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(Abstracted from Obstet Gynecol2023;142:1125–1134)Recommended testing for cervical cancer includes colposcopy after abnormal Pap or human papillomavirus (HPV) test results. This method is designed to diagnose cervical cancers early and to additionally detect precancerous tissue before it becomes cancerous.

Our findings demonstrate substantial variation in the diagnosis of cervical precancerous lesions by colposcopists, pathologists, and particularly between laboratory facilities across the United States.

Unexpected weight loss is a presenting feature of cancer in primary care. Data from primary care are lacking to quantify how much weight loss over what period should trigger further investigation for cancer. This research aimed to quantify cancer diagnosis rates associated with measured weight change in people attending primary care. Retrospective cohort study of primary care electronic health records data linked to the Surveillance, Epidemiology, and End Results cancer registry (Integrated healthcare delivery system in Washington State, United States). Multivariable Cox regression incorporating time varying covariates using splines to model non‐linear associations (age, percentage weight change, and weight change interval). Fifty thousand randomly selected patients aged 40 years and over followed for up to 9 years (1 January 2006 to 31 December 2014). Outcome measures are hazard ratios (95% confidence intervals) to quantify the association between percentage weight change and cancer diagnosis for all cancers combined, individual cancer sites and stages; percentage risk of cancer diagnosis within 6 months of the end of each weight change episode; and the positive predictive value for cancer diagnosis. There were 43 302 included in the analysis after exclusions. Over 287 858 patient‐years of follow‐up, including 24 272 (56.1%) females, 23 980 (55.4%) aged 40 to 59 years, 15 113 (34.9%) 60 to 79 years, and 4209 (9.7%) aged 80 years and over. Adjusted hazard ratios (95% confidence interval) for cancer diagnosis in a 60 years old ranged from 1.04 (1.02 to 1.05, P< 0.001) for 1% weight loss to 1.44 (1.23 to 1.68, P< 0.001) for 10%. An independent linear association was observed between percentage weight loss and increasing cancer risk. The absolute risk of cancer diagnosis increased with increasing age (up to 85 years) and as the weight change measurement interval decreased (<1 year). The positive predictive value for a cancer diagnosis within 1 year of ≥5% measured weight loss in a 60 to 69 years old was 3.41% (1.57% to 6.37%) in men and 3.47% (1.68% to 6.29%) in women. The risk of cancer diagnosis was significantly increased for pancreatic, myeloma, gastro‐oesophageal, colorectal, breast, stage II and IV cancers. Weight loss is a sign of undiagnosed cancer regardless of the interval over which it occurs. Guidelines should resist giving an arbitrary cut‐off for the interval of weight loss and focus on the percentage of weight loss and the patient's age. Future studies should focus on the association between diagnostic evaluation of weight change and risk of cancer mortality.

A 12-month randomized clinical trial was conducted to investigate the effects of long-term aerobic exercise on serum sex hormones in middle-aged to older men. Results indicated that a moderate-intensity exercise program performed for a year increased dihydrotestosterone (DHT) and sex hormone-binding globulin (SHBG) in middle-aged to older men, but did not have an impact on other androgens.

A random study was conducted to find the effects of physical activity on bone mineral density, bone mineral content, and lean mass in postmenopausal, overweight/obese women. The results suggested that a yearlong moderate-intensity exercise does not affect total body bone mineral density, bone mineral content or lean mass in overweight/obese postmenopausal women.

An analysis was conducted to study the effect of a 1 year moderate intensity aerobic exercise program on serum lipoproteins among overweight bese postmenopausal women. The results state that a yearlong moderate intensity exercise program alone does not significantly alter serum lipoprotein levels among overweight/obese postmenopausal women.

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We sought to estimate the direct cost, from the perspective of the health insurer or purchaser, of breast-care services in the year following a false positive screening mammogram compared with a true negative examination.

Objective:To examine whether genetic polymorphisms in CYP19[intron 4 (TTTA)n; n= 7 to 13 and a 3‐base pair deletion, which is in strong linkage disequilibrium with the seven repeat] and COMT(Val108/158Met) modified the change in BMI, total and percentage body fat, or subcutaneous and intra‐abdominal fat during a year‐long exercise intervention trial. These genes metabolize estrogens and androgens, which are important in body fat regulation. Research Methods and Procedures: A randomized intervention trial was used, with an intervention goal of 225 min/wk of moderate‐intensity exercise for one year. Participants (n= 173) were postmenopausal, 50 to 75 years old, sedentary, overweight or obese, and not taking hormone therapy at baseline. Results: Exercisers with two vs. no CYP1911‐repeat alleles had a larger decrease in total fat (−3.1 kg vs. −0.5 kg, respectively, p= 0.01) and percentage body fat (−2.4% vs. −0.6%, respectively, p= 0.001). Exercisers with the COMTMet/Met vs. Val/Val genotype had a smaller decrease in percentage fat (−0.7% vs. −1.9%, respectively, p= 0.05). Among exercisers, women with the COMT Val/Val genotype and at least one copy of the CYP19 11‐repeat allele vs. those with neither genotype/allele had a significantly larger decrease in BMI (−1.0 vs. +0.1 kg/m2, respectively, p= 0.009), total fat (−2.9 vs. −0.5 kg, respectively, p= 0.004), and percentage body fat (−2.6% vs. −0.4%, respectively, p< 0.001). Discussion: Genetic polymorphisms in CYP19and COMTmay be important for body fat regulation and possibly modify the effect of exercise on fat loss in postmenopausal women.