Urine and vaginal sample test could streamline diagnosis for postmenopausal bleeding

In a Lancet Obstetrics, Gynaecology and Women’s Health publication, investigators examined urine and vaginal fluid samples from 1,864 hospital patients presenting with postmenopausal bleeding. When the two sample results were combined, the assay correctly identified 80% of endometrial cancers and showed a 98.8% negative predictive value, meaning a negative result reliably ruled out disease. The test detected almost all aggressive cancers, spotting 95.8% of high-grade tumours and 96.4% of cancers that had spread beyond the uterus, and captured every cancer case among black women.

Vaginal fluid analysis outperformed urine alone. The authors propose using the test to prioritize women most likely to have cancer, enabling faster diagnosis, early reassurance for many, and a reduction in invasive procedures such as ultrasounds, biopsies and hysteroscopies.