King Charles III Crowned in First British Coronation in 70 Years, and Other News from the Week

We’re pleased to bring you “While You Were Out”—Verily's quick takes on the happenings of this week.

Breast cancer screening guidelines are changing — again

The United States Preventive Services Task Force has updated its recommendation for when breast cancer screening should start. The group’s draft guidelines now say that women should have their first mammogram at age 40 and repeat the test every other year.

Stat notes that the previous update in 2016 sparked controversy since it told women and their doctors that biennial screening shouldn’t start until age 50. That advice was meant to help women avoid the consequences of false positives and worthless radiation exposure. Advocates and other health professionals objected that it would lead to preventable deaths and that the risks of screening more often were acceptable.

In particular, critics noted that Black women are 40 percent more likely to die of breast cancer than their White peers, with aggressive tumors and less access to treatment. A reduction in screening could make those health inequalities much worse, they argued.

The Task Force says it based its update on scientific data, including a new model that analyzed the outcomes of Black women specifically. They expect an additional 1 in every 1,000 women will have her life saved. But some experts expressed frustration. “You’re kidding,” Dr. Rita Redberg, editor-in-chief of JAMA Internal Medicine, told Stat regarding the change. She said the harms of over-screening thousands of women continue to outweigh the benefits.

Although the USPSTF is arguably the most influential group when it comes to setting screening guidelines, other organizations give different advice. The American College of Radiology says to get a yearly mammogram starting at 40. The American Cancer Society says to start annually at 45 and consider switching to a biannual schedule at 55. It certainly makes for a confusing environment for women trying to figure out what to do. —Margaret Brady

Jury finds Trump liable for sexually abusing and defaming E. Jean Carroll

On June 21, 2019, New York Magazine released an explosive story: Author and advice columnist E. Jean Carroll alleged that Donald Trump had assaulted her in a Bergdorf Goodman dressing room in the 1990s. Trump denied the accusations, saying he had never met her (even though photographic evidence proved he had).

Now, nearly four years later, Carroll may be getting justice. A Manhattan jury on Wednesday found the former president liable for sexually abusing and defaming the author. The defamation charge came from Carroll, alleging that Trump “defamed her when he denied her claim, said she wasn’t his type and suggested she made up the story to boost sales of her book,” per CNN.

Trump must pay Carroll $5 million in damages.

The case was civil, not criminal and occurred over two decades after the alleged incident. That means that the jury had to determine not that Trump was at fault beyond a reasonable doubt but by a preponderance of evidence (in other words, more likely than not).

Last year, New York passed the “Adult Survivors Act,” which allowed victims of sexual abuse to pursue legal action against their abusers for a period of one year, even if the statute of limitations had expired. The cases had to be civil, not criminal, but they could still mean retribution for victims.

During the trial, two of Carroll’s friends supported her story, saying that she had told them about the incident at the time, though she didn’t report it to the police. Evidence also included two other women who had accused Trump of sexual assault and the infamous Access Hollywood tape.

When Trump’s lawyer asked Carroll why she didn’t scream for help, she said she was “too much in panic to scream.”

“Women who don’t come forward, one of the reasons they don’t come forward is they are asked why they didn’t scream,” she said. “Some women scream, some women don’t. It keeps women silent.”

After the verdict was handed down in her favor, Carroll said the win wasn’t just hers.

“The old view of the perfect victim was a woman who always screamed—a woman who immediately reported. A woman whose life was supposed to fold up, and she’s never supposed to experience happiness again,” Carroll said. “That was just shut down with this verdict. The death of the perfect victim has happened. Now this verdict is for all women.” —Madeline Fry Schultz

Royal coronation of King Charles III, 70 years after the late Queen’s crowning

King Charles III and Queen Camilla were crowned at Westminster Abbey last Saturday in a grand coronation ceremony. Millions of viewers nationwide tuned in to witness the historical event of the new British Monarch’s succession to the throne. It was the first British coronation in approximately 70 years, the last being the coronation of the late Queen Elizabeth II in 1953.

The royal couple’s coronation day commenced with a procession in a horse-drawn Diamond Jubilee State Coach, guarded by 1,000 members of the armed forces. Many royal family members—including Prince William and Catherine, Princess of Wales—were seen in the procession. Per usual, the Prince and Princess of Wales were a favorite; footage of the royal couple's synchronized movements, filmed shortly before they joined the over 2,000 other coronation guests within the Abbey walls, has gone viral.

The so-called “undoubted King” Charles prayed quietly after entering the Abbey: “I come not to be served, but to serve.”

The ceremony included intervals of quietude and ancient traditions. In a private, shielded moment, the Archbishop of Canterbury anointed the King with holy oils, a representation of a “moment between the Sovereign and God.” A choir awaited the appearance of the King by singing Handel’s “Zadok the Priest,” which has been sung at every coronation ceremony since 1727.

“God Save the King” echoed inside and outside Westminster Abbey to mark the moment the newly appointed King was crowned. Throughout the country, gun salutes resounded.

While most of those gathered were there to participate in celebratory salutations, some gathered in protest: A large group of anti-royalists protested the coronation ceremony. The Republic group has been campaigning to “abolish the monarchy and replace it with an elected head of state, and others.” The Metropolitan police arrested a total of six protesters in this group. —Hannah Rose Ward

New artificial intelligence tool predicts pancreatic cancer up to 3 years early

Researchers led in part by scholars from Harvard Medical School have developed a “machine learning” model that successfully identified people at high risk for pancreatic cancer years before they were diagnosed with the disease.

The study’s AI algorithm was initially trained on the medical records of more than 6 million people in Denmark, spanning more than four decades. Nearly 24 thousand of those patients were diagnosed with pancreatic cancer at some point. Successive versions of the AI learned to detect specific patterns in the sequence of other (sometimes seemingly-unrelated) illnesses, like anemia or gallstones, that popped up before the tumors.

The researchers then tested the algorithm on three million records from the U.S. Department of Veterans Affairs. The AI was slightly less accurate, given the smaller data set, but it still was remarkably adept at flagging high-risk patients. The data was published in the journal Nature Medicine this week.

Currently, screening for pancreatic cancer is expensive, complex, and limited to people with a family history of the disease or genetic predisposition. At the same time, the survival rates are stubbornly dismal: Less than ten percent of people are still alive five years after late-stage diagnosis. Other researchers project that by 2030, pancreatic cancer will be the second biggest cancer killer in the United States. The success of this AI model suggests the tantalizing possibility of large-scale, population-based screening that could find more cases before it’s too late. —MB

Good News of the Week

In a recent clinical trial, medical professionals at Boston Children’s Hospital performed a successful brain surgery on an unborn baby to reduce the baby’s risk of heart failure or stroke. The 34-week pregnant mother gave birth to the baby two days later, and after spending several weeks in the neonatal intensive care unit, the newborn was permitted to go home with mom.

This baby had a rare prenatal condition known as Vein of Galen malformation (VOGM), which occurs when those arteries delivering high-pressure blood connect to a major vein near the base of the brain. The condition can be fatal for the baby after birth.

Since birth, the baby has been monitored for brain function and heart rate abnormalities. Professor Darren Orbach of Boston Children’s Hospital concluded that the baby was recovering well: “We are pleased to report that at six weeks, the infant is progressing remarkably well, on no medications, eating normally, gaining weight and is back home.”

Some experts believe the new procedure will create a shift in the way doctors manage VOGM. The procedure could change the odds significantly for these newborns marked with this rare condition. Yet, others like Professor Colin Derdeyn suggest proceeding with caution. “The key advance here is to intervene before the physiologic events of birth can cause life-threatening heart failure. There are caveats; one successful case is not enough experience for us to conclude that the risks of this procedure are worth the benefits.”

Nevertheless, we’re glad that a breakthrough has been made to advance the care for these infants. Hopefully, doctors will be encouraged by this success story and continue healing other unborn babies who have VOGM. —HRW

Watch of the Week

Watch these highlighted moments of King Charles III’s coronation ceremony Saturday, May 6.