Is health innovation for women keeping pace with a changing cancer landscape?

Published by FemTech World

September is Gynecologic Cancer Awareness Month, an important opportunity to raise awareness of symptoms, screening and early detection. It should also prompt a broader question: Is innovation in women’s health keeping pace with a changing cancer landscape?

A recent global analysis of breast, cervical, uterine and ovarian cancers estimated 3.7 million new cases and 1.3 million deaths worldwide.

Age-standardised incidence has risen and is projected to continue increasing through 2050.

At the same time, some cancers traditionally associated with later life are being diagnosed more often in younger adults.

A major National Cancer Institute analysis found that incidence increased for 14 cancer types in at least one group under age 50 between 2010 and 2019.

Female breast and uterine cancers were among those contributing the largest numbers of additional early-onset diagnoses. Uterine cancer alone accounted for an estimated 1,200 additional early-onset cases in 2019 compared with the number expected based on 2010 rates.

These trends challenge the assumption that cancer risk belongs mainly to an older population. They also have implications beyond oncology, including how clinicians approach surgery for conditions believed to be benign.

When Benign Is an Assumption

Uterine fibroids are a clear example. They are extremely common, overwhelmingly benign and a major reason women undergo gynecologic surgery.

Yet presumed benign and confirmed benign are not the same.

Before surgery, clinicians evaluate risk using a patient’s history, imaging, symptoms and other available information. Even with careful assessment, however, uterine leiomyosarcoma cannot be reliably ruled out before an operation.

The FDA estimates that a hidden uterine sarcoma may be present in approximately 1 in 225 to 1 in 580 women undergoing surgery for presumed fibroids.

Estimates vary across studies, but the central challenge remains: uncertainty cannot be eliminated.

The probability is low, but the consequences for an affected patient can be profound. If an unsuspected malignancy is fragmented in the abdominal cavity, cancerous tissue may be disseminated and prognosis may worsen.

The principle of doing no harm therefore includes taking reasonable precautions against rare events with potentially catastrophic consequences.

Preparing for the Diagnosis Nobody Expected

The answer is not to treat every younger woman as though she has cancer, nor is it to retreat from minimally invasive surgery. Laparoscopic hysterectomy and myomectomy can offer meaningful benefits, including smaller incisions and faster recovery.

The better question is: What safeguards can be put in place before the procedure begins?

Large specimens may need to be fragmented, or morcellated, so they can be removed through small incisions. When tissue thought to be benign contains an unexpected malignancy, fragmentation can spread cancerous cells. It may also disseminate benign tissue, including endometriosis.

This is why dedicated tissue-containment systems have been developed and why the FDA recommends contained morcellation when laparoscopic power morcellation is appropriate.

Safety innovation, however, is rarely adopted overnight.

Hand disinfection was introduced in the 1840s, yet widespread acceptance took decades. Surgical masks were introduced in the late 1890s, but it took until the mid-1930s before they were used by most surgeons.

Today, these precautions feel self-evident. Their history offers a sobering lesson: when evidence points toward a practical safeguard, waiting for universal adoption can allow preventable harm to continue.

Patient safety should not have to wait decades for hindsight.

A New Layer of Surgical Protection

Newer containment technologies are designed to address this risk. One example is ARK Surgical’s LapBox, an FDA-cleared tissue-containment system designed to isolate tissue during minimally invasive surgery.

LapBox has FDA clearance for manual tissue extraction and FDA clearance for power morcellation and uses a dual-wall inflatable chamber to provide an additional barrier around the tissue.

The concept is similar to an airbag: it is designed for the event no one expects but everyone would want to be prepared for.

Containment does not replace patient selection, informed consent, diagnostic evaluation or surgical judgment. It adds another layer of protection when certainty is impossible.

Dr. Veronica Gillispie-Bell, a minimally invasive gynecologic surgeon and nationally recognised advocate for women’s health, describes the importance of containment even when tissue appears benign:

“Containment is critical. Even in cases where we are confident that fibroids are benign, we still have to be careful.”

What Will We Say Ten Years From Now?

Gynecologic Cancer Awareness Month rightly focuses attention on earlier detection. Better screening, biomarkers, imaging and diagnostics remain critical.

But cancer innovation cannot end with finding disease. Cancer risk also intersects with fertility, benign gynecology, surgery and pathology.

Sometimes innovation means becoming better at predicting risk. Sometimes it means protecting patients when that risk cannot be predicted at all.

Ten years from now, the question may not be whether clinicians knew cancer was present. It may be why, knowing certainty was impossible, women still underwent tissue fragmentation without every reasonable safeguard being considered.

Protecting women from preventable harm is a shared responsibility.

Patients can ask their surgeons how tissue will be removed and what safeguards will be used. Surgeons can consider whether every reasonable safeguard is being used when tissue is fragmented.

But this is not a decision for the operating room alone.

Hospital leaders responsible for quality, patient safety and risk management can ask whether current surgical protocols reflect both the risks we now understand and the safeguards now available. When a known risk cannot be eliminated through preoperative diagnosis, the question becomes whether reasonable measures are in place to contain that risk if it occurs.

For Chief Quality Officers, Patient Safety Officers and Risk Management leaders, that raises an important question: If preventable tissue dissemination occurs, will the safeguards in place today still look reasonable in hindsight?

Regulators can set expectations. Surgeons can advocate for safer practices. But healthcare systems ultimately decide which safeguards become standard practice.

Hand hygiene took decades to become routine. Surgical masks took nearly forty years.

Effective tissue containment is available today. How long must it take this time?