A new, simple diagnostic test that analyzes cells from urine and vaginal fluid can correctly identify more than 80% of womb cancers in women experiencing postmenopausal bleeding, according to a major study published in Lancet Obstetrics, Gynaecology, & Women’s Health. Developed by researchers at the University of Manchester and Manchester University NHS foundation trust, the approach aims to transform care by sparing patients from invasive and costly procedures.
New Non-Invasive Test Detects Over 80% of Womb Cancers
Every year, hundreds of thousands of women worldwide—including approximately 10,200 women in the UK, where diagnoses have increased by 12% over the last decade—are diagnosed with womb cancer, also referred to as uterine or endometrial cancer. Postmenopausal bleeding triggers an urgent cancer referral, yet only 5% to 10% of women reporting this symptom actually have an underlying malignancy. Conventional diagnostic investigations—such as internal ultrasound scans, womb lining biopsies, and hysteroscopies involving a camera passed into the womb—are invasive, uncomfortable, stressful, and costly for healthcare systems.
Study Findings and Diagnostic Performance
The evaluation, known as the DETECT study, is one of the largest assessments of this non-invasive approach to date. It evaluated 1,864 women attending seven hospitals in north-west England who presented with postmenopausal bleeding. Before undergoing routine clinical tests, participants provided urine and vaginal fluid samples.
When cytologists unaware of the patients’ diagnoses examined the combined urine and vaginal cell samples, the method correctly identified over 80% of cancers—specifically detecting 80 of the 99 confirmed womb cancers in the trial, alongside other cancer types found in the broader cohort of 115 total cancer cases. Furthermore, the combined testing achieved a negative predictive value of 98.8% for womb cancer, indicating that patients receiving a negative result were highly unlikely to have the disease. The procedure also correctly returned a negative result for 93% of women who did not have womb cancer.
According to the research data reported by The Independent, the vaginal fluid test performed slightly better than urine analysis alone, although both showed promising diagnostic accuracy. The evaluation also noted that the method detected almost all aggressive cancers, successfully identifying 95.8% of high-grade tumours and 96.4% of cancers that had already spread beyond the uterus. Additionally, the test picked up 100% of cancers in Black women with 96% specificity, demonstrating near-perfect performance in that subgroup.
Potential Impact on the Diagnostic Pathway
Researchers emphasized that the test is not currently accurate enough to rule out cancer entirely on its own. Instead, it could serve as a valuable triage tool in clinical practice, helping clinicians fast-track women at the highest risk for urgent invasive investigations while safely reassuring lower-risk patients much earlier in the diagnostic pathway. If successfully introduced into primary care and community settings, the test could reduce health inequities, ease patient anxiety, and lower burdens on healthcare systems.
Lead researcher Professor Emma Davidson, from the University of Manchester and Honorary Consultant in Gynaecological Oncology at Manchester University NHS Foundation Trust, noted the emotional weight of postmenopausal bleeding. Bleeding after the menopause is understandably alarming for women because it can be a sign of cancer, but the vast majority of those investigated will not have the disease,
she stated. Our study shows that a simple test using urine and vaginal samples could help identify the women most likely to have cancer while safely reassuring many others much earlier in the diagnostic pathway.
Investigators cautioned that the samples in the study were evaluated by highly trained specialist cytologists, meaning it remains to be confirmed whether identical accuracy can be reproduced in routine clinical settings or among asymptomatic women. Further studies are required to confirm these findings before the approach is widely deployed to transform care for thousands of women every year.