UK Doctors Develop Non-Invasive Urine and Vaginal Fluid Test for Womb Cancer in Women Bleeding After Menopause
Doctors in Manchester have developed a cheap, non-invasive test using urine and vaginal fluid that identified 80 of 99 womb cancers in women with postmenopausal bleeding, though researchers say it cannot yet rule out cancer on its own.
The study, run by researchers at the University of Manchester and Manchester University NHS foundation trust, assessed 1,864 women who attended seven hospitals in north-west England with postmenopausal bleeding. Each woman gave a urine sample and a vaginal fluid sample before her routine tests. Ninety-nine of the participants, or 5%, were diagnosed with womb cancer through a biopsy or surgery. Cytologists who were not told the women's diagnoses identified 80 of the 99 womb cancers using the new test and returned a correct negative result for 93% of the women who did not have cancer.
Bleeding after menopause triggers an urgent cancer referral, but only about 5% to 10% of women who report the symptom are found to have an underlying cancer. Hundreds of thousands of women worldwide are diagnosed with womb cancer each year.
The researchers said the test was not accurate enough to rule out cancer on its own. They said it could instead be used to fast-track women at highest risk for urgent investigation while sparing lower-risk women immediate invasive testing, with repeat sampling or full assessment if symptoms continued. They cautioned that samples in the study were assessed by highly trained specialist cytologists, so it is not known whether the same accuracy could be reproduced in other settings, and that the test has not been studied in women without symptoms.
Emma Davidson, a professor at 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 that the vast majority of those investigated will not have the disease. She said many women currently face invasive, uncomfortable tests that can be stressful as well as costly for health services before cancer can be ruled out. According to Davidson, the 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.
She added that if further studies confirm the findings in routine practice, the approach has the potential to transform care for thousands of women every year.
Researchers said the test could be used to triage women suspected of having womb cancer, to support rapid diagnosis, provide quick reassurance and reduce the burden of invasive testing for women with postmenopausal bleeding.