New test could cut need for invasive womb cancer checks

A urine and vaginal fluid test could help rule out womb cancer in women with postmenopausal bleeding, potentially reducing invasive checks.

In a study of 1,864 women with postmenopausal bleeding, the test identified 80 of 99 womb cancers and correctly gave a negative result for 93 per cent of women without the disease.

Researchers said the test was not accurate enough to rule out cancer on its own, but could help fast-track women at the highest risk for urgent investigation while reducing immediate invasive testing for those at lower risk.

Professor Emma Davidson, of the University of Manchester and Manchester University NHS Foundation Trust, said: “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.

“At the moment, many women face invasive, uncomfortable tests that can be stressful as well as costly for health services before cancer can be ruled out.

“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.

“If further studies confirm these findings in routine practice, this approach has the potential to transform care for thousands of women every year.”

Developed at the University of Manchester and Manchester University NHS Foundation Trust, the test examines cells collected from urine and vaginal fluid samples.

Postmenopausal bleeding currently triggers an urgent cancer referral, although only about 5 to 10 per cent of women who report it have an underlying cancer.

Current investigations include an internal ultrasound scan, a biopsy of the womb lining and hysteroscopy, in which a camera is passed into the womb.

Women taking part in the study attended seven hospitals in north-west England and provided urine and vaginal fluid samples before undergoing their routine tests.

Five per cent of participants, 99 of 1,864 women, were diagnosed with womb cancer through biopsy or surgery.

Cytologists assessed the samples without knowing the women’s diagnoses.

Researchers said the test could be used to triage women suspected of having womb cancer, with lower-risk patients monitored through repeat sampling or given a full assessment if symptoms continued.

They cautioned that the samples were assessed by highly trained specialist cytologists, so it is not yet known whether the same accuracy could be achieved in other settings.

The test has also not been studied in women without symptoms.