A new and non-invasive urine test can accurately detect womb cancer.
The test is accurate at detecting womb cancer by looking at a urine or vaginal sample with a microscope according to a proof-of-concept study by University of Manchester and Manchester University NHS Foundation Trust (MFT) scientists.
Womb cancer is the sixth most common cancer affecting women, with approximately 382,000 new diagnoses and 89,900 deaths from the disease in 2018 globally. It has a five-year survival rate of just 15%. and 20% of women present with advanced disease.
The researchers say the test could have major benefits for patients if it is adopted across the NHS. The analysis has been published in Nature Communications.
Diagnosing womb cancer
Womb cancer is currently diagnosed using a narrow telescope, called a hysteroscope, to examine the inside of the womb where a biopsy is taken, however, 31% of women who have the procedure must have it repeated because of technical difficulties or intolerable pain and thousands of women who do not have womb cancer also undergo the procedure, with huge financial implications for the NHS.
Womb cancer is known to shed malignant cells through the cervix into the lower genital tract which can then be collected from the vagina by gentle lavage or from self-collected urine samples. Testing the cells could be a useful tool because the expertise and infrastructure required to deliver it is already established in the NHS. Its advantages include low costs, quick turnaround times and the potential for diagnosis at the point of care.
The team, led by Professor Emma Crosbie from The University of Manchester, tested the new tool on 103 women with known cancer and 113 with unexplained postmenopausal bleeding.
The proportion of women with womb cancer who were identified by the new tool was 91.7% and the proportion of women without womb cancer who tested negative with the new tool was 88.9%.
Professor Crosbie, who is also an Honorary Consultant in Gynaecological Oncology at Saint Mary’s Hospital, part of MFT, said: “Our results show that womb cancer cells can be detected in urine and vaginal samples using a microscope. 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.
“New strategies to facilitate early diagnosis of womb cancer are urgently needed to enable curative hysterectomies 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. While our data are very promising, we must confirm them in a larger diagnostic accuracy study of women with unexplained postmenstrual bleeding undergoing routine diagnostic investigations.”
The study was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre.