients
The Mount Sinai Hospital / Mount Sinai School of Medicine
New York, NY (September 30, 2025) – Researchers at the Mount Sinai Health System have identified specific ways in which addressing religion and spirituality during radiation therapy can play an important role in the care of patients with gynecologic cancers. The study, published in the September/October 2025 issue of Practical Radiation Oncology, is the first to identify which aspects of spiritual history patients themselves prioritize and find most meaningful.
A collaborative team from Mount Sinai and NYU Langone Health led the research. Key contributors included Lauren Jacobs, MD, a resident physician in Radiation Oncology at the Icahn School of Medicine at Mount Sinai; Karyn Goodman, MD, MS, Vice Chair for Research and Quality in the Department of Radiation Oncology at Mount Sinai; and senior author Stella Lymberis MD, Director of Quality Initiatives and GYN Disease Management Group Co-Lead in the Department of Radiation Oncology at NYU Langone. This is the first study to assess which spiritual history questions matter most to patients.
Using the validated FICA Spiritual History Tool (developed in 1999 by Christina Puchalski, MD, and a group of primary care physicians); the team interviewed 11 patients with gynecologic malignancies who had received external beam radiation therapy and/or brachytherapy. These patients adhered to a range of faiths, including Christianity, Buddhism, Judaism, Islam, and Hinduism.
“Our study highlights that patients want these conversations and that spirituality plays a vital role in how they cope with stress during cancer treatment,” said Dr. Jacobs, first author. “By asking the right questions, clinicians can create meaningful dialogue without adding burden to already time-limited visits.”
The study found that 82 percent of patients rated their faith as extremely important, giving it the highest score possible. On average, participants considered nearly all of the FICA Spiritual History Tool questions to be helpful, with six questions consistently identified as especially valuable. The two questions most often highlighted as meaningful ways to begin conversations with providers were: “Do you have spiritual beliefs that help you cope with stress?” and “Have your beliefs influenced you in how you handle stress?”
The findings are especially significant for patients undergoing gynecologic radiation therapy, such as brachytherapy, which can be invasive and emotionally distressing. Previous research has shown that nearly one-third of patients with cervical cancer develop acute stress symptoms after treatment, with more than 40 percent reporting post-traumatic stress months later.
“Patients are telling us clearly that their spiritual health matters just as much as their physical health,” said Dr. Goodman. “By engaging with them on these issues, we can better support emotional well-being, reduce distress, and provide truly whole-patient cancer care.”
The research team plans to expand the study to larger patient cohorts, apply the approach earlier in the cancer journey (diagnosis and pre-treatment), and extend it to other cancer types. They also aim to develop protocols and training for clinicians and trainees to normalize and integrate these discussions into routine practice.
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About the Icahn School of Medicine at Mount Sinai
The Icahn School of Medicine at Mount Sinai is internationally renowned for its outstanding research, educational, and clinical care programs. It is the sole academic partner for the seven member hospitals* of the Mount Sinai Health System, one of the largest academic health systems in the United States, providing care to New York City’s large and diverse patient population.
The Icahn School of Medicine at Mount Sinai offers highly competitive MD, PhD, MD-PhD, and master’s degree programs, with enrollment of more than 1,200 students. It has the largest graduate medical education program in the country, with more than 2,600 clinical residents and fellows training throughout the Health System. Its Graduate School of Biomedical Sciences offers 13 degree-granting programs, conducts innovative basic and translational research, and trains more than 560 postdoctoral research fellows.
Ranked 11th nationwide in National Institutes of Health (NIH) funding, the Icahn School of Medicine at Mount Sinai is among the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. More than 4,500 scientists, educators, and clinicians work within and across dozens of academic departments and multidisciplinary institutes with an emphasis on translational research and therapeutics. Through Mount Sinai Innovation Partners (MSIP), the Health System facilitates the real-world application and commercialization of medical breakthroughs made at Mount Sinai.
* Mount Sinai Health System member hospitals: The Mount Sinai Hospital; Mount Sinai Brooklyn; Mount Sinai Morningside; Mount Sinai Queens; Mount Sinai South Nassau; Mount Sinai West; and New York Eye and Ear Infirmary of Mount Sinai.
September 29, 2025(BRONX, NY)—A large, long-term study led by an Albert Einstein College of Medicine researcher has found that the introduction of the human papillomavirus (HPV) vaccine in community settings is highly effective in protecting young women from infections caused by the cervical-cancer-causing virus—including women who didn’t even receive the vaccine. The study was published today in JAMA Pediatrics.
“There are two encouraging takeaways from our study,” said lead author Jessica Kahn, M.D., M.P.H., professor of pediatrics and the Dr. Ernest Baden Chair in Head and Neck Pathology at Einstein. “First, HPV vaccines work remarkably well in a real-world setting, even among women at high risk for HPV and who may not have received all vaccine doses. Second, we saw clear evidence of herd immunity, meaning when enough people are vaccinated, the vaccine indirectly protects unvaccinated people by reducing overall virus transmission. These results reinforce the potential of the HPV vaccine to prevent infection and, ultimately, eliminate cervical cancer globally.”
HPV is the most common sexually transmitted infection worldwide and is the primary cause of cervical cancer. HPV also causes other genital cancers as well as head and neck cancers in both women and men. According to the International Agency for Research on Cancer, HPV is responsible for more than 690,000 new cancer cases each year—about 4.5% of all cancers globally.
Testing a Vaccine’s Real-World Performance While randomized clinical trials have shown that HPV vaccines confer strong protection from infection, “participants in those studies tended to be healthier and at lower risk for HPV than the general population, so they weren’t necessarily representative of the broader community,” said Dr. Kahn, who also serves as senior associate dean for clinical and translational research and director of the Harold and Muriel Block Institute for Clinical and Translational Research at Einstein and Montefiore. “That’s why we needed to evaluate how the vaccine works in real-world settings that included young women who were at relatively high risk for HPV and had different levels of vaccine uptake.”
The research team conducted six studies in Cincinnati of 2,335 adolescent and young adult women between 2006—just before the first HPV vaccine became available—and 2023. Participants ranged in age from 13 to 26 at enrollment. Many reported sexual behaviors that increased risk for HPV (79% had two or more male sexual partners) and 51% had a history of at least one sexually transmitted infection.
Participants were considered vaccinated if they had received at least one dose of any of the available HPV vaccines:
the 2-valent vaccine, which protects against HPV types 16 and 18 (responsible for over 70% of cervical cancers);
the 4-valent vaccine, which protects against HPV types 16 and 18 and adds protection against types 6 and 11 (which cause about 90% of genital warts);
and the current 9-valent vaccine, introduced in 2014, which in addition to HPV types 6, 11, 16 and 18, protects against five additional cancer-related HPV types (31, 33, 45, 52, and 58); the types targeted by this vaccine cause about 90% of cervical cancers.
Over the 17-year study period, HPV vaccination rates rose from 0% to 82%. As vaccination coverage increased, the rates of HPV infection dropped dramatically among vaccinated participants:
Infections from HPV types covered by the 2-valent vaccine fell by 98.4%
Infections from types covered by the 4-valent vaccine dropped by 94.2%
Infections from types covered by the 9-valent vaccine declined by 75.7%
“These outcomes show that HPV vaccines are highly effective outside of controlled trials and could dramatically reduce rates of cervical cancer and other HPV-caused cancers, including other genital cancers and head and neck cancers,” said Dr. Kahn.
“Our analysis of the data indicates that those reductions in infection rates were primarily due to the vaccine’s introduction and not because of changes in sexual behavior or other factors,” said Aislinn DeSieghardt, M.S., the paper’s first author and clinical research coordinator at Cincinnati Children’s Hospital Medical Center, Cincinnati, OH. “I also want to thank the all the young women who participated in the study, who have meaningfully contributed to this research that has the potential to save more lives.”
A Vaccine’s Benefits Extend to Unvaccinated Women The researchers also found strong evidence of herd immunity. Among unvaccinated women:
Infections with HPV types covered by the 2-valent vaccine decreased by 71.6%
Infections with HPV types covered by the 4-valent vaccine dropped by 75.8%
Dr. Kahn noted that the high degree of herd immunity was likely related to robust vaccination rates and vaccination of boys as well as girls. While there wasn’t enough data yet to confirm herd protection from the more recently introduced 9-valent vaccine, the results are promising.
“In the U.S. and other countries with widespread HPV vaccination programs, cervical cancer rates are already declining,” Dr. Kahn said. “Yet in 42 countries, it remains the leading cause of cancer death among women. Globally, only 27% of girls have received at least one dose of this lifesaving vaccine – with coverage ranging from just 1% in the Eastern Mediterranean region to 68% in the Americas. By expanding uptake of this highly safe and effective vaccine, and ensuring access to screening and treatment, we can achieve one of the greatest public health victories of our time: the elimination of cervical cancer worldwide.”
The study is titled “Population-Level Effectiveness and Herd Protection 17 Years After Human Papillomavirus Vaccine Introduction.” Additional authors include Aislinn DeSieghardt and Lili Ding both at Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, Aaron Ermel and Darron Brown, both at Indiana University School of Medicine, Indianapolis, IN, Eduardo L. Franco at McGill University, Montreal, Canada, Casey Dagnall at Leidos Biomedical Research, Inc., Frederick, MD and National Cancer Institute, Rockville, MD, and Sem Yao at Western Reserve Hospital, Cuyahoga Falls, OH.
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About Albert Einstein College of Medicine Albert Einstein College of Medicine is one of the nation’s premier centers for research, medical education and clinical investigation. During the 2024-25 academic year, Einstein is home to 712 M.D. students, 226 Ph.D. students, 112 students in the combined M.D./Ph.D. program, and approximately 250 postdoctoral research fellows. The College of Medicine has more than 2,000 full-time faculty members located on the main campus and at its clinical affiliates. In 2024, Einstein received more than $192 million in awards from the National Institutes of Health. This includes the funding of major research centers at Einstein in cancer, aging, intellectual development disorders, diabetes, clinical and translational research, liver disease, and AIDS. Other areas where the College of Medicine is concentrating its efforts include developmental brain research, neuroscience, cardiac disease, and initiatives to reduce and eliminate ethnic and racial health disparities. Its partnership with Montefiore, the University Hospital and academic medical center for Einstein, advances clinical and translational research to accelerate the pace at which new discoveries become the treatments and therapies that benefit patients. For more information, please visit einsteinmed.edu, follow us on Twitter, Facebook,Instagram, LinkedIn, and view us on YouTube.
Journal
JAMA Pediatrics
Method of Research
Case study
Subject of Research
People
Article Title
“Population-Level Effectiveness and Herd Protection 17 Years After Human Papillomavirus Vaccine Introduction.”
Article Publication Date
29-Sep-2025
Population-level effectiveness and herd protection 17 years after HPV vaccine introduction
JAMA Pediatrics
About The Study: In this study, population-level effectiveness and herd protection were robust 17 years after human papillomavirus (HPV) vaccine introduction, even in sexually experienced adolescent girls and young women at relatively high risk for HPV who may not have received the full vaccination series.
Corresponding Author: To contact the corresponding author, Jessica Kahn, MD, MPH, email jessica.kahn@einsteinmed.edu.
Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.
AI model for imaging-based extranodal extension detection and outcome prediction in HPV−positive oropharyngeal cancer
JAMA Otolaryngology–Head & Neck Surgery
About The Study: This single-center cohort study found that an artificial intelligence (AI)-driven pipeline can successfully automate lymph node segmentation and imaging-based extranodal extension (iENE) classification from pretreatment computed tomography scans in human papillomavirus (HPV)-associated oropharyngeal carcinoma. Predicted iENE was independently associated with worse oncologic outcomes. External validation is required to assess generalizability and the potential for implementation in institutions without specialized imaging expertise.
Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.
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Media advisory: This study is being presented at the ASTRO (American Society for Radiation Oncology) 2025 Annual Meeting.
Materials used to run the HPV LAMP assay. A cytology brush is used to collect a cervicovaginal swab sample into ThinPrep buffer. Samples are lysed in screw-on tubes and lysate is added to LAMP reagents in PCR tubes. The assay is run on the Axxin T8-ISO heater/fluorimeter.
Ateam of researchers led by Rice University, in collaboration with colleagues in Mozambique and The University of Texas MD Anderson Cancer Center, has developed a simple, affordable human papillomavirus (HPV) test that delivers results in less than an hour with no specialized laboratory required. The breakthrough could provide an option for women in low-resource settings to be screened and treated for cervical cancer in a single clinic visit, a step that global health experts say could save countless lives. The research was recently published inNature Communications.
Cervical cancer is considered easily preventable, yet it remains one of the deadliest cancers for women worldwide. According to the World Health Organization (WHO), each year more than 350,000 women die from the disease, and nearly 90% of those deaths occur in low- and middle-income countries where access to regular cervical cancer screening is limited. Persistent infection with high-risk types of HPV causes nearly all cases of cervical cancer. While vaccines are helping reduce HPV infections globally, most women at risk today are adults who did not get the vaccine in childhood. For them, regular and reliable screening is the only path to early detection and lifesaving treatment.
“Cervical cancer is almost entirely preventable, yet it still claims hundreds of thousands of lives each year,” said first author Maria Barra, a bioengineering graduate student at Rice. “Our goal was to build a test accurate enough to guide treatment, fast enough to use during a clinic visit and inexpensive enough to scale. This assay meets all three goals.”
The WHO recommends HPV DNA testing as the gold standard for cervical cancer screening, but existing HPV DNA tests often require expensive lab equipment and trained laboratory technicians — barriers that make widespread use in low-resource settings unattainable. As a result, many women are not screened for cervical cancer. Even where screening programs exist, results may take days or weeks to return. Patients leave to await results. However, where care facilities are remote, few in number and difficult to access, patients are often unable to return for treatment, leaving precancerous lesions to progress unchecked. A faster test without reliance on a lab could provide results and prompt treatment during the same patient visit.
“This is the kind of pragmatic innovation we focus on when engineering for global health — fewer steps, lower cost, higher impact,” said Rebecca Richards-Kortum, the Malcolm Gillis University Professor of Bioengineering and co-director of the Rice360 Institute for Global Health Technologies at Rice. “Our data show you can bring lab-grade molecular screening to almost any setting without sacrificing reliability. Providing accurate results quickly enables clinicians to start treatment without delay.”
The new test uses a method called loop-mediated isothermal amplification (LAMP), which simplifies DNA detection by running at a single temperature. Instead of requiring DNA extraction — a complicated step in many existing tests — this process is extraction-free. A swab sample is chemically lysed, added directly to the LAMP reagents and incubated for about 45 minutes in a portable heater then read by fluorescence.
The test detects three of the most dangerous HPV types (HPV16, HPV18 and HPV45), which together cause about 75% of all cervical cancers. It also includes a built-in cellular control to ensure that the sample was collected properly.
In clinical studies, the test showed 100% agreement with the reference standard in 38 samples from Houston and 93% agreementin 191 samples from Maputo, Mozambique. The cost of the test is projected to be less than $8 each, and the portable device it runs on is battery-operated, making it ideal for clinics without consistent electricity.
“High mortality rates from cancer are closely associated with delays in diagnoses and limited access to early treatment,” said Cesaltina Lorenzoni, head of the National Cancer Control Program at the Mozambican Ministry of Health, director of science and teaching at Maputo Central Hospital and professor of pathology at the Eduardo Mondlane University Faculty of Medicine. “Point-of-care technologies that can aid clinicians in identifying cancer and guide treatment options in a single patient visit could be lifesaving in clinical settings in Maputo. This assay performed very well in our clinical setting and holds promise of delivering the kind of rapid, specific, cost-effective cancer detection that would meaningfully improve outcomes for women in our country.”
The WHO has set ambitious targets to screen 70% of women worldwide by 2030as part of its public health campaign to eliminate cervical cancer. Meeting that goal will require screening millions of women in various global settings that lack advanced lab equipment or resources.
By cutting out expensive instruments, minimizing sample handling and delivering rapid, accurate results, the LAMP assay represents a significant step toward realistically achieving the WHO goal. Critically, it opens the door to “screen-and-treat” strategies, where if a positive result is found, the patient can be treated on the same medical visit, reducing treatment delays and loss to follow-ups.
The team is currently working to expand the test to cover additional high-risk HPV types and is also working on lyophilized (freeze-dried) reagents that don’t require refrigeration, further increasing the test’s usability in rural or resource-limited areas. The team also plans to conduct usability studies with frontline health workers to refine the design before larger clinical rollouts.
“Our goal is a complete, field-ready kit that community clinics can use anywhere,” Richards-Kortum said.“If we can help health systems move to same-day screen-and-treat, we can move towards a future where cervical cancer can be eliminated globally.”
This study was conducted by a multidisciplinary team in the U.S. and Mozambique with IRB approvals from MD Anderson, Harris Health, Rice and Mozambique’s National Bioethics Committee. All participants provided informed consent. The research was also supported by the National Institutes of Health.
