A simple test using urine and vaginal fluid samples could help rule out womb cancer in women experiencing bleeding after menopause, potentially sparing thousands of patients from invasive and uncomfortable medical procedures. Bleeding after menopause is an alarming symptom that triggers urgent cancer referrals, yet only about 5% to 10% of women who report it actually have underlying cancer.
Currently, diagnosing womb cancer relies on invasive procedures such as internal ultrasound scans, biopsies of the womb lining, and hysteroscopies, in which a small camera is passed into the womb. These tests can be stressful for patients and costly for health services. The new non-invasive test, developed by researchers at the University of Manchester and Manchester University NHS Foundation Trust, analyzes cells collected from routine urine and vaginal fluid samples to detect signs of disease.
In a study published in Lancet Obstetrics, Gynaecology, & Women’s Health, researchers evaluated 1,864 women with postmenopausal bleeding across seven hospitals in north-west England. Biopsies or surgery later confirmed that 99 of the women (5%) had womb cancer. Working without prior knowledge of the diagnoses, specialist cytologists using the new test identified 80 of the 99 cancer cases and correctly returned negative results for 93% of the women who did not have womb cancer.
Researchers cautioned that the test is not accurate enough to rule out cancer on its own, but it could act as a triage tool to fast-track high-risk women for urgent care while sparing lower-risk patients immediate invasive procedures. They also noted that the study relied on specialist cytologists, so further research is needed to see if similar accuracy can be achieved in routine medical settings. Prof Emma Davidson noted that if larger trials confirm these findings, the approach could transform care for thousands of women each year.