Researchers at the University of Manchester and Manchester University NHS Foundation Trust have developed a non-invasive test that may improve the diagnosis process for womb cancer in women experiencing postmenopausal bleeding. The test, which analyzes cells from urine and vaginal fluid samples, aims to reduce the need for invasive and costly procedures currently used to detect the disease.

Womb cancer affects hundreds of thousands of women globally each year. Postmenopausal bleeding prompts urgent referral for cancer evaluation, but only about 5% to 10% of women presenting with this symptom are ultimately diagnosed with the cancer. Presently, diagnosis typically involves internal ultrasound scans, biopsies of the womb lining, or hysteroscopy—a procedure involving the insertion of a camera into the womb—each of which can be uncomfortable and expensive.

In a study published in Lancet Obstetrics, Gynaecology, & Women’s Health, researchers assessed the new test with 1,864 women from seven hospitals in northwest England who reported bleeding after menopause. Each participant provided both urine and vaginal fluid samples prior to undergoing routine diagnostic tests. Among them, 99 women (5%) were confirmed to have womb cancer through biopsy or surgical examination.

Blind to patients’ clinical outcomes, cytologists evaluated the samples, correctly identifying 80 of the 99 cancer cases. The test also accurately returned a negative result for 93% of women who were cancer-free. Despite these promising results, researchers noted the test is not sufficiently accurate to definitively exclude cancer on its own. Instead, it could be used to prioritize women who require prompt investigation, while safely postponing invasive testing for those deemed at lower risk. In cases where symptoms persist, repeated sampling or comprehensive assessment would remain necessary.

The researchers also highlighted certain limitations. As trained cytologists interpreted the samples, it remains uncertain whether the test’s accuracy can be consistently replicated outside specialized settings. Additionally, the test has not yet been evaluated in women without symptoms of bleeding.

Professor Emma Davidson, involved in the study, emphasized the potential impact of the approach. She stated that the test could reduce the physical and psychological burden women face while undergoing current diagnostic procedures, and alleviate costs for healthcare systems. Davidson added that, pending confirmation from further studies in routine clinical practice, this new method could transform care for thousands of women annually by identifying those most likely to have womb cancer earlier and reassuring many others more quickly.