Miriam Mints - new professor 2020

Miriam Mints researches diseases linked to the uterine lining, both benign and malignant. In her thesis, she studied heavy menstrual bleeding and its connection to the formation of new blood vessels.

“The formation of new blood vessels is a characteristic element of almost every disease process in the uterine lining,” says Miriam Mints.

Together with her research team, she has succeeded in charting how the formation of new blood vessels affects the occurrence and development of idiopathic menorrhagia, a benign disease in the uterine lining causing heavy and lengthy menstruations with no apparent cause.

“The results from these studies have laid the foundation for a new view of this disease. Based on this new approach to disease processes, we want to examine whether therapy focusing on this abnormal vascular growth results in a regression of heavy bleeding.”

Miriam Mints also researches endometrial cancer – often referred to as uterine cancer – forming in the outermost layer of the uterine lining. It is the fourth most common form of tumours in women and makes up around six per cent of cancer affecting women. The number of cases of uterine cancer among gynaecological cancers has risen to 40 per cent.

Approximately 1–2 per cent of uterine cancer cases are part of a cancer syndrome called Lynch syndrome (LS). Women with LS run a 40–60 per cent risk of developing uterine cancer as well as colon cancer. And in around half of LS cases, uterine cancer develops before colon cancer.

The project Registry of Endometrial Cancer in Sweden (RENDOCAS) is charting heredity and identifying genes that cause uterine cancer to tailor adequate prevention programmes.

“One of the goals is to identify male carriers of high-risk genes so that both fathers, and above all their daughters, can be monitored by an appropriate control programme,” says Miriam Mints.

In an international collaboration, she has drawn up a risk assessment method for the incidence of cancer and survival in LS patients. Researchers have developed the website, www.LScarisk.org. The website can estimate the cumulative risk for cancer, providing guidance in genetic counselling connected to Lynch syndrome.

“My current research aims to find markers that can help us to identify high-risk patients,” says Miriam Mints.

She studies not only uterine cancer but also cervical cancer. Each year, 40,000 women are diagnosed with cell changes detected via screening. Of these, around 10,000 are treated for serious precursors to cervical cancer.

Research has concluded that the human papillomavirus (HPV) infection causes cervical cancer. The National Board of Health and Welfare recommends the HPV test as a routine component of the general screening programme. After treatment, a gynaecological follow-up is recommended every other year over 25 years.

“Since society’s resources are limited, we need access to gynaecological follow-up in healthcare and effective clinical tests to reduce the number of cancer cases. Right now, I’m reviewing an alternative follow-up with self-testing of vaginal secretions and urine.”

Preliminary results from one hundred women treated for precursors to cervical cancer have shown that results from self-testing and tests taken by a gynaecologist were mostly consistent.

“The results also show that fewer women develop cervical cancer and die prematurely of the disease, giving rise to better health effects and lower costs for society,” explains Miriam Mints.

She has received SEK 100,000 from the non-profit organisation ‘I wear teal’ for her research on gynaecological cancer.

As part of her clinical work, Miriam Mints has put together a chain of care for investigating and treating women with benign and malignant conditions in the uterus and cervix.

“This setup provides a unique opportunity – parallel with the treatment of patients – to conduct research, study clinical research questions and apply results clinically.”

In addition to her clinical work and research, Miriam Mints teaches students in the Programme in Medicine and instructs colleagues in gynaecological cancer and minimally-invasive surgery. In the spring of 2019, she was named best supervisor on the course in reproduction on the medical programme at Karolinska Institutet.

Translation: Jerry Gray