BMC Women's Health最新文献

{"title":"The effect of using lubricant for vaginal speculum insertion on the rate of unsatisfactory results of Pap smear: a systematic review and meta-analysis.","authors":"Mohammad Roodsarabi, Parvaneh Mirabi, Zeynab Farhadi, Mouloud Agajani Delavar, Hajar Pasha","doi":"10.1186/s12905-026-04674-x","DOIUrl":"10.1186/s12905-026-04674-x","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer affects approximately 620,000 women annually and remains a leading cause of cancer mortality, particularly in low-resource settings. This meta-analysis evaluates whether lubricant use during vaginal speculum insertion affects unsatisfactory cytologic results in Pap smear procedures.</p><p><strong>Methods: </strong>We systematically searched WoS/ISI, PubMed/MEDLINE, Scopus, Google Scholar, and Cochrane databases. RCTs and cohort studies were analysed in separate subgroup analyses per Cochrane Handbook recommendations. Quality was assessed using the Newcastle-Ottawa Scale and Cochrane RoB 2 tool; evidence certainty was rated via GRADE. Sensitivity analyses and publication bias assessment (funnel plots, Egger's test) were performed.</p><p><strong>Results: </strong>Of 2,112 identified records, 14 studies comprising 18,681 women (7,757 lubricant; 10,924 control) met inclusion criteria (Cohen's Kappa = 0.79). Overall, water-based lubricant did not significantly affect unsatisfactory Pap smear rates (OR = 1.14, 95% CI: 0.90-1.44; P = 0.280; I² = 38.74%). Subgroup analysis confirmed no significant impact in RCTs (OR = 0.83, 95% CI: 0.58-1.16; P = 0.253; I² = 0%), while cohort studies showed a borderline trend toward increased rates (OR = 1.37, 95% CI: 0.98-1.90; P = 0.062; I² = 59.98%). A non-significant trend toward pain reduction was observed (SMD = - 0.77, 95% CI: -1.55 to 0.01; P = 0.054); however, extreme heterogeneity (I² = 94.21%) precludes reliable interpretation.</p><p><strong>Conclusions: </strong>Lubricant use does not compromise Pap smear adequacy based on RCT evidence of moderate certainty; the borderline cohort trend is of low certainty and should be interpreted with caution. Pain evidence is inconsistent and highly heterogeneous; no clinical recommendation regarding patient comfort can be made. Large-scale standardized RCTs examining LSIL/HSIL detection are warranted. These findings support cautious guideline consideration of lubricant use pending higher-certainty evidence.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transnational strategies to promote female circumcision practice: voices from ghanaian families with relatives living in Europe and North America.","authors":"Alhassan Abdullah, Felix Mensah, Aisha Adam Mahama, Ebenezer Cudjoe, Peter Dwumah, Clifton R Emery","doi":"10.1186/s12905-026-04690-x","DOIUrl":"10.1186/s12905-026-04690-x","url":null,"abstract":"<p><strong>Background: </strong>The results from qualitative studies have revealed that some African migrants subject their young girls to female genital cutting (FGC) before or after migrating to high-income countries, such as the USA and the UK. This raises important questions as to why some African migrants continue to adhere to FGC after migration, given that the practice is socially rejected in destination countries and, in some cases, already criminalised in countries of origin. Little has been documented on the motivational factors for African migrants to continue promoting the practices even after migrating to Europe and North America. Consequently, we investigated the strategies used by Ghanaian families in motivating commitment to FGC norms and practices among their relatives in Europe and North America.</p><p><strong>Methods: </strong>Using a narrative qualitative research approach, we interviewed 13 family members in rural Ghana who strongly supported FGC and have family members who have migrated to Europe and North America. The interviews were analysed in NVivo using the narrative thematic analysis strategy.</p><p><strong>Findings: </strong>The interviews revealed both targeted and non-deliberate strategies, such as pressure from family members, building confidant relationships, and encouraging participation in African community associations. Family members became confidants and a source of connection for their relatives who felt isolated or experienced racism. However, they capitalised on the bonds and trusting relationships to influence their relatives to support FGC through daily conversations.</p><p><strong>Conclusion: </strong>The findings give important insights into how norms are promoted across borders, highlighting the need to strengthen existing transnational collaborative efforts to address FGC, including cross-border legislation.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for antibiotic treatment failure in tubo-ovarian abscess: a systematic review and meta-analysis.","authors":"Minmin Zhao, Rong Chen, Liting Fan, Haiyan Zhang","doi":"10.1186/s12905-026-04534-8","DOIUrl":"10.1186/s12905-026-04534-8","url":null,"abstract":"<p><strong>Background: </strong>Tubo-ovarian abscess (TOA) is a severe complication of pelvic inflammatory disease (PID). Conservative antibiotic therapy is the preferred first-line treatment; however, treatment failure necessitates surgical intervention in a subset of patients. This study aimed to identify risk factors associated with antibiotic treatment failure in TOA through a systematic review and meta-analysis, thereby providing evidence for clinical decision-making.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, Embase, the Cochrane Library and Web of Science to identify controlled studies on risk factors for antibiotic treatment failure in TOA published between database inception and December 2025. The Newcastle-Ottawa Scale was used to assess the quality of the literature. Mean differences (MDs) or odds ratios with 95% confidence intervals were calculated. Heterogeneity was assessed using the I² statistic and the Q test.</p><p><strong>Results: </strong>Thirteen studies involving 1,759 patients were included. The meta-analysis revealed that patients in the antibiotic treatment failure group were significantly older (MD = 3.61 years, P < 0.0001) and had significantly larger abscess diameters (MD = 18.43 mm, P < 0.0001) than those in the success group. Furthermore, higher gravidity (MD = 0.59, P = 0.0001) and parity (MD = 0.32, P = 0.002) were identified as significant risk factors for treatment failure. No statistically significant associations were found between treatment failure and history of smoking, history of PID, intrauterine device use, palpable pelvic mass or positive pathogen culture.</p><p><strong>Conclusion: </strong>Advanced age, larger abscess diameter and multiparity are potential risk factors for antibiotic treatment failure in TOA. For such high-risk patients, more aggressive monitoring or early combined minimally invasive drainage strategies are recommended.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, risk factors, and comparative diagnostic performance of cryptic plasmid and MOMP-based real-time PCR assays for genital Chlamydia trachomatis infection among women of reproductive age in the West Region of Cameroon: a cross-sectional study.","authors":"Boris Emmanuel Djoumsie Gomseu, Mahamat Mustapha Anouar","doi":"10.1186/s12905-026-04673-y","DOIUrl":"10.1186/s12905-026-04673-y","url":null,"abstract":"<p><strong>Background: </strong>Chlamydia trachomatis (C. trachomatis) is a leading cause of sexually transmitted infections (STIs) in resource-limited settings. In low-income contexts such as Cameroon, the epidemiology of this bacterium remains poorly documented. This study aimed to determine the prevalence and risk factors of C. trachomatis infection among women of reproductive age in the West Region of Cameroon, and to assess the analytical performance and concordance of cryptic plasmid and major outer membrane protein (MOMP)-based real-time PCR (R-T PCR) assays.</p><p><strong>Materials and methods: </strong>A cross-sectional study was conducted among 570 women of reproductive age presenting at four selected health facilities in the West Region of Cameroon. Endocervical swabs were collected and analyzed using R-T PCR targeting the MOMP and cryptic plasmid genes to detect C. trachomatis DNA. Socio-demographic, behavioral, and clinical data were recorded using a structured questionnaire. Statistical analyses were performed using SPSS version 24. Multivariable logistic regression was used to identify factors associated with C. trachomatis infection. Diagnostic performance of MOMP and cryptic plasmid R-T PCR was evaluated using Cohen's kappa statistic and McNemar's test, with ompA R-T PCR assay, used as the comparator.</p><p><strong>Results: </strong>The prevalence of C. trachomatis infection was 12.98%. Infection was associated with secondary education level (aOR = 7.39, [95% CI]: 2.24-24.41), Bantu ethnicity (aOR = 6.52, [95% CI]: 2.35-18.11), being a secondary school student (aOR = 3.04, [95% CI]: 1.24-7.46), lack of knowledge of transmission routes (aOR = 5.91, [95% CI]: 2.16-16.12), postcoital pain (aOR = 14.86, [95% CI]: 4.12-55.10) and history of miscarriage (aOR = 2.40, [95% CI]: 0.94-6.08).</p><p><strong>Conclusions: </strong>Study shows that genital Chlamydia trachomatis infection was identified among women of reproductive age in the West Region of Cameroon and was associated with education level, ethnicity, occupation, limited knowledge of transmission routes, postcoital pain, and history of miscarriage. Cryptic plasmid-based R-T PCR showed acceptable diagnostic performance in this setting. These findings support strengthening sexual health education and considering the integration of C. trachomatis testing into reproductive health services in similar contexts.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of hands-on breast self-examination training on knowledge, health beliefs, and BSE practice among female university students: a randomized controlled trial.","authors":"Ezgi Ağadayı, Tounaja El Arby, Asude Tuğba Balta, Öznur Kübra Odabaş, Naim Karagöz","doi":"10.1186/s12905-026-04656-z","DOIUrl":"10.1186/s12905-026-04656-z","url":null,"abstract":"<p><strong>Background: </strong>Breast self-examination (BSE) is a simple, low-cost method for promoting breast awareness and early detection of breast abnormalities, particularly among young women. However, lack of confidence and perceived barriers often limit regular BSE practice. Educational interventions that combine theoretical knowledge with hands-on training may enhance self-efficacy and support sustainable behavioral change.</p><p><strong>Objective: </strong>This study aimed to compare the effects of theoretical education alone versus theoretical plus hands-on BSE training on breast cancer knowledge, health beliefs, and BSE practice among female university students.</p><p><strong>Methods: </strong>This randomized controlled study was conducted among 40 female university students residing in university dormitories. Participants were stratified based on pretest scores and randomly assigned to either a theoretical education-only group (n = 20) or a theoretical plus hands-on training group (n = 20). The primary outcomes were breast cancer knowledge, health beliefs, and BSE practice. Breast cancer knowledge was assessed at baseline, immediately after training, and at a 3-month follow-up using the Breast Cancer Knowledge Test (BCKT). Health beliefs were assessed at baseline and at the 3-month follow-up using the Champion Health Belief Model Scale. BSE practice frequency and perceived barriers were also recorded. Repeated-measures and mixed-design ANOVA and chi-square tests were used for data analysis.</p><p><strong>Results: </strong>Breast cancer knowledge increased significantly in all participants from pretest to posttest (p < 0.001) and remained significantly higher than baseline at the 3-month follow-up, although a slight decline was observed. No significant Time × Group interaction was found for knowledge scores. In contrast, significant Time × Group interactions were observed for health motivation (p = 0.001), perceived barriers to BSE (p < 0.001), and self-efficacy (p = 0.005), all favoring the theoretical plus hands-on training group. Regular BSE practice increased from 0% at baseline to 60% at follow-up across the cohort, with a significantly greater increase in the hands-on training group compared with the theoretical-only group (75% vs. 45%, p = 0.038).</p><p><strong>Conclusion: </strong>While theoretical education effectively improves breast cancer knowledge, the addition of hands-on BSE training is critical for reducing perceived barriers, enhancing self-efficacy, and promoting regular BSE practice. Incorporating hands-on training into breast health education programs may substantially improve behavioral outcomes among young women.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between women's occupation and fertility outcomes in The Gambia, 2019-2020.","authors":"Baboucarr Jatta, Adriana A E Biney, Joseph W Jatta","doi":"10.1186/s12905-026-04659-w","DOIUrl":"10.1186/s12905-026-04659-w","url":null,"abstract":"<p><strong>Background: </strong>Women's occupation and labour force participation are assumed to lower fertility levels as they compete with women's household obligations. While research has demonstrated this to be true in industrialized nations, developing countries, such as The Gambia, require further investigation.</p><p><strong>Methods: </strong>Secondary data extracted from the Gambia Demographic Health Survey (GDHS) 2019-2020 were used. A weighted sample of 11,865 women of reproductive age (15-49 years) was included in the study. At the bivariate level, one-way ANOVA and t-tests were used to examine the relationship between the dependent variable, children ever born, and the independent variable, women's occupation, as well as each control variable. Multivariable analysis, comprising Poisson regression models, was used to assess the impact of the independent variable on the dependent variable while controlling for confounders.</p><p><strong>Results: </strong>The analysis revealed that women's occupational type was significantly associated with fertility in The Gambia. After adjustment for socio-demographic characteristics, women in professional, technical, managerial, and clerical occupations had approximately 12.8% fewer children than non-working women (IRR = 0.872, p < 0.01), while women in agricultural occupations had approximately 6.3% more children (IRR = 1.063, p < 0.01). Age, education, wealth status, contraceptive use, religion, and marital status were also significantly associated with children ever born.</p><p><strong>Conclusion: </strong>The findings show that measures aimed at lowering fertility should be multifaceted, focusing on variables that were found to be significant in this study. These could be effective tools for empowering Gambian women and lowering fertility. There is also a need for further primary data-based research into the relationship.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ectocervical margin involvement is associated with postoperative hrHPV positivity after hysterectomy or residual cervix resection for incompletely excised CIN3: a retrospective study.","authors":"Yedan Ren, Xiuli Zhang, Junfen Xu","doi":"10.1186/s12905-026-04667-w","DOIUrl":"10.1186/s12905-026-04667-w","url":null,"abstract":"<p><strong>Background: </strong>Persistent high-risk human papillomavirus (hrHPV) infection after hysterectomy or residual cervix resection for incompletely excised cervical intraepithelial neoplasia grade 3 (CIN3) remains a clinical concern. However, the factors associated with postoperative hrHPV positivity in this setting are not well characterized.</p><p><strong>Methods: </strong>This retrospective study included 288 patients who were treated between 2014 and 2024. We evaluated factors associated with postoperative hrHPV positivity after hysterectomy or residual cervix resection for incompletely excised CIN3. Patients were grouped according to their hrHPV status at the first postoperative follow-up, and associated factors were identified by using logistic regression.</p><p><strong>Results: </strong>At the first postoperative follow-up, 50 patients (17.4%) were hrHPV positive. According to the univariate analysis, postoperative hrHPV positivity was associated with ectocervical margin involvement, older age, and lower gravidity (all p < 0.05). Multivariate analysis revealed that ectocervical margin involvement remained independently associated with postoperative hrHPV positivity (OR 5.273, 95% CI 1.491-18.640; p = 0.010). For the patients who were hrHPV positive at the first postoperative follow-up, subsequent clearance of infection mostly occurred within 2 years after surgery.</p><p><strong>Conclusions: </strong>Ectocervical margin involvement was associated with a higher likelihood hrHPV positivity at the first follow-up after hysterectomy or residual cervix resection for incompletely excised CIN3. This observation warrants confirmation in future prospective studies.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-contact sexual violence and its association with sexual & psychosocial health in Iranian women: a national cross-sectional study.","authors":"Elnaz Khayer, Rezvan Zarei, Beáta Bőthe, Farnaz Farnam","doi":"10.1186/s12905-026-04655-0","DOIUrl":"10.1186/s12905-026-04655-0","url":null,"abstract":"<p><strong>Background: </strong>Non-contact sexual violence (NCSV) and its trauma remain understudied, limiting prevention and legal protection. This national study examined NCSV patterns and compared sexual, psychological, and social health among women with and without NCSV experiences globally.</p><p><strong>Methods: </strong>A controlled cross-sectional study recruited 540 married women aged 18-76 years from all 31 provinces of Iran between November 2022 and June 2023 using online and in-person convenience sampling. Participants were categorized into NCSV + and NCSV- groups. Demographic data, NCSV patterns, and standardized measures of sexual, psychological, and social health were collected. Data were analyzed using independent t-tests, chi-square tests, and backward logistic regression.</p><p><strong>Results: </strong>Overall, 16.9% of women reported experiencing NCSV, with a mean age of victimization of 12.3 (5-32) years. Nearly half were under 13, 36.6% were 13-18, and 13.8% were over 18 at exposure. Exhibitionism was reported by 86.1%. Most incidents (44.8%) occurred once and were mainly perpetrated by strangers (68.4%). 74% of survivors never disclosed the experience. While univariate analyses showed negative associations between NCSV and multiple sexual and psychological variables, backward logistic regression identified higher risks of depression, sexual dysfunction, sexual avoidance, and lower religiosity.</p><p><strong>Conclusion: </strong>The reported prevalence and severity, the wide age range of survivors, and the silence of three in four women highlight that NCSV occurs across diverse groups and warrants attention. These findings also suggest the potential harm associated with NCSV and underscore the importance of raising awareness, providing education on sexual self-care, and ensuring access to support services.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating epigenetic and metabolic indicators for non-invasive endometrial cancer triage: a machine learning approach.","authors":"Xiaodan Mao, Xite Lin, Yashi Shi, Jingyi Zhao, Huifeng Xue, Xiaoqi Wu, Gang Chen, Pengming Sun, Xiane Peng","doi":"10.1186/s12905-026-04680-z","DOIUrl":"10.1186/s12905-026-04680-z","url":null,"abstract":"<p><strong>Objective: </strong>Abnormal uterine bleeding (AUB) is a primary symptom indicative of endometrial cancer (EC), yet its diagnosis still primarily relies on invasive biopsy. This study aimed to develop and validate a non-invasive, interpretable machine learning (ML) model integrating local epigenetic (exfoliated cell CDO1 methylation) and systemic metabolic indicators for EC triage.</p><p><strong>Methods: </strong>CDO1 was identified as a potential biomarker via bioinformatics. Its diagnostic performance was assessed using quantitative methylation-specific PCR (qMSP) in a clinical cohort of 267 women with AUB. Subsequently, a multimodal ML framework was developed that incorporated logistic regression (LR), support vector machine (SVM), Random Forest (RF), and eXtreme Gradient Boosting (XGBoost) algorithms to integrate methylation data with clinical metabolic profiles. Model interpretability was ensured by SHapley Additive exPlanations (SHAP) analysis, with final testing in an internal holdout cohort.</p><p><strong>Results: </strong>CDO1 hypermethylation was identified as a significant epigenetic alteration associated with metabolic pathways in EC. Within our clinical cohort, CDO1 methylation emerged as a strong independent risk factor, with an odds ratio (OR) of 12.76 and a 95% confidence interval (CI) ranging from 6.31 to 25.80. Using LASSO regression, four critical predictive variables were identified: CDO1 methylation, menopausal status, diabetes and age. After integrating CDO1 methylation and metabolic profiles, the support vector machine model demonstrated stable performance in the validation set, achieving an area under the curve (AUC) of 0.775 (95% CI: 0.669-0.880), with a sensitivity of 0.800 and a specificity of 0.733. SHAP analysis was used to elucidate the contribution of each feature to the predictive model. The finalized SVM-based model's diagnostic utility was further confirmed in an internal holdout cohort, yielding an AUC of 0.904 (95% CI: 0.838-0.969), with a sensitivity of 0.833 and a specificity of 0.905, demonstrating its preliminary clinical reliability. Using our model with a cutoff of 0.647 in the internal holdout cohort (n = 160), 24 patients were triaged for biopsy, with 2 EC cases missed, representing a clinical false-negative rate of 16.7%. The finalized SVM-based predictive model was developed into a free online risk calculator ( https://phw1996.shinyapps.io/EC_risk/ ) for real-time clinical triage.</p><p><strong>Conclusions: </strong>Our SVM-based model offers a non-invasive and highly specific approach for the triage of patients experiencing AUB. By correlating localized molecular changes with systemic metabolic dysregulation, this tool supports personalized risk stratification and clinical triage. It is designed for relative risk stratification, and external recalibration is required for clinical absolute risk estimation.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"We Have Come to Work as Maids, not Sex Slaves\": young women domestic workers and sexual violence in Uganda.","authors":"Annet A Onzia, Adelline Twimukye, Patricia A Ajeru, Rosalind Parkes-Ratanshi, Matthew M Hamill, Johan H Melendez, Barbara Castelnuovo, Stephen Okoboi, Yukari C Manabe, Andrew Mujugira","doi":"10.1186/s12905-026-04677-8","DOIUrl":"10.1186/s12905-026-04677-8","url":null,"abstract":"<p><strong>Introduction: </strong>Young women with limited education who migrate from rural to urban areas in Uganda for household domestic work face multiple, intersecting vulnerabilities that increase their risk of sexual violence and other forms of exploitation. These vulnerabilities are often shaped by economic dependence, limited social support, and unequal power dynamics within households. This study explored their lived experiences, perceptions, barriers, and facilitators to accessing support following sexual violence.</p><p><strong>Methods: </strong>Within a community-based cross-sectional study, we conducted a qualitative study using 18 in-depth interviews (IDIs) and 10 focus group discussions (FGDs) between November 2023 and March 2024. A total of 84 female domestic workers aged 15-24 years were purposively selected from urban communities in Uganda to capture diverse experiences. Interviews and discussions were audio-recorded with participants' consent, transcribed verbatim, and translated into English where necessary. Data were analyzed using an inductive thematic analysis in NVivo 12 to identify key themes and subthemes related to sexual violence. The study findings are reported narratively, supported by illustrative quotes from participants.</p><p><strong>Results: </strong>Multiple levels of intersecting individual, interpersonal, and structural vulnerabilities were identified. (1) Male household members perpetrated sexual violence, exploiting workers' social isolation and economic dependence. (2) Sexual violence resulted in negative reproductive and mental health outcomes. (3) Survivors remained silent due to victim-blaming, stigma, shame, and police corruption. (4) Exploitative workplace practices, like wage theft, denial of formal contracts, and long working hours, increased young women's vulnerability to sexual violence and limited their ability to seek help. (5) Domestic workers advocated comprehensive interventions, including legal reforms, workplace protections, community services, and labor rights advocacy.</p><p><strong>Conclusions: </strong>Overlapping vulnerabilities, including exploitative workplace practices, power imbalances within households, social isolation, economic dependence, and limited access to reporting and support systems, drive sexual violence against domestic workers. Addressing these issues requires comprehensive, rights-based approaches, including stronger legal protections, enforcement of labor rights, improved access to survivor-centered services, and community efforts to reduce stigma and foster protective norms, thereby safeguarding the safety, dignity, and justice of these marginalized young women.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}