Research published in the Journal of Clinical Oncology found that relatively low-cost PCR tests were able to successfully detect endometrial cancer (EC) using samples taken from the cervix or vagina.
The pioneering tests, developed by researchers at the University of Innsbruck in Austria and University College London, could mean a significant reduction in the time taken to diagnose patients with EC, and a decrease in the need for more invasive diagnostic procedures.
EC incidence has been rising over the past ten years and patient survival is strongly dependent on the stage at diagnosis, with delays in diagnosis and treatment resulting in significant adverse impacts on survival.
The current route of diagnosis for suspected EC is a transvaginal ultrasound (TVUS) followed by hysteroscopy and endometrial biopsy. The study outlines that a simple test to triage women with at least equivalent accuracy to current standards, without the need for specialist referral, is ‘urgently needed’.
The researchers used 1,288 cervicovaginal screening samples from patients with and without EC, collected by a large team of investigators. Early results demonstrated the test was as effective for all groups, regardless of menopausal status, age, stage of cancer, ethnicity and histology.
Crucially, the test successfully detected all eight of the womb cancers that were mixed among 63 women who presented consecutively because of postmenopausal bleeding at 89% specificity, with only a few women without cancer receiving a positive result.
Not only does the data collected indicate that the test performs equally as well as other strategies used to screen and triage patients with EC, but the results also suggest that the test may have the potential to enable targeted, more frequent monitoring of individuals at risk of being diagnosed with EC.
‘Because of its suitability for use in self-collected samples, the test may be a suitable tool for managing women with abnormal bleeding, particularly when access to specialist care is restricted,’ the study states.
It is concluded that the pioneering tests could represent a ‘patient-friendly’ test for the screening and triage of women with symptoms suggestive of EC or those at risk of EC.
The study does note, however, that future large-scale prospective studies will be required to further strengthen the data collected, in particular for covariates for which sample numbers in the current study were small, such as premenopausal status and non-white ethnicities.
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