Mind the gap: Why diagnostic disparities damage women’s health

In a panel discussion held on June 18, 2024, at HLTH Europe in Amsterdam, experts discussed how women’s health has long lagged behind men’s health in medical research, understanding, and innovation. Significant disparities exist in how quickly and accurately women are diagnosed compared to men for many health conditions.

“There was actually a study done in Denmark in 2019. The study covered 20 years of electronic record data of the healthcare system. And what we found is that women are diagnosed later than men for 700 conditions and that includes things like diabetes, various cancers, and heart disease,” explained Katherine Folkendt, the founder and CEO of FemTech Insider.

Folkendt moderated an illuminating panel discussion with pioneering entrepreneurs and clinicians developing innovative diagnostic technologies to help close the gender gap in healthcare. The panelists included:

• Caroline Mitterdorfer, co-founder of Flovy Health, which provides clinical decision support software to healthcare providers to improve diagnosis of endocrine disorders in women
• Dr. Frank Hoffmann, founder of Discovering Hands, which trains and employs visually impaired women to provide breast cancer screening using their enhanced sense of touch
• Dr Sara Naseri, co-founder of QVIN, has developed the first FDA-cleared diagnostic menstrual pad to enable convenient screening for cervical cancer and other conditions
• Dr Sofiane Bendifallah, a gynecologic surgeon at the American Hospital of Paris who is working to improve care pathways for women with endometriosis and gynecologic cancers

The panelists discussed the challenges that lead to diagnostic disparities for women and their innovative approaches to overcoming these issues.

“80% of women once in their lifetime, suffer from an endocrine disorder, but it does take years and also very many providers to actually get to the bottom of a diagnosis,” said Mitterdorfer. Her company, Flovy Health, aims to empower gynecologists, primary care doctors, and nurse practitioners with software to improve the detection of often misdiagnosed or undiagnosed endocrine conditions like PCOS.

Dr Hoffmann explained that while mammograms are an important breast cancer screening tool, many women avoid them due to fears about radiation and painful compression. Discovering Hands takes a novel approach, employing blind and visually impaired women to provide comfortable and attentive manual breast exams.

“The tactile sensitivity for detecting tumors, especially the small six to eight-millimeter ones we want to detect, is over 80%,” said Hoffmann. “More importantly, [our examiners] use that time to answer the patients’ questions because nothing is more important than making women realize that early detection means a cure.”

Dr Naseri’s company, QVIN, is taking aim at the global burden of cervical cancer by developing a convenient diagnostic menstrual pad women can use at home. Many women have to take time off work to get a Pap smear at the doctor’s office every few years. During the COVID-19 pandemic, cervical cancer screening rates dropped by 20–30%.

“Menstrual blood contains endometrial tissue and vaginal fluid, so over 400 unique proteins that provide information specifically about the reproductive organs,” explained Naseri. “We’re very excited about being able to screen for cervical cancer very conveniently and affordably using frankly just cotton and paper.”

For Dr Bendifallah, an important part of improving women’s health is greater empathy from the medical system. “All the healthcare systems, especially for women, are based on an old mindset which needs to be changed because the biology and needs of women are not the same as men,” he said. “The first step is to listen to patients and understand what they really need.”

The panelists agreed that overcoming stigma and lack of awareness are key to achieving more timely diagnoses for women’s health conditions. “It is important we detect things early because time is the most important prognostic factor for any condition, whether it’s breast cancer, PCOS or endometriosis,” said Naseri.

Mitterdorfer emphasized the need to incentivize healthcare providers to spend more time with patients for thorough evaluations and patient education. “Women trust their provider and continuously seek guidance, so we need to find ways to incentivize gynecologists and primary care providers to take the time to educate patients,” she said. “At the moment that is not the case. A typical gynecologist has seven minutes per patient visit.”

Hoffmann highlighted the enthusiastic patient response to Discovering Hands’ compassionate care model. Over 97% of patients recommend manual breast exams by their blind examiners to friends and family. “Diagnostic services that are experienced as pleasant lead to acceptance. A measure that evokes unpleasant associations is suppressed,” he explained.

The panelists hoped their innovations would make important strides in women’s health diagnostics and care. However, Naseri pointed out, “Women’s health is behind, and we have some catching up to do…We need to look for where women have an advantage.” She believes the monthly menstrual blood that half the population produces provides an incredible untapped opportunity for diagnostic insights.

In concluding the discussion, the panelists shared some key takeaways:

“If there was one thing I wish people would realize, it’s incentivizing providers,” said Mitterdorfer. “Value-based care, actually giving the provider a slice of the cake if they are treating, healing or bringing down costs by providing better care, has huge potential.”

“I hope that everyone, especially women themselves, realize that effective early detection of breast cancer saves lives,” said Hoffmann. “You can do something for yourself. I hope that will lead women to all the preventive instruments available.”

“It wasn’t until 1990 that women were even included in medical research,” Naseri pointed out. “As a field, women’s health is behind. We believe menstrual blood, that advantage that we’ve been throwing away every month, could be a way to accelerate participation and representation in clinical research and close the gender data gap.”

Dr. Bendifallah emphasized the importance of empathy. “Women need to be listened to. If we have more empathy, this will bring more empathy from our hospitals and doctors to be better,” he said. “And we have to trust technology’s accuracy and use it to do better, higher and faster for this huge topic.”

While much work remains to achieve health equity, the pioneering spirit and tireless efforts of innovators like these panelists provide hope for a future where women’s health is given the priority it deserves. Through novel diagnostic technologies, improved models of care, greater awareness, and medical providers who truly listen to women’s needs, the gender gap in healthcare can eventually become a thing of the past.