UK doctors develop non-invasive womb cancer

Doctors in the UK have developed a simple, non-invasive test that could help rule out womb cancer in women who experience bleeding after menopause. The test, which analyzes cells from urine and vaginal fluid, has the potential to transform care and spare thousands of women from uncomfortable, invasive diagnostic procedures each year.

Bleeding after menopause triggers an urgent cancer referral, yet only about 5% to 10% of women who report this symptom actually have an underlying cancer. Current diagnostic tests-an internal ultrasound scan, a biopsy of the womb lining, and a hysteroscopy where a camera is passed into the womb-are all invasive and costly for healthcare systems.

How the new test works

Researchers at the University of Manchester and Manchester University NHS Foundation Trust created the new test. It is cheap and non-invasive, requiring only a urine sample and a vaginal fluid sample. In a study published in the journal Lancet Obstetrics, Gynaecology, & Women’s Health, 1,864 women attending seven hospitals in north-west England with postmenopausal bleeding provided samples before their routine tests.

Of these women, 5% (99 of the 1,864) were later diagnosed with womb cancer via biopsy or surgery. Using the new test, specialist cytologists who were unaware of the women’s diagnoses identified 80 of those 99 womb cancers. The test correctly returned a negative result for 93% of the women who did not have womb cancer.

Potential impact on patient care

Researchers say the test is not yet accurate enough to rule out cancer on its own. However, it could be used to triage women. It would fast-track those at highest risk for urgent investigation while sparing lower-risk women from immediate invasive testing. Those with a negative result could be monitored with repeat sampling or a full assessment if their symptoms continued.

Professor Emma Davidson of the University of Manchester and Manchester University NHS Foundation Trust explained the significance. Bleeding after the menopause is understandably alarming for women because it can be a sign of cancer, but the vast majority of those investigated will not have the disease, she said. Our study shows that a simple test using urine and vaginal samples could help identify the women most likely to have cancer while safely reassuring many others much earlier in the diagnostic pathway.

Study limitations and next steps

The researchers issued cautions. The samples in the study were assessed by highly trained specialist cytologists, so it is not known if the same accuracy could be reproduced in other, routine healthcare settings. Also, the test has not been studied in women without symptoms.

Despite these limitations, the team is optimistic about the test's future role. It is designed to "support rapid diagnosis, provide quick reassurance and reduce the burden of invasive testing for women with postmenopausal bleeding." Professor Davidson stated that if further studies confirm these findings in routine practice, "this approach has the potential to transform care for thousands of women every year."

The test represents a significant step toward a less stressful diagnostic process for a common and worrying symptom in postmenopausal health.