Doctors at the University of Manchester and Manchester University NHS Foundation Trust have created a new diagnostic approach for evaluating postmenopausal bleeding in women. The method analyzes cells collected from urine and vaginal fluid samples rather than relying on invasive procedures, addressing a significant clinical challenge affecting hundreds of thousands of women globally each year.
Currently, womb cancer diagnosis involves several invasive and costly procedures, including transvaginal ultrasound scans, endometrial biopsies, and hysteroscopy procedures. While postmenopausal bleeding prompts urgent cancer referrals, only 5% to 10% of women reporting this symptom actually have underlying malignancy, meaning the majority undergo unnecessary invasive testing.
Researchers conducted a study involving 1,864 women at seven hospitals in north-west England who provided both urine and vaginal fluid samples before receiving standard diagnostic testing. Among these participants, 5% were subsequently diagnosed with womb cancer through biopsy or surgery. The new test identified 80 of the 99 confirmed cancer cases and correctly returned negative results for 93% of women without cancer. Results were published in the journal Lancet Obstetrics, Gynaecology, & Women’s Health.
Researchers noted the test should not be used independently to exclude cancer but rather to stratify patients by risk level, prioritizing high-risk women for expedited investigation while deferring immediate invasive testing for lower-risk cases. Study findings were based on assessments by highly trained specialist cytologists, raising questions about reproducibility in other clinical settings. The test has not been evaluated in asymptomatic women.
Professionals suggested that if further studies validate these results in routine clinical practice, the approach could potentially improve care for thousands of women annually by providing rapid reassurance while reducing unnecessary invasive procedures and associated stress.
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