A new test, developed by University College London, identifies women with womb cancer from a sample taken from the cervix or vagina.
Womb cancer usually starts in the lining of the endometrium. Symptoms include bleeding or spotting from the vagina after menopause, heavy periods that are unusual, a change in discharge and vaginal bleeding between periods.
New research could revolutionise womb cancer diagnosis, with the test offering more accurate results than current methods and may work equally well on all women. The researchers hope this diagnostic tool will speed up the identification of womb cancer and reduce the need for invasive and painful diagnosis procedures.
Testing for womb cancer
The new test, named the WID TM-qEC, was developed by Professor Martin Widschwendter (UCL EGA Institute of Women’s Health, Universität Innsbruck, Karolinska Institutet) and his team. It works by examining three regions of DNA that show different levels of methylation, a type of modification ‘on top’ of the DNA, in those with or without cancer. DNA methylation levels are measured by PCR, a relatively low-cost and routinely used device.
The researchers assessed the reliability of the test by using 1,288 cervical screening samples from women both with and without this cancer, collected by a team of investigators in the UK and Europe.
The test identified all eight cases of womb cancer within a cohort of 63 women presenting post-menopausal bleeding.
Furthermore, only a few women without cancer were given a false positive result (less than 11% of the women without womb cancer), making the test more specific than transvaginal ultrasound.
The test also delivered reliable results both when the sample was taken by a medical professional and self-collected with a vaginal swab. The benefit of self-collected swabs is that they speed up the cancer diagnosis process.
Professor Widschwendter said: “It was critical to us that this research addressed all of the issues associated with current detection methods for womb cancer. Most importantly, using our test, far fewer women with abnormal bleeding will have to undergo invasive diagnostic procedures. Our test does not depend on the operator, and results can be returned quickly, reducing anxiety.
“Post-menopausal women with abnormal bleeding have a 1 in 10 chance of having womb cancer; for pre-menopausal women, the chance is much lower (as low as 1 in 200). For these women, the simplicity and accuracy of the WID™-qEC test offer real advantages for detecting womb cancer early.
“We want to thank all of the teams in the collaboration who helped to deliver this improved early detection method for womb cancer.”
Offering a new alternative to transvaginal ultrasounds
Transvaginal ultrasound is a diagnostic tool that uses a small scanner probe placed in the vagina to get a detailed image of the womb and can look for signs of a thickened womb lining. It is an effective method to detect womb cancer in post-menopausal women; however, it is a less reliable method in pre- and peri-menopausal women and black women.
The initial results from the PCR test highlight the effectiveness of diagnosing cancer for all groups – regardless of age, ethnicity, being pre- or post-menopausal, and the stage, grade and type of cancer they have. The researchers have started clinical studies with more plans to validate these results.
Athena Lamnisos, CEO of The Eve Appeal, said: “Womb cancer is the most common cancer that no one has heard of. When a patient is referred for diagnosis with abnormal bleeding, the wait and the procedure are really tough. This research shows real promise in reducing the time to diagnosis, providing a specific diagnosis for everyone and reducing the need for painful and invasive interventions. It really does bring early detection of cancer one stage closer.”
