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  • 1. Singer Casandra ‘Cassie’ Ventura took the stand for four days

    Ventura, widely viewed as the prosecution’s key witness, testified over four days during the trial’s first week while eight and a half months pregnant.

    The singer, who dated Combs on and off from 2007 to 2018, alleged that during their relationship, Combs physically abused her and coerced and blackmailed her into participating in drug-fueled sex marathons with male escorts, referred to as “freak offs” – which she said Combs orchestrated, directed, watched, masturbated to and sometimes filmed.

    She shared graphic details about the sexual encounters. She told jurors that Combs controlled most aspects of her life and was frequently violent with her. Ventura said that he would threaten to release explicit videos of her and stifle her career if she defied him, and alleged that he raped her after their 2018 breakup.

    On cross-examination, Combs’s attorneys portrayed her as a consenting participant in the “freak-offs”. They also presented dozens of messages between the two, including explicit texts and others in which she appeared to speak positively about the encounters.


  • 2. Another one of Combs’s former girlfriends told the court that she was coerced taking part in the ‘freak-offs’

    A woman testifying under the pseudonym “Jane”, who dated Combs from 2021 until his 2024 arrest, took the stand in weeks four and five of the trial.

    Much of her testimony echoed Ventura’s, describing the frequent “freak-offs”, or “hotel nights” she said was pressured by Combs to participate in.

    Jane said she initially participated to please Combs but later felt “obligated” after he began paying her rent. Jane told the court that she feared she’d lose her home, where she lived with her son, if she refused and that Combs used the rent payments as leverage over her.

    She said she repeatedly told Combs she no longer wanted to participate, but that he was dismissive. She also described a violent altercation between her and Combs in 2024 that left her with a black eye.

    Under cross-examination, Combs’s attorneys portrayed Jane, as they did with Ventura, as a consenting participant. They cited texts in which Jane seemed to speak positively about the encounters.

    The attorneys also noted that Jane sometimes arranged the encounters herself. Jane said that she did so to retain some control over who was involved.


  • 3. A former employee testified that Combs sexually and physically assaulted her

    A former personal assistant to Combs, testifying as “Mia”, told jurors that during her employment, Combs sexually and physically assaulted her multiple times.

    She described the incidents as “random”, “sporadic” and “so oddly spaced out” that she believed that each time was the last. She said she felt “trapped” in the situation and feared retaliation.

    On cross-examination, Combs’s lawyer suggested that she fabricated the claims, and also pointed to social media posts and messages from Mia after the alleged assaults in which she is seen praising Combs.


  • 4. Kid Cudi testified that Combs broke into his house

    Rapper Scott Mescudi, known as Kid Cudi, who briefly dated Ventura in 2011, testified in week two that Combs broke into his home after discovering the relationship.

    Weeks later, Mescudi’s car was firebombed, which Mescudi believes was Combs – an allegation Combs and his lawyers deny.


  • 5. A former employee testified that Combs kidnapped her at gunpoint

    Capricorn Clark, a former employee of Combs’s, testified that on the morning of the alleged break-in at Mescudi’s home, Combs “kidnapped” her while holding a gun. She said he then forced her to accompany him to Mescudi’s home, telling her he was going “to kill” Mescudi.

    During her employement, Clark said Combs threatened her, subjected her to lie detector tests, and once pushed her.


  • 6. The judge threatened to remove Combs from the courtroom

    On 5 June, the judge overseeing the case, Judge Arun Subramanian, warned that he would remove Combs from court if he continued to interact with the jury.

    During the lunch break that day, after the jury left the room, Subramanian said he saw Combs looking at the jury and “nodding vigorously” during the cross-examination of Bryana Bongolan, a former graphic designer for Combs and a longtime friend Ventura.

    The judge cautioned Combs’s lawyers that if he saw it again, it “could result in the exclusion of your client from the courtroom”.

    “There should be no efforts whatsoever to have an interaction with this jury,” the judge said.

    Combs’s lawyer assured the judge that it would not happen again.


  • Eddy Garcia, a former security guard at an InterContinental hotel in Los Angeles, testified in early June that Combs and his team sought to acquire the 2016 surveillance footage showing Combs assaulting Ventura at the hotel.

    Garcia testified that Combs gave him $100,000, which he split among hotel security staff, in exchange for the footage and said that he signed a nondisclosure agreement.

    The footage was released by CNN last year, though it remains unclear how CNN obtained the video.

    After the video’s release last year, Combs took to social media to publicly apologize for his behavior in the footage.

    The video was played several times for the jurors during the trial.


  • 8. Kanye West briefly showed up at the courthouse

    Kanye West, legally known as Ye, briefly visited Combs’s trial on 13 June to show support for Combs.

    He didn’t stay long. West was reportedly directed to an overflow room, and left shortly after through the front entrance. He was then seen getting into a car and driving away.

    During closing arguments, Ye released a song with one of Combs’s sons titled ‘Diddy Free’.


  • 9. A juror was dismissed over conflicting statements about his residency

    On 17 June, the judge dismissed a juror over conflicting residency claims.

    The juror, identified as Juror 6, reportedly claimed during jury selection that he lived in the Bronx. He later told court staff he lived in New Jersey, making him ineligible for the New York jury.

    “The record raised serious concerns as to the juror’s candor and whether he shaded answers to get on and stay on the jury,” Subramanian said in court.

    Combs’s legal team opposed the juror’s removal. They argued that Combs would be “severely prejudiced” if Juror 6, who they said was one of two Black men on the jury, were removed.

    The alternate juror who replaced him was a white man from Westchester, New York.


  • 10. Jurors watched videos of ‘freak-off’ sex marathons

    Jurors were shown video clips of the so-called “freak-offs”– the multi-day sex marathons with male escorts.

    Due to their graphic content, only jurors, the prosecution, defense and Combs could watch and hear the videos, all wearing headphones.

    Reporters and the public were barred from viewing or hearing them. The clips lasted several minutes and the jurors largely kept their reactions muted.

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  • Hydrogen Europe

    Hydrogen Europe

    Brussels, 2 July 2025

    CEOs from the world’s leading energy, automotive, and technology companies have come together to issue a strong and unified message to European policymakers: Hydrogen mobility is essential to Europe’s climate goals, industrial competitiveness, and strategic autonomy – and urgent action is needed on infrastructure buildout.

    In a joint letter addressed to EU and Member State leaders, the CEOs urge policymakers to firmly position hydrogen mobility at the heart of Europe’s clean transport and industrial strategies. The letter has been signed by executives from more than 30 companies, from multinationals to smaller vendors that combined span the entire hydrogen mobility ecosystem. It calls for immediate and targeted policy support to unlock investment and scale deployment of hydrogen vehicles and infrastructure across the EU.

    CEOs point to three critical issues:

    Hydrogen mobility unlocks critical energy system synergies: Hydrogen enables demand aggregation, supports hard-to-abate sectors, and drastically reduces renewable energy waste.

    Hydrogen mobility is a strategic imperative: Complementing battery-electric vehicles, hydrogen technologies are vital to ensuring a diversified, resilient, and cost-effective decarbonisation of road transport. A combined approach could save Europe between 300-500 billion euros in infrastructure costs by 2050. Two mobility infrastructures will be cheaper for Europe than relying on just electrification.

    Hydrogen mobility is a vector for jobs and industrial growth: Europe’s existing industrial strengths in automotive and advanced manufacturing can be leveraged to lead in hydrogen technology, providing up to 500,000 jobs by 2030.

    Despite progress, the CEOs warn that hydrogen mobility in Europe will stagnate unless a more coordinated and pragmatic policy framework is implemented to support the rollout of the necessary infrastructure and achieve the scale needed for the hydrogen mobility market to flourish. For this to happen, hydrogen mobility must form a central element of strategic initiatives such as the Sustainable Transport Investment Plan and Clean Industrial Deal, while the ongoing push to simplify EU regulations can help drive down the cost and complexity of building hydrogen mobility infrastructure.

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  • Jasprit Bumrah told to ‘keep cards close to chest’ after Edgbaston omission; surprises former pacer with off-field act

    Jasprit Bumrah told to ‘keep cards close to chest’ after Edgbaston omission; surprises former pacer with off-field act

    The omission of Jasprit Bumrah from the second Test against England in the Anderson-Tendulkar Trophy in Birmingham on Wednesday left several individuals surprised. While experts questioned the decision to leave out Bumrah despite taking a five-wicket haul, India captain Shubman Gill called it a part of workload management on the pacer.

    Bumrah was never in contention to play all the five Tests, more so after his injury in Australia earlier this year, which kept him out of action for almost three months. In fact, it was BCCI chief selector Ajit Agarkar who confirmed that Bumrah will be playing three Tests ahead of the tour.

    Former England quick Stuart Broad was one among the surprised. But what baffled Broad was Bumrah’s act of making the revealing the strategy publicly which should have stayed indoors. “A week is a very good time off for a fast bowler,” Broad said in a pre-match show.

    “(Bumrah’s omission) does surprise me and what also surprised me was him saying before the series he will only play three of the five Tests. You keep those cards close to your chest and play each week as it comes. They will definitely want Bumrah at Lord’s because of the movement you can get through the air,” added Broad.

    What has Jasprit Bumrah said pre-series?

    Ahead of the start of the five-match series, Bumrah sat down with former India teammate Dinesh Karthik for an interview with Sky Sports. The Indian pacer stated that he had contacted the BCCI about his workload management after realising that he was being considered for leadership role.

    “I called the BCCI and said I don’t want to be looked at in a leadership role because I won’t be able to give [it my] all Test matches coming a five Test-match series. So then, yes, the BCCI was looking at me at leadership. But then I had to say no,” Bumrah had said.

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  • Gareth Bale experiences Sheer Driving Pleasure at the BMW M Driving Academy.

    Gareth Bale experiences Sheer Driving Pleasure at the BMW M Driving Academy.

    +++ Welsh football legend completes safety driver training at the BMW
    M Driving Academy +++ +++ Spectacular images from Maisach +++ Bale
    plays BMW International Open Pro-Am with German NHL Stars and Ryder
    Cup Captain Luke Donald +++



    Munich.
    A day before his appearance at the Pro-Am
    tournament as part of the BMW International Open (July 2–6, 2025, GC
    München Eichenried), football legend Gareth Bale got into the swing of
    things in Maisach. At the BMW M Driving Experience in Maisach, the
    five-time Champions League winner completed a BMW Safety Driver
    Training course – proving that his athletic talent extends far beyond
    the football pitch.

    Behind the wheel of a BMW M4 Competition, Bale’s programme included
    evasive manoeuvres without braking, drifting, and, above all, plenty
    of driving pleasure. The 35-year-old was thrilled and stated how
    comfortable he feels in Munich and at the BMW International Open: “I
    played in Munich in football for Real Madrid quite a few times, and
    had some very good results, so Munich has been a great place for me.
    Coming back to play in the BMW International Open in the last few
    years has been really fun, enjoyed the course, enjoyed the city. It is
    always nice to be back.”

    On Wednesday, the passion-filled golfer swapped the asphalt for the
    greens once again. Just as in the past two years, Bale teed off at the
    Pro-Am tournament in Eichenried – and did so in excellent company. He
    played alongside European Ryder Cup Captain Luke Donald (ENG) and
    German NHL stars Moritz Seider and Tim Stützle.

    BMW M4 Competition Coupé: fuel consumption in l/100
    km: 9,9; CO2 emissions, combined in g/km: 223; CO2 class: G

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  • Tesla deliveries plummet 14% in second quarter

    Tesla deliveries plummet 14% in second quarter

    Elon Musk’s Tesla has reported a 14% decline in vehicle deliveries in the second quarter of the year, as the electric car-maker’s problems show no sign of abating.

    The just over 384,000 vehicles it delivered between April and June represents the second quarterly drop in a row.

    Tesla faces increasing competition from rivals, including China’s BYD. Musk’s controversial role as a government efficiency czar in the Trump administration has also been blamed for the plummeting numbers.

    Musk has since left the role – but has publicly sparred with US President Donald Trump over a massive spending bill pushed by the White House.

    In response, Trump floated cutting the subsidies received by Musk’s firms or even deporting him.

    Trump suggested that the ad-hoc Department of Government Efficiency – known as Doge – could be used to harm the billionaire’s companies.

    “Elon may get more subsidy than any human being in history, by far,” Trump wrote on social media Tuesday. “Perhaps we should have DOGE take a good, hard, look at this? BIG MONEY TO BE SAVED!!!”

    “I am literally saying CUT IT ALL. Now,” Musk replied.

    Trump has said that Musk’s opposition to the spending bill stems from a provision that removes incentives to buy electric vehicles.

    “He’s upset that he’s losing his EV mandate, he’s very upset, he could lose a lot more than that, I can tell you that,” Trump told reporters on Tuesday.

    Though the quarterly deliveries metric is tracked closely by investors, some analysts have shrugged off the figures.

    “The good news: that ~14% should mark the bottom,” wrote Deepwater Asset Management’s Gene Munster on Musk’s social media site X. “I have September down 10% and December flat.”

    Munster said he expected uncertainty about the US EV tax credit to boost near-term sales as buyers scramble to purchase before it expires.

    Tesla’s push into robotaxis which kicked off in Austin, Texas last month in uncertain fashion could prove critical, he said.

    “Over the next two years, I think investors will be fine with flat deliveries as long as autonomy shows measurable progress,” Munster added.

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  • Sabalenka moves on at Wimbledon, but not without a fight

    Sabalenka moves on at Wimbledon, but not without a fight

    WIMBLEDON — Aryna Sabalenka has made it her business to take care of business against players she’s expected to beat. As the World No. 1, that’s virtually every match.

    Pushed to the limit early on Centre Court, Aryna Sabalenka delivered another methodically relentless performance on Wednesday, edging past Marie Bouzkova 7-6(4), 6-4 to reach the third round.

    Next up is an enticing matchup Friday against the winner of the later contest between Marketa Vondrousova and Emma Raducanu, Grand Slam champions both.

    Sabalenka’s record this year against opponents ranked outside the Top 20 is now a sporty 29-4. It’s 20-4 in the second round of Grand Slams, including 18 straight.

    Sabalenka’s power was calibrated nicely, as she finished with 40 winners, against only 18 unforced errors. She served five aces and won 31of 35 first-serve points and was a searing 27-for-34 in points that she finished at net,

    Bouzkova is a clever, resourceful player. She doesn’t have the weight of shot or the athleticism of Sabalenka, but finds a way with well-placed shots, surprising serves and remarkable defense.

    The score was on serve at 4-5 in the first-set tiebreak when Sabalenka finally separated herself. After two huge shots from Sabalenka, Bouzkova couldn’t land a forehand. On set point, against Bouzkova’s weak 67 mile-an-hour second serve, Sabalenka hit a forehand return so hard it may still be going.

    The second set was more conventional, with Sabalenka breaking Bouzkova’s serve in the sixth game and riding that advantage to the end. Match point was a forehand into the open court that nicely captured her victory.

    Sabalenka didn’t play on Tuesday, but the field of challengers was thinned dramatically when No. 2 seed Coco Gauff, No. 3 Jessica Pegula and No. 5 Zheng Qinwen all lost.

    In her only two appearances here over the past four years, Sabalenka has reached the semifinals. This year, she looks determined to take it a step further.

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  • Wimbledon 2025: Full order of play, 3 July

    Wimbledon 2025: Full order of play, 3 July

    Olympic tennis medallists Novak Djokovic and Iga Swiatek will take on Centre Court for day four of Wimbledon 2025 (30 June-13 July).

    Paris 2024 champion Djokovic faces Great Britain’s Dan Evans in the opening match on the main show court on Thursday (3 July), while bronze medallist Swiatek meets the USA’s Caty McNally. The final match of the day on Centre Court will be between world number one Jannik Sinner and Aleksandar Vukic.

    Among the other stars in action on day four are 2022 women’s singles champion Elena Rybakina, British number one Jack Draper and Olympic silver medallist Mirra Andreeva.

    Read on to find out the start times and all the matches at the Championships.

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  • Can Hormone Therapy Affect Breast Cancer Risk in Younger Women

    Can Hormone Therapy Affect Breast Cancer Risk in Younger Women

    Investigators have found that two common types of hormone therapy may alter breast cancer risk in women before age 55. Women treated with unopposed estrogen hormone therapy (E-HT) were less likely to develop the disease than those who did not use this type of hormone therapy. Additionally, women treated with estrogen plus progestin hormone therapy (EP-HT) were more likely to develop breast cancer than women who did not use this type of hormone therapy. Together, these results—published by O’Brien et al in The Lancet Oncology—may help to guide clinical recommendations for hormone therapy use among younger women.

    The two hormone therapies analyzed in the study are often used to manage symptoms related to menopause or following hysterectomy or oophorectomy. Unopposed estrogen therapy is recommended only for women who have had a hysterectomy because of its known association with uterine cancer risk.

    “Hormone therapy can greatly improve the quality of life for women experiencing severe menopausal symptoms or those who have had surgeries that affect their hormone levels,” said lead author Katie O’Brien, PhD, of the National Institutes of Health’s (NIH) National Institute of Environmental Health Sciences (NIEHS). “Our study provides greater understanding of the risks associated with different types of hormone therapy, which we hope will help patients and their doctors develop more informed treatment plans.”

    Key Results

    The researchers conducted a large-scale analysis that included data from more than 459,000 women younger than age 55 across North America, Europe, Asia, and Australia. Women who used E-HT had a 14% reduction in breast cancer incidence compared with those who never used this type of hormone therapy. Of note, this protective effect was more pronounced in women who started E-HT at younger ages or who used it longer. In contrast, women using EP-HT experienced a 10% higher rate of breast cancer compared with nonusers, with an 18% higher rate seen among women using EP-HT for more than 2 years relative to those who never used this type of therapy.

    According to the authors, this suggests that for EP-HT users, the cumulative risk of breast cancer before age 55 could be about 4.5%, compared with a 4.1% risk for women who never used this type of hormone therapy and a 3.6% risk for those who used E-HT. Further, the association between EP-HT and breast cancer was particularly elevated among women who had not undergone hysterectomy or oophorectomy. That highlights the importance of considering gynecologic surgery status when evaluating the risks of starting hormone therapy, the researchers noted.

    “These findings underscore the need for personalized medical advice when considering hormone therapy,” said NIEHS scientist and senior author Dale Sandler, PhD. “Women and their health-care providers should weigh the benefits of symptom relief against the potential risks associated with hormone therapy, especially EP-HT. For women with an intact uterus and ovaries, the increased risk of breast cancer with EP-HT should prompt careful deliberation.”

    The authors noted that their study is consistent with previous large studies that documented similar associations between hormone therapy and breast cancer risk among older and postmenopausal women. This new study extends those findings to younger women, providing essential evidence to help guide decision-making for women as they go through menopause.

    Disclosure: For full disclosures of the study authors, visit thelancet.com.

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  • The ITA to deliver – on behalf of the UCI – a comprehensive, intelligence-driven anti-doping program for the 2025 Tour de France

    The ITA to deliver – on behalf of the UCI – a comprehensive, intelligence-driven anti-doping program for the 2025 Tour de France

    As part of its anti-doping mandate delegated by the UCI, the ITA is responsible for the year-round implementation of the cycling anti-doping program. Within this framework, the ITA will independently manage the clean sport strategy for the 2025 Tour de France. This program features a targeted, intelligence-led testing plan grounded in the latest scientific developments and risk-based analysis.

    Key features of the ITA anti-doping strategy for the 2025 Tour de France include:

    • Deployment of over 40 ITA and sample collection personnel at the Grand Départ in Lille
    • Around 350 out-of-competition tests in the month prior to the race
    • Around 600 in-competition samples to be collected during the event
    • Strengthened data analysis capacity to refine the testing and Athlete Biological Passport (ABP) strategy both out-of-competition and in-competition, with a particular focus on Grands Tours
    • Strong cooperation with French national authorities
    • Long-term storage and potential re-analysis of selected samples over a 10-year horizon in anticipation of future new detection methods or scientific developments
    • Increased focus on the endogenous steroid markers measured in blood serum as part of the steroidal module of the ABP, and on the endocrine module of the ABP to better detect markers of human Growth Hormone (hGH) abuse

    The strategy is based on an adaptive risk assessment approach that integrates various dynamic factors, such as rider performance trends, to ensure strategic testing throughout the event. Insights from the ABP, including the endocrine module, as well as information gathered by the ITA’s dedicated cycling team within its Intelligence & Investigations (I&I) department, inform these efforts.

    Testing during the Tour de France will be targeted and may occur at any point during the three-week race, not just at stage finishes. Like every year, the yellow jersey wearer and each stage winner will be tested. In addition, all participating riders will undergo pre-race testing as part of their medical monitoring protocols. For the 2025 edition, the Paris-based WADA-accredited laboratory will serve as the primary facility for sample analysis.

    Approximately 600 urine and blood samples will be collected during the Tour itself. The ITA is also placing a strong emphasis on the period leading up to the race by planning around 350 out-of-competition tests to secure a level playing field from the outset. Following the conclusion of the race, a targeted selection of samples will be retained for long-term storage and future re-analysis based on intelligence gathered throughout the season and during the event. The ITA will continue its monitoring efforts post-Tour using all collected data.

    Throughout the race, sample collection will be executed primarily by the ITA’s own experienced personnel, including 13 expert doping control and blood collection officers. The ITA is also coordinating closely with the French National Anti-Doping Organisation (AFLD), whose sample collection staff will contribute to the testing operations. Additional cooperation with local, national, and international authorities will support operational execution and intelligence exchange.

    The 2025 Tour de France also benefits from the sustained increase in resources allocated to clean sport efforts in men’s professional cycling. As part of a multi-year initiative culminating in 2024, the UCI, UCI WorldTeams, UCI ProTeams, WorldTour organisers, and riders committed to a 35% funding increase to the ITA for implementing the UCI anti-doping program. This enhanced budget continues to support critical areas such as I & I, scientific development, data analysis, testing, long-term sample storage, and re-analysis.

    In 2024, the ITA strengthened its investigative capacity by doubling the human resources dedicated to cycling and, together with the UCI, developed a policy and operational framework to implement and apply for the first time enhanced investigative powers, a pivotal measure to support evidence gathering in anti-doping investigations. The ITA also doubled the overall number of samples retained in long-term storage by selecting 1,690 samples after careful assessment of various risk-factors, 76 of them from the 2024 Tour de France. 490 samples collected in 2015 were also re-analysed, with all of them returning negative.

    “The Tour de France is not only one of the most iconic events in sport, but it is also a key moment for protecting the integrity of cycling. Our approach in 2025 reflects a continued commitment to intelligent, data-driven anti-doping strategies grounded in science, collaboration and continuous improvement. By combining targeted testing with advanced analytical tools such as the endocrine module, long-term sample storage and performance monitoring initiatives, we aim to ensure that this prestigious race is contested on a level playing field. We are proud to lead these efforts on behalf of the UCI and in close coordination with all our trusted partners,” said ITA Director General Benjamin Cohen.

    As part of its broader anti-doping strategy, the ITA is also developing a new longitudinal performance monitoring tool based on power data from professional men road riders, designed to act as an additional source of intelligence to guide targeted testing and advanced laboratory analysis, prioritise investigative, or refine its long-term sample storage

    Following consultation with the Funding Committee of the UCI anti-doping program, the ITA received approval in 2025 to develop this concept based on historical power data from male riders, aiming to create an additional tool in the fight against doping. In collaboration with the University of Kent (UK), the ITA has launched a one-year feasibility study to analyse this data and map how rider performance evolves over time. These insights will support the development of performance models across teams and rider profiles, taking into account various influencing factors. Several UCI WorldTeams and professional male riders have agreed to voluntarily participate in the feasibility study and share their data to support the project.

    Findings from the first year will be used to develop a model of “normal” and “expected” career trajectory performance over time, allowing for the identification of “abnormal” or “unexpected” performances. This will help identify “abnormal” or “unexpected” patterns that may indicate possible performance enhancement. While the model is not intended to serve as direct evidence of an anti-doping rule violation, it will act as an important additional intelligence tool to support the ITA’s broader anti-doping strategy—such as guiding targeted testing, advanced laboratory analysis, investigative prioritisation, or long-term sample storage.

    The results from this feasibility study phase will be presented to the Cycling Families, to determine whether to proceed with the Year 2 pilot project. This next phase would shift from the retrospective analysis of historical data to the implementation of power monitoring and other related metrics, using data collected during a cycling season. If successful, the initiative could be expanded to cover the entire men’s professional road cycling peloton.

    The ITA remains fully committed and is confident that these key features will contribute to delivering a top-tier anti-doping program for the 2025 Tour de France, reinforcing its mission to protect the integrity of the race and promote a level playing field for all riders involved.

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  • Uterine Cancer Incidence and Mortality Rates Projected to Rise Substantially by 2050

    Uterine Cancer Incidence and Mortality Rates Projected to Rise Substantially by 2050

    Uterine cancer is the fourth most common cancer diagnosed in women in the United States, with about 69,120 new cases and nearly 14,000 deaths from the disease expected this year. Black women experience a twice as high mortality rate compared with women of other races and ethnicities, and that number is expected to rise sharply over the coming decades.

    According to a study by Wright et al published in Cancer Epidemiology, Biomarkers & Prevention, the incidence and mortality rates of uterine cancer in the United States are projected to increase significantly over the next 3 decades, with incidence-based mortality expected to be nearly three times higher in Black women compared with White women.

    Study Methodology

    The researchers developed the Columbia University Uterine Cancer Model (CU-UTMO) as part of the National Cancer Institute’s Cancer Intervention and Surveillance Modeling Network (CISNET). This state-transition microsimulation model simulates the trajectories for uterine cancer incidence and mortality based on characteristics from a sample population, taking into account age (between 18 and 84 years); Black and White race; birth cohort grouped in 10-year intervals starting in 1910 to 1920; cancer stage, as determined by the American Joint Committee on Cancer; and separately modeled endometrioid and nonendometrioid tumors, which usually have a worse prognosis.

    To validate the model, the researchers used CU-UTMO to predict the median age of diagnosis, survival rate, and distribution of diagnosis by stage for uterine cancer in 2018; they found those projections were comparable to the actual Surveillance, Epidemiology, and End Results data from that year. Then the researchers estimated the future rates of the cancer based on publicly available sources through 2018.

    Key Results

    The researchers found that the model closely fit population-based incidence and mortality data of uterine cancer. They determined that from 2020 to 2050, the incidence of uterine cancer is projected to increase in White women to 74.2 cases per 100,000 (compared with 57.7 cases per 100,000 in 2018) and to increase to 86.9 cases per 100,000 (compared with 56.8 cases per 100,000 in 2018) in Black women.

    Among White women, incidence-based mortality will increase from 6.1 per 100,000 in 2018 to 11.2 per 100,000 in 2050, and incidence-based mortality in Black women will increase from 14.1 per 100,000 to 27.9 per 100,000. In addition, the incidence of endometrioid tumors is expected to increase considerably in both White and Black women. However, although White women will experience only a slight increase in nonendometrioid tumors, the incidence of these tumors in Black women will increase substantially.

    “These population-level trends support the urgent need to develop and implement novel primary and secondary prevention strategies for uterine cancer,” concluded the study authors.

    Understanding Disease Disparities

    “There are likely a number of factors that are associated with the increased burden of uterine cancer in Black women,” said lead study author Jason D. Wright, MD, the Sol Goldman Professor of Gynecologic Oncology at Columbia University Vegelos College of Physicians and Surgeons. “They more commonly have aggressive types of uterine cancer, face delayed diagnosis resulting in later-stage disease at diagnosis, and there are often delays in their treatment.”

    Reducing Burden of Disease

    In addition to building this state-transition microsimulation model of uterine cancer, Dr. Wright and his colleagues also performed a stress test of the model by incorporating hypothetical screening and intervention methods that could detect uterine cancer and precancerous changes prior to a clinical diagnosis. They found that the screening and intervention methods were most effective when introduced at age 55, with declines in cancer incidence that lasted up to 15 years in White women and up to 16 years in Black women.

    “The stress testing suggests that if there was an effective screening test, we may be able to substantially reduce the burden of disease. While there is presently no screening or prevention that is routinely used for uterine cancer, we are currently examining the potential impact of integrating screening for this cancer into practice,” said Dr. Wright.

    Disclosure: Funding for this study was provided by the National Cancer Institute. For full disclosures of the study authors, visit aacrjournals.org/cebp.

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