Urine test detects womb cancer, study suggests

A simple urine test could detect womb cancer, research suggests.

Also known as uterine or endometrial cancer, the disease usually manifests as abnormal vaginal bleeding. This may prompt a doctor to carry out a physical examination, with at-risk women then being referred to a specialist for an internal scan or biopsy.

With calls for a non-invasive method of diagnosis, scientists from the University of Manchester found malignant cells are shed by womb tumours before passing into the genital tract.

These are then detectable in self-collected urine samples when examined under a microscope.

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When tested on 103 women with diagnosed womb cancer and 113 with unexplained bleeding, the urine assessment detected the disease 91.7% of the time.

"Our results show womb cancer cells can be detected in urine and vaginal samples using a microscope," said lead author Professor Emma Crosbie.

"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."

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Around 9,300 new cases of womb cancer arise every year in the UK. The survival rate is relatively good, with nearly three quarters (72%) of patients living at least 10 years post-diagnosis in England and Wales.

In the US, more than 65,000 women are expected to have been diagnosed with womb cancer in 2020.

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Under existing diagnostic guidelines, a woman with suspected womb cancer may have a transvaginal ultrasound scan (TVS), which involves placing a probe in the vagina to create a detailed image of the internal uterus. Some find the procedure uncomfortable, however, it should not be painful.

If the TVS detects changes to the womb lining's thickness, the woman will usually be offered a hysteroscopy.

This is where a thin telescope is inserted into the womb via the vagina to better examine the uterus' lining.

According to the Manchester scientists, just under a third (31%) of women have the procedure more than once, due to them finding it intolerably uncomfortable the first time round, or experiencing technical difficulties.

A sample of womb lining, a biopsy, is usually taken during the hysteroscopy.

Believing a new detection tool could be added to the existing regimen, the Manchester scientists tested their at-home urine collection method on more than 200 women, with and without diagnosed womb cancer.

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Results, published in the journal Nature Communications, suggest the assessment identified the proportion of women with womb cancer 91.7% of the time.

It also picked out women who did not have the disease in 88.9% of cases.

"New strategies to facilitate early diagnosis of womb cancer are urgently needed to enable curative hysterectomy for women who present with biologically aggressive disease," said Professor Crosbie.

"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."

Examining the samples under a microscope is reportedly already part of the NHS' expertise.

Assessing urine samples would also be relatively inexpensive and quick, as well as potentially providing a woman with a diagnosis there and then.

"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," added Professor Crosbie.

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