Researchers have developed a simple test analyzing cells in urine and vaginal fluid that correctly identifies 80 per cent of womb cancers in women experiencing postmenopausal bleeding, according to a study published in The Lancet Obstetrics, Gynaecology and Women’s Health. The diagnostic approach aims to transform care for thousands of patients by sparing them from invasive, uncomfortable procedures like biopsies and hysteroscopies while providing rapid reassurance.
Clinical Trial Results and Diagnostic Accuracy
According to the study of 1,864 women attending hospital with postmenopausal bleeding, specialists examined urine and vaginal fluid samples collected prior to routine diagnostic tests. Researchers at the University of Manchester and Manchester University NHS Foundation Trust reported that 115 women in the cohort were diagnosed with cancer, including 99 confirmed cases of womb cancer, which is also known as uterine or endometrial cancer.
When researchers combined the results from the urine and vaginal cell samples, the test achieved a negative predictive value of 98.8 per cent. This metric indicates that patients receiving a negative result face a very low likelihood of having the disease. Furthermore, the evaluation detected 95.8 per cent of high-grade tumours, 96.4 per cent of cancers that had spread beyond the uterus, and 100 per cent of cancers in black women. Data from the research team showed that the vaginal fluid sample analysis performed slightly better on its own than the urine sample analysis alone.
Reducing Invasive Tests for Postmenopausal Bleeding
Postmenopausal bleeding serves as a primary symptom that triggers urgent cancer referrals across the UK, where approximately 10,200 women receive a womb cancer diagnosis each year, according to figures from The Eve Appeal cited by PA Media. Over the past decade, diagnoses have risen by 12 per cent. Standard diagnostic pathways currently involve ultrasound scans, biopsies of the womb lining, and hysteroscopies where a camera passes directly into the womb.
However, researchers emphasize that only 5 per cent to 10 per cent of patients presenting with postmenopausal bleeding actually have cancer, rendering most current hospital investigations unnecessary. Professor Emma Davidson, of the University of Manchester and honorary consultant in gynaecological oncology at Manchester University NHS Foundation Trust, stated that bleeding after menopause causes understandable alarm.
Professor Davidson noted that patients frequently face uncomfortable and invasive tests that cause stress and add costs to health services before clinicians can rule out cancer. She explained that the new urine and vaginal sampling method could help identify patients who require priority investigation while safely reassuring the majority of women much earlier in the diagnostic pathway. If subsequent clinical trials confirm these findings in standard medical practice, the approach could reshape care standards for thousands of patients annually.
Keep reading