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Simple test can identify endometrial cancer

Friday February 12th 2021

A simple urine or vaginal test carried out at home can accurately detect endometrial cancer – removing the need for painful invasive hospital procedures, a new UK study has found.

A proof of concept study by University of Manchester and Manchester University NHS Foundation Trust (MFT) scientists showed that the new detection tool, which uses cytology from cells collected the vagina by gentle lavage or from self-collected urine samples, could be incorporated into clinical practice once large scale trials have been completed.

Professor Emma Crosbie from The University of Manchester led the study, which tested the tool on 103 women with known cancer and 113 with unexplained postmenopausal bleeding.

She said the tool identified 91.7% of women with endometrial cancer, and the proportion of women without cancer who tested negative with the new tool was 88.9%.

Writing in Nature Communications, Prof Crosbie, who is also an honorary consultant in gynaecological oncology at Saint Mary’s Hospital, said the tool is low cost, has quick turnaround times and has the potential for diagnosis at the point of care.

It would replace the need for a hysteroscope examination, which has to be repeated in about 31% of women because of technical difficulties or intolerable pain.

“Our results show that womb cancer cells can be detected in urine and vaginal samples using a microscope,” she said.

“Women who test positive with this test could be referred for diagnostic investigations while women who test negative are safely reassured without the need for unpleasant, invasive, anxiety-provoking and expensive procedures.

“We think our new test could offer a simple, acceptable, and easy to administer solution that could be used in primary care as a triage tool for women with suspected womb cancer.”

Most women present early, following the onset of postmenopausal bleeding and have a good prognosis, but 20% of women present with advanced disease and have a five-year survival rate of just 15%.

Prof Crosbie added: “New strategies to facilitate early diagnosis of womb cancer are urgently needed to enable curative hysterectomy for women who present with biologically aggressive disease.

“However, though postmenopausal bleeding is a recognisable symptom, only 5 to 10% of women with it have sinister underlying pathology, so this test, if adopted, will put these patients’ minds at rest.”

She said a larger, diagnostic accuracy study of women with unexplained postmenstrual bleeding undergoing routine diagnostic investigations was now needed to confirm their findings.

O’Flynn H, Ryan NAJ, Narine N et al. Diagnostic accuracy of cytology for the detection of endometrial cancer in urine and vaginal samples. Nature Communications 11 February 2021. Doi: 10.1038/s41467-021-21257-6.


Tags: Cancer | UK News | Women's Health & Gynaecology

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