HPV-vaccinated women may require fewer cervical cancer screenings
Women vaccinated against human papillomavirus (HPV) at a young age may need only two or three screenings for cervical cancer—which can be caused by HPV—over the course of their lifetimes, according to a new study co-authored by researchers at Norway’s University of Oslo and Harvard T.H. Chan School of Public Health.
The study was published Feb. 3 in the Annals of Internal Medicine. Co-authors included members of Harvard Chan School’s Center for Health Decision Science: Stephen Sy, Allison Portnoy, Jane Kim, and Emily Burger.
The American Cancer Society recommends that women and other individuals with a cervix be screened for cervical cancer every three to five years. These guidelines do not consider whether a patient was vaccinated against HPV, however. The vaccine has been shown to reduce the risk of cervical cancer by more than 90%.
The researchers aimed to find out if the currently recommended screening frequency is still best practice for preventing cervical cancer, given the high uptake of the HPV vaccine. To do so, they used government health data from Norway to model the health impacts and cost-effectiveness of making cervical cancer screenings less frequent among HPV-vaccinated women ages 12 to 30.
The study found that women who received the HPV vaccine before age 30 could safely receive only two or three cervical cancer screenings over the course of their lifetimes, and the younger they are when vaccinated, the longer they can go between screenings. Those vaccinated between ages 25 and 30 could be screened every 10 years; those vaccinated between ages 19 and 21 could be screened every 20 years, starting at age 25; and those vaccinated before age 19 could be screened every 25 years.
The screening cadences outlined in the new study are safe for health while also reducing health care costs and unnecessary procedures, according to the researchers. They added, however, that more research is needed before clinicians begin reducing screenings.
“We are trying to build the evidence around the case for changing the guidelines for vaccinated women,” Kim said in a Feb. 3 Medscape article about the study.
The researchers also emphasized that while overarching guidelines could be changed, the choice to be screened for cervical cancer is an individual one, and should also take into account a patient’s unique risk factors, such as a weakened immune system or prior history of abnormal screenings or cervical cancer.
Read the study: Optimizing Cervical Cancer Screening by Age at Vaccination for Human Papillomavirus: Health and Resource Implications
Read the Medscape article: HPV-Vaccinated Women May Only Need Two Cervical Cancer Screenings in Lifetime
Read a Healthline article about the study: Fewer Cervical Cancer Screenings Needed for Females Vaccinated Against HPV
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Federal funding cuts driving Massachusetts brain drain
A combination of moves by the Trump administration—including research funding cuts, policy shifts, and an immigration crackdown—are taking a huge toll on the personal and professional lives of scientists in Massachusetts and creating upheaval in the state’s research landscape and in the overall economy, according to a Feb. 11 Boston Globe article.
The Globe partnered with MassINC Polling Group to ask National Institutes of Health (NIH) grant recipients about the impact of federal funding cuts.
John Quackenbush of Harvard T.H. Chan School of Public Health was among those who participated in the survey, and one of about two dozen interviewed for the article. The professor of computational biology and bioinformatics, who has worked at the School for 20 years, is now shuttering his lab after losing a key grant from the NIH’s National Cancer Institute. Quackenbush had expected to receive a second Outstanding Investigator award worth nearly $7 million over seven years, but the program was terminated. His Harvard Chan lab used to have eight postdoctoral researchers and one PhD student—now he has just two postdocs.
Given the loss of NIH funding, Quackenbush has decided to move his lab to Houston’s Baylor College of Medicine, where he will receive $8 million in grants from Baylor and the state of Texas, thus reducing his reliance on federal funds. He told the Globe that the federal cuts are driving talent and investment away from Harvard and from Massachusetts. He said, “I thought I would work [at Harvard] until I couldn’t work anymore.”
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The toll of uncertainty
More than two-thirds of the Globe’s survey respondents said that the cuts and policy changes had moderately or significantly reduced the scope of their work. Respondents also reported advising their students to consider careers outside academia, delaying hiring in their labs or laying off workers, and losing researchers to institutions in other countries.
The article noted that although most of the federal funding that was frozen or cut by the Trump administration in 2025 was restored after court challenges, significant damage has already been done—plus future funding remains uncertain. Experts quoted in the article said that it’s tough to recruit or retain promising international scientists amid immigration crackdowns. Given the uncertainties, many schools, including Harvard, are cutting their PhD enrollments, and there are fewer research positions available because of hiring freezes.
Lisa Berkman, Thomas D. Cabot Professor of Public Policy and of Epidemiology, told the Globe that her lab, which studies aging and dementia in low-income countries, had its funding frozen, which forced the layoffs of two-thirds of the staff. The money was eventually restored but no one has yet been rehired because of the hiring freeze and uncertainty about future funding, she said.
LGBTQ health researcher Colleen Reynolds left Harvard Chan School last September for a postdoc position in the Netherlands after her lab lost support and her position was eliminated. She said it’s been painful to watch her colleagues scatter, although at least she is now “at peace being in an environment where my work and my personal life are safer.”
Read the Boston Globe article: Boston built a global biotech empire. Now the talent is quietly drifting away.
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The Cure for Everything by Michelle A. Williams, SM ’88, ScD ’91
Michelle A. Williams, SM ’88, ScD ’91, is a professor of epidemiology and population health at Stanford University School of Medicine and former Dean of the Faculty at Harvard Chan School, where she also served as the Angelopoulos Professor in Public Health and International Development and currently holds an adjunct professorship.
Williams is an internationally renowned epidemiologist; award-winning educator; and has authored more than 550 peer-reviewed research articles and is recognized as a leading voice in public health science and global health.
Williams’ latest endeavor is The Cure for Everything: The Epic Struggle for Public Health and a Radical Vision for Human Thriving.
At a moment when the U.S. is experiencing declining life expectancy, record levels of public distrust, and rising political attacks on science, Williams offers a gripping narrative of how public health—not medicine alone—lifted humanity out of a world of infectious disease, poisonous environments, and early death; why public health was sidelined in favor of clinical medicine; and how that shift left Americans uniquely vulnerable to poor health outcomes and medical misinformation.
Through vivid storytelling, Williams shows that it was public health interventions like clean water, sanitation, housing reform, nutrition, workplace protections, and vaccine mandates, not pharmaceutical drugs, that doubled life expectancy and fueled prosperity between the mid-1800s and today, as well as how during that time, funding and political support shifted away from public health and its emphasis on community-wide, preventative solutions and toward the reactive, profit-driven, individually focused model that characterizes our health care system today.
The book, co-authored by Linda Marsa, blends together history, narrative reporting, and cutting-edge science; and makes a compelling case for public health to guide politics and policy.
Richard Tofel, former president of ProPublica and author of Sounding the Trumpet, says “Michelle Williams is unapologetic in defense of a vision of public health rooted in justice and committed to the facts.”
By authoring this book, Williams hopes to show that “a society that fails to improve health for everyone, regardless of race or income, has failed in its most basic purpose.”
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A call to document harms from nutrition policy changes and to fight for families
In a recent interview on the implications of changes to federal nutrition policies, Harvard T.H. Chan School of Public Health’s Sara Bleich called for health professionals, researchers, and advocates to document harms caused by these changes and to fight to help families keep their benefits.
Bleich, professor of health policy, served in the U.S. Department of Agriculture during the Obama and Biden administrations. On the Feb. 4 episode of the Sound Bites podcast, she provided an overview of federal nutrition assistance programs including SNAP (the Supplemental Nutrition Assistance Program) and school meals, which collectively serve one in four Americans over the course of a year.
She expressed concerns about recent changes to SNAP, including a $186 billion budget cut through 2034 and stricter work requirements for parents of school-aged children over 14 and for older adults.
She also said that changes in the government’s recently updated Dietary Guidelines for Americans may prove confusing for consumers and difficult for schools to implement in meals they serve.
For those who would like to address these policy changes, Bleich suggested providing clarity to the public around evidence-based nutrition and changes to SNAP, and pushing for administrative changes at the state level—and she stressed the urgent need to fight for low-income families who need food assistance.
“One of the ways that you change policy is that you document harm and you document impacts,” she said. Work is now underway by researchers to understand the effects of changes to nutrition programs and the dietary guidelines, she said, adding, “When there’s an opportunity for a new way of thinking about things, a new type of policy, we will be poised with the right information.”
Listen to Sound Bites podcast: SNAP, School Meals, New DGAs: What’s Changing & Why It Matters – Dr. Sara Bleich
Learn more
Understanding the new Dietary Guidelines for Americans (Harvard Chan School news)
Pressure not off for SNAP recipients (Harvard Chan School news)
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Healthy body weight, regular exercise ‘a big part of the battle’ for reducing cancer risk
A growing body of research has linked diet and exercise to cancer risk. Harvard T.H. Chan School of Public Health’s Edward Giovannucci was one of the experts quoted in a Jan. 27 New York Times article on the latest findings.
The article noted that dietary patterns emphasizing whole grains, fruits and vegetables, and lean or plant proteins have consistently been linked to lower cancer risk, likely due in part to their ability to lower high insulin levels and inflammation. Processed and red meats, ultra processed foods, and alcohol, on the other hand, have been linked with increased risk.
But the single biggest way that diet increases cancer risk is by contributing to excess weight, said Giovannucci, professor of nutrition and epidemiology. Fat tissue increases estrogen, a driver for some cancers, and can also promote inflammation and insulin resistance.
He recommended getting at least 30 minutes of exercise at a moderate-intensity level most days to help with weight loss and metabolic health. That’s “a big part of the battle” to reduce the risk of cancer and other chronic conditions, he said. “It overlaps a lot with diabetes, cardiovascular risks and dementia. I think they’re all tied together.”
Read the New York Times article: How What You Eat Affects Cancer Risk
Learn more
Cancer FactFinder (Harvard Chan School’s Zhu Family Center for Global Cancer Prevention)
Diets high in plant-based foods, low in processed foods, may help reduce cancer risk (Harvard Chan School news)
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Why finding a primary care provider can be so tough
The number of primary care physicians (PCPs) seeing new patients in the U.S. is declining and the number of advanced practice providers (APPs)—including physician assistants and nurse practitioners—available for these visits isn’t enough to fill the gap, according to a new study from researchers at Harvard T.H. Chan School of Public Health.
The study was published Jan. 20 as a research letter in JAMA Internal Medicine. Harvard Chan co-authors included first author Kate Majzoub Morgan, a candidate in the MPH in Clinical Effectiveness program and an internal medicine physician at Brigham and Women’s Hospital (BWH); postdoctoral research fellow René Karadakic; and Michael Barnett, former associate professor of health policy and management.
Morgan was interviewed about the study findings in a JN Learning podcast, along with Ishani Ganguli, a primary care physician at BWH and associate editor at JAMA Internal Medicine, who co-authored an editorial accompanying the new study.
Even though there are a high number of physicians in the Boston area, Morgan said that she and colleagues had increasingly been hearing from people who couldn’t find a PCP. She noted that it’s well-documented that the number of practicing PCPs in the U.S. is declining. But some recent studies suggest there are other factors at play, such as PCPs seeing fewer patients for ongoing care and cutting back on their work hours.
To explore PCP availability, Morgan and colleagues decided to look specifically at new patient visits, “thinking that in the real world, when somebody needs a primary care physician … really what matters is how many clinicians are accepting new patients,” Morgan explained.
They examined fee-for-service Medicare claims data between 2013 and 2021 to learn how the number of clinicians available to see new patients and the number of new patient visits provided changed over time. They also looked at how PCPs versus APPs were contributing to these new visits.
The researchers found a persistent decline in the number of PCPs accepting new patients. In 2013, there were 75,140 PCPs available for new visits; by 2021, the number had dropped to 56,438—a 23% decrease. “That’s enormous,” Morgan said. Fewer than half of all PCPs in the U.S. were available for new visits in 2021, according to the researchers.
During the same time period, the number of APPs available for new visits rose from 12,768 to 24,432—a 91% jump—but because there were fewer APPs to begin with, that increase didn’t offset the decline in PCPs. Overall, Morgan said, there was a 5% decrease in the number of clinicians available for new visits.
“Based on our study, it’s very clear that APPs have become a core part of the primary care workforce,” Morgan said. “And the solution is going to depend on how well we can design our systems to make the most of the APP workforce and the physician workforce and really thinking thoughtfully about what each profession has to bring to primary care.”
Listen to the JN Learning podcast: Primary Care Clinicians Available for New Patient Visits
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Low-carb and low-fat diets associated with lower heart disease risk if rich in high-quality, plant-based foods, low in animal products
Findings suggest that it’s the quality—not quantity—of macronutrients that make a difference for heart health, debunking myth that modulating carbohydrate and fat intake alone is inherently beneficial
For immediate release: Feb. 11, 2026
Boston, MA—Low-carbohydrate and low-fat diets rich in high-quality, plant-based foods and low in animal products and refined carbohydrates were linked with lower risk of heart disease, according to a new study led by researchers at Harvard T.H. Chan School of Public Health. The same diets that were rich in refined carbohydrates and high in animal fats and proteins were associated with a higher risk of heart disease. The study suggests that it’s the quality of the macronutrients composing these diets that make a difference for heart health, rather than the quantity.
The study was published Feb. 11, 2026, in JACC.
“Low-carbohydrate and low-fat diets have been widely promoted in the U.S. over the past two decades for weight control and metabolic health, but their effects on heart disease risk have remained unclear,” said first author Zhiyuan Wu, postdoctoral research fellow in the Department of Nutrition. “Our findings help debunk the myth that simply modulating carbohydrate or fat intake is inherently beneficial, and clearly demonstrate that the quality of foods constructing low-carbohydrate and low-fat diets is what’s most important to protect heart health.”
Previous studies have shown that diets emphasizing healthy sources of carbohydrates and fats (such as whole grains, fruits, vegetables, nuts, legumes, and olive oil) are associated with lower risk of coronary heart disease (CHD). The researchers sought to examine this evidence specifically in the context of low-carbohydrate and low-fat diets. To do so, they used diet and health data from nearly 200,000 men and women participating in the Health Professionals Follow-Up Study, Nurses’ Health Study, and Nurses’ Health Study II. The researchers analyzed participants’ diets and scored them to distinguish healthy and unhealthy low-carbohydrate and low-fat diets. They assessed scores in the context of whether participants developed CHD, controlling for various health and lifestyle confounders. The researchers also analyzed participants’ blood samples and measured levels of cardiovascular risk biomarkers.
The study found that low-carbohydrate and low-fat diets emphasizing high-quality carbohydrates and plant-based sources of proteins and fats were associated with about a 15% lower risk of CHD. In contrast, the same two diets rich in refined carbohydrates and animal proteins and fats were associated with a higher CHD risk. In their analysis of the blood samples, the researchers also found that healthy versions of low-carbohydrate and low-fat diets were associated with improved cardiovascular biomarkers, such as higher HDL (good) cholesterol and lower levels of triglycerides.
“For clinicians, dietitians, and patients, our study suggests that promoting an overall healthy eating pattern, rather than strict macronutrient restriction, should be a central strategy for the primary prevention of heart disease,” said corresponding author Qi Sun, associate professor in the Departments of Nutrition and Epidemiology.
Article information
“Effect of Low-Carbohydrate and Low-Fat Diets on Metabolomic Indices and Coronary Disease in US Individuals,” Zhiyuan Wu, Binkai Liu, Xiaowen Wang, Hala Alessa, Oana Zeleznik, A. Heather Eliassen, Clary Clish, Molin Wang, Kenneth J. Mukamal, Eric B. Rimm, Yang Hu, Frank B. Hu, Qi Sun, JACC, February 11, 2025, doi: 10.1016/j.jacc.2025.12.038
The Nurses’ Health Studies and Health Professional Follow-up Studies are supported by National Institutes of Health grants UM1 CA186107, R01 CA49449, R01 HL034594, U01 HL145386, R01 HL088521, U01 CA176726, U01 CA167552, R01 HL60712, and R01 HL035464. Sun was supported by DK120870, DK129670, ES022981, DK126698, and ES036206.The Nurses’ Health Studies are also supported by the NUS-Harvard Chan Women’s Health Initiative. The analysis was also supported by funding from the Dana-Farber/Harvard Cancer Center SPORE in Prostate Cancer, P50 CA090381-15.
Visit the Harvard Chan School website for the latest news and events from our Studio.
For more information:
Maya Brownstein
mbrownstein@hsph.harvard.edu
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Harvard T.H. Chan School of Public Health is a community of innovative scientists, practitioners, educators, and students dedicated to improving health and advancing equity so all people can thrive. We research the many factors influencing health and collaborate widely to translate those insights into policies, programs, and practices that prevent disease and promote well-being for people around the world. We also educate thousands of public health leaders a year through our degree programs, postdoctoral training, fellowships, and continuing education courses. Founded in 1913 as America’s first professional training program in public health, the School continues to have an extraordinary impact in fields ranging from infectious disease to environmental justice to health systems and beyond.
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Each year, millions of people are diagnosed with tuberculosis (TB) incorrectly, leaving their true health conditions unknown and untreated, according to a new study led by Harvard T.H. Chan School of Public Health.
The study was published Jan. 7 in Nature Medicine. Nicolas Menzies, associate professor of global health, was the corresponding author.
Missed cases of TB are a well-established global health problem, known to have serious consequences for patients and for the continued spread of the world’s top infectious disease killer. False positive diagnoses have received far less attention and study. But, Menzies explained in a Feb. 6 NPR article, their consequences can also be severe.
“Some people who have false positive diagnoses actually have some quite serious conditions that would benefit from prompt diagnosis and treatment,” such as pneumonia, lung cancer, or COPD, Menzies told NPR.
To understand the magnitude of TB misdiagnoses, Menzies and colleagues analyzed World Health Organization data on 6.8 million TB diagnoses across 111 countries in 2023. They estimated the number of false negatives and false positives using an assumed 25% rate of disease among individuals evaluated for TB, a rate based on a meta-analysis of TB diagnostics. The co-authors of the new study calculated that more than two million people received a false positive diagnosis and one million people received a false negative diagnosis.
According to Menzies, false positives likely result from “the challenges that clinicians—mostly those working within weaker health systems in low- and middle-income countries—face when diagnosing patients who they think might have TB.” Many TB rapid diagnostic tests (RDTs) have poor sensitivity and can produce false negatives. Meanwhile, clinicians assessing patients’ symptoms and making their best medical guess of TB can result in false positives.
“Clinicians may be making the best decision for the patient, but the diagnostics they are using have big deficiencies,” Menzies explained. “Without changing the technology available, the only way to reduce false positive diagnoses would be to treat fewer of these individuals with an unclear diagnosis, which would increase false negative diagnoses.”
The researchers wrote that a combination of adopting improved RDTs and improving clinical diagnosis guidelines offers the best odds to tackle both false negatives and false positives. Overall, however, they stressed the need for ongoing and increased investment in the development of higher-sensitivity TB diagnostic tests that can reduce the need for other methods of diagnosis.
Read the NPR article:
TB or not TB? That is the question
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Rethinking aquatic foods management to tackle global malnutrition
Around the world, more than four billion people aren’t getting enough of key vitamins and minerals they need to stay healthy, according to research led by Harvard T.H. Chan School of Public Health’s Chris Golden. One promising solution: better stewardship of sources of nutrient-rich aquatic foods.
Golden, Bruce A. Beal, Robert L. Beal and Alexander S. Beal Associate Professor of Nutrition and Planetary Health, and his team have documented the impact of climate and environmental change on malnutrition in countries such as Madagascar and Kiribati and explored ways to help their populations improve food security. Their latest research, published in two papers in PNAS, outlines two strategies for improving access to seafood in nutritionally vulnerable countries—by making the trade of farmed aquatic foods more equitable and helping wild coral reef fish stocks recover.
Changing aquatic trade policies
Aquaculture (farming aquatic animals) can play a vital role in reducing global malnutrition, the researchers noted in a paper published Feb. 9. To see how well food from this sector is benefitting people in the countries where most of it is produced, they looked at the nutrient composition of more than 2,800 aquatic species such as tilapia and shrimp. They also looked at more than two million trade transactions between 2015 and 2019 to track the sources and destinations of aquatic foods.
The researchers found that the aquaculture foods they analyzed had the potential to provide key nutrients, such as vitamin B12, for up to 2.7 billion people, but trade in these foods disproportionately disadvantaged nutritionally vulnerable countries.
“Undeniably aquaculture plays a key role in nutrition and food security,” said lead author Laura Elsler, research associate in Golden’s lab. “But nutritionally secure countries such as the U.S. and France reap disproportionate benefits while small island nations such as Tuvalu and the Seychelles lose critical nutrients by exporting wild-caught fish as aquaculture feed.”
If exporting countries were to retain these wild-caught fish used for fishmeal exports for domestic human consumption, they could meet the needs of up to 31 million undernourished individuals.
“Often, the economic benefits of international aquaculture trade do not reach nutritionally vulnerable people. Companies may benefit, but it is unlikely that the economic value that trickles down to local producers could equal the nutritional benefit of consuming these critical sources of nutrition,” said senior author Golden.
Helping reef fisheries recover
Coral reef fisheries are important sources of food and income for people in tropical countries, but most have been severely impacted by overfishing and climate change. In a paper published Dec. 16, 2025, Golden’s team and colleagues found that helping fish stocks on coral reefs recover could significantly increase the number of people who are able to meet fish intake recommendations, particularly in countries with high malnutrition.
They looked at 1,211 individual reefs around the world that are below maximum sustainable production levels and found that these sites could increase their yields of fish by 50% if allowed to recover. These additional yields could provide millions of people with yearly recommended seafood intakes. On average across sampled reefs, recovery to maximum production levels could take as few as six and as many as 50 years, depending on the state of depletion and how strictly fishing was restricted in the area, according to the study.
The researchers found that the locations with the greatest potential for sustainable gains in yield were among those experiencing the highest rates of food insecurity and malnutrition, including Madagascar, Mozambique, and Tanzania.
They noted that fishery management reforms would need to be paired with investments in local communities, such as helping reef fishers find alternative sources of income and food, while allowing their coral reef fish stocks to recover.
“Our study provides clear, quantitative evidence of how much food tropical coastal communities are losing, and could regain, through better-sustainably managed reef fisheries,” said first author Jessica Mason Zamborain, who partially conducted the research as a postdoctoral research associate in Golden’s lab. “These insights give relevant stakeholders the scientific foundation needed to strengthen food security and human health through effective fisheries management.”
Read more about Chris Golden’s work: Christopher Golden on Nutrition, Food Security, and Climate-Smart Public Health (Harvard Center for International Development)
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ER doctor and MPH student Nellie Darling wants to fix disaster medicine
Nellie Darling, an emergency medicine doctor, was inspired to pursue public health after witnessing how hospitals struggled during the COVID-19 pandemic.
Program
Expected graduation year
2027
Hometown
Portland, Maine
Transcript
As an ER doctor, one of the things I love about my job is that I get to see something different every day. I never really know what’s going to come through the door. Working clinically in the middle of a pandemic, I learned firsthand exactly what we can do if we can combine disaster medicine and public health. So, I started seeking out public health programs bridging this gap.
Flexibility was extremely important for me. [Harvard Chan School] was very accommodating and really attracts professionals and pre-professionals who are also working. So, I’m continuing to work as an ER doctor while I’m doing my degree.
One of the papers that I’m working on is on the effect of mass casualties on pre-hospital care delivery. One of my co-workers is trying to figure out, you know, do we start LVAD [Left Ventricular Assist Device, a surgical implant that helps the heart pump] soon enough on patients with heart failure?
I was truly inspired by seeing how many like-minded people were coming together in this climate to try and make change. And I just I felt like I was home.
Just for fun
Dog mom to a golden retriever named Aurora and a pit bull named Hank