Women diagnosed with breast cancer who carry particular BRCA1 and BRCA2 genetic variants are offered surgery to remove the ovaries and fallopian tubes as this dramatically reduces their risk of ovarian cancer. Now, Cambridge researchers have shown that this procedure – known as bilateral salpingo-oophorectomy (BSO) – is associated with a substantial reduction in the risk of early death among these women, without any serious side-effects. Our findings will be crucial for counselling women with cancer linked to one of the BRCA1 and BRCA2 variants, allowing them to make informed decisions about whether or not to opt for this operation Antonis Antoniou Women with certain variants of the genes BRCA1 and BRCA2 have a high risk of developing ovarian and breast cancer. These women are recommended to have their ovaries and fallopian tubes removed at a relatively early age – between the ages 35 and 40 years for BRCA1 carriers, and between the ages 40 and 45 for BRCA2 carriers. Previously, BSO has been shown to lead to an 80% reduction in the risk of developing ovarian cancer among these women, but there is concern that there may be unintended consequences as a result of the body’s main source of oestrogen being removed, which brings on early menopause. This can be especially challenging for BRCA1 and BRCA2 carriers with a history of breast cancer, as they may not typically receive hormone replacement therapy to manage symptoms. The overall impact of BSO in BRCA1 and BRCA2 carriers with a prior history of breast cancer remains uncertain. Ordinarily, researchers would assess the benefits and risks associated with BSO through randomised controlled trials, the ‘gold standard’ for testing how well treatments work. However, to do so in women who carry the BRCA1 and BRCA2 variants would be unethical as it would put them at substantially greater risk of developing ovarian cancer. To work around this problem, a team at the University of Cambridge, in collaboration with the National Disease Registration Service (NDRS) in NHS England, turned to electronic health records and data from NHS genetic testing laboratories collected and curated by NDRS to examine the long-term outcomes of BSO among BRCA1 and BRCA2 PV carriers diagnosed with breast cancer. The results of their study, the first large-scale study of its kind, are published today in The Lancet Oncology. The team identified a total of 3,400 women carrying one of the BRCA1 and BRCA2 cancer-causing variants (around 1,700 women for each variant). Around 850 of the BRCA1 carriers and 1,000 of the BRCA2 carriers had undergone BSO surgery. Women who underwent BSO were around half as likely to die from cancer or any other cause over the follow-up period (a median follow-up time of 5.5 years). This reduction was more pronounced in BRCA2 carriers compared to BRCA1 carriers (a 56% reduction compared to 38% respectively). These women were also at around a 40% lower risk of developing a second cancer. Although the team say it is impossible to say with 100% certainty that BSO causes this reduction in risk, they argue that the evidence points strongly towards this conclusion. Importantly, the researchers found no link between BSO and increased risk of other long-term outcomes such as heart disease and stroke, or with depression. This is in contrast to previous studies that found evidence in the general population of an association between BSO and increased risk of these conditions. First author Hend Hassan, a PhD student at the Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, and Wolfson College, Cambridge, said: “We know that removing the ovaries and fallopian tubes dramatically reduces the risk of ovarian cancer, but there’s been a question mark over the potential unintended consequences that might arise from the sudden onset of menopause that this causes. “Reassuringly, our research has shown that for women with a personal history of breast cancer, this procedure brings clear benefits in terms of survival and a lower risk of other cancers without the adverse side effects such as heart conditions or depression.” Most women undergoing BSO were white. Black and Asian women were around half as likely to have BSO compared to white women. Women who lived in less deprived areas were more likely to have BSO compared to those in the most-deprived category. Hassan added: “Given the clear benefits that this procedure provides for at-risk women, it’s concerning that some groups of women are less likely to undergo it. We need to understand why this is and encourage uptake among these women.” Professor Antonis Antoniou, from the Department of Public Health and Primary Care, the study’s senior author, said: “Our findings will be crucial for counselling women with cancer linked to one of the BRCA1 and BRCA2 variants, allowing them to make informed decisions about whether or not to opt for this operation.” Professor Antoniou, who is also Director of the Cancer Data-Driven Detection programme, added: “The study also highlights the power of exceptional NHS datasets in driving impactful, clinically relevant research.” The research was funded by Cancer Research UK, with additional support from the National Institute for Health and Care Research (NIHR) Cambridge Biomedical Research Centre. The University of Cambridge is fundraising for a new hospital that will transform how we diagnose and treat cancer. Cambridge Cancer Research Hospital, a partnership with Cambridge University Hospitals NHS Foundation Trust, will treat patients across the East of England, but the research that takes place there promises to change the lives of cancer patients across the UK and beyond. Find out more here. Reference Hassan, H et al. Long-term health outcomes of bilateral salpingo-oophorectomy in BRCA1 and BRCA2 pathogenic variant carriers with personal history of breast cancer: a retrospective cohort study using linked electronic health records. Lancet Oncology; 7 May 2025; DOI: 10.1016/S1470-2045(25)00156-1 The text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified. All rights reserved. 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A majority of individuals who are deaf or have hearing loss face significant communication barriers when accessing care through the National Health Service (NHS), with nearly two-thirds of patients missing half or more of vital information shared during appointments. Better communication for deaf patients benefits everyone. We’re not just pointing out problems – we’re providing practical solutions. Bhavisha Parmar A team of patients, clinicians, researchers and charity representatives, led by the University of Cambridge and the British Society of Audiology, surveyed over 550 people who are deaf or have hearing loss about their experiences with the NHS – making it the largest study of its kind. Their findings, reported in the journal PLOS One, highlight systemic failures and suggest changes and recommendations for improving deaf-aware communication in the NHS. “The real power of this study lies in the stories people shared,” said lead author Dr Bhavisha Parmar from Cambridge’s Department of Clinical Neurosciences (Sound Lab) and UCL Ear Institute. “Patients weren’t just rating their experiences – they were telling us how these barriers affect every part of their healthcare journey, and in many cases, why they avoid healthcare altogether.” The study found that despite being a legal requirement under the Accessible Information Standards, NHS patients have inadequate and inconsistent access to British Sign Language (BSL) interpreters and other accessibility accommodations such as hearing loop systems. Nearly two-thirds (64.4%) of respondents reported missing at least half of the important information during appointments, and only a third (32%) expressed satisfaction with NHS staff communication skills. Respondents said they had to rely on family members or advocates to communicate with healthcare workers, raising privacy and consent concerns. The research found that communication barriers extend across the entire patient journey – from booking appointments to receiving results. Simple actions, like calling a patient’s name in a waiting room or giving instructions during a scan, become anxiety-inducing when basic accommodations are lacking. Respondents noted that hearing aids often must be removed for X-rays or MRI scans, leaving them struggling or unable to follow verbal instructions. “We heard over and over that patients fear missing their name being called, or avoid making appointments altogether,” said Parmar. “These aren’t isolated experiences – this is a systemic issue.” The idea for the study was sparked by real-life experiences shared online by NHS patients, particularly audiology patients– a field Parmar believes should lead by example. “We’re audiologists: we see more patients with hearing loss than anyone else in the NHS,” she said. “If we’re not deaf-aware, then how can we expect other parts of the NHS to be?” The research team included NHS patients with deafness or hearing loss, who contributed to study design, data analysis, and report writing. As part of the study, they received training in research methods, ensuring the work was grounded in and reflective of lived experiences. Co-author Zara Musker, current England Deaf Women’s futsal captain and winner of deaf sports personality of the year 2023 said her disappointing experiences with the NHS in part motivated her to qualify as an audiologist. “The research is extremely important as I have faced my own experiences of inadequate access, and lack of deaf awareness in NHS healthcare not just in the appointment room but the whole process of booking appointments, being in the waiting room, interacting with clinicians and receiving important healthcare information,” said Musker. “I really hope that the results will really highlight that NHS services are still not meeting the needs of patients. Despite this, the study also highlights ways that the NHS can improve, and recommendations are suggested by those who face these barriers within healthcare.” The researchers have also released a set of recommendations that could improve accessibility in the NHS, such as: Mandatory deaf awareness and communication training for NHS staff Consistent provision of interpreters and alert systems across all NHS sites Infrastructure improvements, such as text-based appointment systems and visual waiting room alerts The creation of walk-through assessments at hospitals to ensure accessibility across the full patient journey “This is a legal obligation, not a luxury,” said Parmar. “No one should have to write down their symptoms in a GP appointment or worry they’ll miss their name being called in a waiting room. These are simple, solvable issues.” A practice guidance resource – developed in consultation with patients and driven by this research – is open for feedback until 15 June and will be made publicly available as a free tool to help clinicians and NHS services improve deaf awareness. People can submit feedback at the British Society of Audiology website. “Ultimately, better communication for deaf patients benefits everyone,” Parmar said. “We’re not just pointing out problems – we’re providing practical solutions.” Reference: Bhavisha Parmar et al. ‘“I always feel like I’m the first deaf person they have ever met.” Deaf Awareness, Accessibility and Communication in the United Kingdom's National Health Service (NHS): How can we do better?’ PLOS One (2025). DOI: 10.1371/journal.pone.0322850 The text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

One of the first studies in this area to use clinical-level diagnoses reveals a range of differences between young people with and without mental health conditions when it comes to social media – from changes in mood to time spent on sites. Young people with a diagnosable mental health condition report differences in their experiences of social media compared to those without a condition, including greater dissatisfaction with online friend counts and more time spent on social media sites. This is according to a new study led by the University of Cambridge, which suggests that adolescents with “internalising” conditions such as anxiety and depression report feeling particularly affected by social media. Young people with these conditions are more likely to report comparing themselves to others on social media, feeling a lack of self-control over time spent on the platforms, as well as changes in mood due to the likes and comments received. Researchers found that adolescents with any mental health condition report spending more time on social media than those without a mental health condition, amounting to an average of roughly 50 minutes extra on a typical day.* The study, led by Cambridge’s Medical Research Council Cognition and Brain Sciences Unit (MRC CBU), analysed data from a survey of 3,340 adolescents in the UK aged between 11 and 19 years old, conducted by NHS Digital in 2017.** It is one of the first studies on social media use among adolescents to utilise multi-informant clinical assessments of mental health. These were produced by professional clinical raters interviewing young people, along with their parents and teachers in some cases.*** “The link between social media use and youth mental health is hotly debated, but hardly any studies look at young people already struggling with clinical-level mental health symptoms,” said Luisa Fassi, a researcher at Cambridge’s MRC CBU and lead author of the study, published in the journal Nature Human Behaviour. “Our study doesn’t establish a causal link, but it does show that young people with mental health conditions use social media differently than young people without a condition. “This could be because mental health conditions shape the way adolescents interact with online platforms, or perhaps social media use contributes to their symptoms. At this stage, we can’t say which comes first – only that these differences exist,” Fassi said. The researchers developed high benchmarks for the study based on existing research into sleep, physical activity and mental health. Only findings with comparable levels of association to how sleep and exercise differ between people with and without mental health conditions were deemed significant. While mental health was measured with clinical-level assessments, social media use came from questionnaires completed by study participants, who were not asked about specific platforms.**** As well as time spent on social media, all mental health conditions were linked to greater dissatisfaction with the number of online friends. “Friendships are crucial during adolescence as they shape identity development,” said Fassi. “Social media platforms assign a concrete number to friendships, making social comparisons more conspicuous. For young people struggling with mental health conditions, this may increase existing feelings of rejection or inadequacy.” Researchers looked at differences in social media use between young people with internalising conditions, such as anxiety, depression and PTSD, and externalising conditions, such as ADHD or conduct disorders. The majority of differences in social media use were reported by young people with internalising conditions. For example, “social comparison” – comparing themselves to others online – was twice as high in adolescents with internalising conditions (48%, around one in two) than for those without a mental health condition (24%, around one in four). Adolescents with internalising conditions were also more likely to report mood changes in response to social media feedback (28%, around 1 in 4) compared to those without a mental health condition (13%, around 1 in 8). They also reported lower levels of self-control over time spent on social media and a reduced willingness to be honest about their emotional state when online.***** “Some of the differences in how young people with anxiety and depression use social media reflect what we already know about their offline experiences. Social comparison is a well-documented part of everyday life for these young people, and our study shows that this pattern extends to their online world as well,” Fassi said. By contrast, other than time spent on social media, researchers found few differences between young people with externalising conditions and those without a condition. “Our findings provide important insights for clinical practice, and could help to inform future guidelines for early intervention,” said Cambridge’s Dr Amy Orben, senior author of the study. “However, this study has only scratched the surface of the complex interplay between social media use and mental health. The fact that this is one of the first large-scale and high-quality studies of its kind shows the lack of systemic investment in this space.” Added Fassi: “So many factors can be behind why someone develops a mental health condition, and it's very hard to get at whether social media use is one of them.” “A huge question like this needs lots of research that combines experimental designs with objective social media data on what young people are actually seeing and doing online.” “We need to understand how different types of social media content and activities affect young people with a range of mental health conditions such as those living with eating disorders, ADHD, or depression. Without including these understudied groups, we risk missing the full picture.” Notes: *Study participants were asked to rate their social media use on a typical school day and a typical weekend or holiday day. This was given as a nine-point scale, ranging from less than 30 minutes to over seven hours. Responses from adolescents with any mental health condition approached on average "three to four hours," compared to adolescents without a condition, who averaged between "one to two hours" and "two to three hours." The category of all mental health conditions in the study includes several conditions that are classed as neither internalising or externalising, such as sleep disorders and psychosis. However, the numbers of adolescents suffering from these are comparatively small. **The survey was conducted as part of NHS Digital’s Mental Health of Children and Young People Survey (MHCYP) and is nationally representative of this age group in the UK. The researchers only used data from those who provided answers on social media use (50% male, 50% female). *** Previous studies have mainly used self-reported questionnaires (e.g. a depression severity questionnaire) to capture mental health symptoms and conditions in participants. **** The researchers point out that, as responses on social media use were self-reported, those with mental health conditions may be perceiving they spend more time on social media rather than actually doing so. They say that further research with objective data is required to provide definitive answers. ***** For data on social media use, study participants were asked to rate the extent to which they agree with a series of statements on a five-point Likert scale. The statements ranged from “I compare myself to others on social media” to “I am happy with the number of friends I have on social media”. Researchers divided responses into 'disagree' (responses 1 to 3) and 'agree' (responses 4 and 5) and then calculated the proportion of adolescents agreeing separately for each diagnostic group to aid with public communication of the findings. The text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.