Could a Simple Urine and Vaginal Test Change Womb Cancer Diagnosis?

A new approach to detecting womb cancer could make the diagnosis process quicker and less uncomfortable for thousands of women in the UK.

Researchers from the University of Manchester and Manchester University NHS Foundation Trust have been investigating whether cells found in urine and vaginal fluid could help identify women who are most likely to have womb cancer.

The research is particularly significant for women who experience bleeding after the menopause, a symptom that can require urgent investigation because it may sometimes be linked to cancer.

Why womb cancer diagnosis can be challenging

Womb cancer, also known as uterine or endometrial cancer, is one of the cancers affecting the female reproductive system. According to figures reported by The Independent, around 10,200 women are diagnosed with womb cancer in the UK each year.

Bleeding after menopause is one of the key symptoms that doctors investigate. Although the symptom can be alarming, most women who experience postmenopausal bleeding will not ultimately be diagnosed with womb cancer.

The current diagnostic pathway can involve several examinations. Depending on the circumstances, a woman may undergo an ultrasound scan, a biopsy of the womb lining or a hysteroscopy. During a hysteroscopy, a small camera is inserted through the vagina and cervix to allow doctors to examine the inside of the womb.

These investigations can be uncomfortable and stressful, particularly when patients are already worried that their symptoms could indicate cancer.

Researchers believe a straightforward sample-based test could potentially help doctors identify which patients need further investigation.

How does the new test work?

The research looked at cells collected from urine and vaginal fluid.

Rather than immediately relying on invasive investigations, researchers examined these samples for signs associated with womb cancer.

The study involved 1,864 women who attended hospital because they had experienced bleeding after menopause. Samples were collected before the women underwent their usual investigations.

Of those participants, 115 were diagnosed with cancer. This included 99 women who were found to have womb cancer.

When the results from urine and vaginal samples were considered together, the test identified approximately 80 per cent of cancers.

The researchers also reported a particularly high negative predictive value. The test had a negative predictive value of 98.8 per cent for womb cancer.

In simple terms, this means that among women who received a negative test result, very few were subsequently found to have womb cancer in the study population.

Could the test help women avoid unnecessary procedures?

One of the most interesting aspects of the research is its potential use as a triage tool.

A triage test does not necessarily replace a full diagnostic investigation. Instead, it can help healthcare professionals determine which patients may require further testing and which patients could potentially be reassured more quickly.

This could be particularly useful because only a minority of women investigated for postmenopausal bleeding are ultimately diagnosed with cancer.

The researchers suggested that a urine and vaginal cell test could help identify women who are more likely to have cancer earlier in the diagnostic process.

For patients, that could potentially mean fewer unnecessary invasive procedures.

For healthcare services, it could also help reduce pressure on specialist clinics and diagnostic pathways.

However, the research is not evidence that women with postmenopausal bleeding should stop having conventional medical investigations.

Promising results for aggressive cancers

The findings were also notable because the test appeared to perform particularly well when researchers looked at more aggressive forms of cancer.

According to the study, the combined testing approach detected 95.8 per cent of high-grade tumours.

It also identified 96.4 per cent of cancers that had already spread beyond the uterus.

These findings are important because detecting cancer at an earlier stage can be an important part of cancer management. However, the study was designed to assess the diagnostic potential of the test, and further research is needed before it could become part of routine healthcare.

The researchers also reported that the test detected all womb cancers among Black women included in the study. This is an encouraging finding, although the result should be interpreted in the context of the study population and sample size rather than treated as proof that the test will perform identically across every population.

Vaginal samples appeared to perform better than urine alone

The researchers compared different types of samples as part of their investigation.

Vaginal fluid testing performed slightly better than urine testing on its own. However, combining information from urine and vaginal samples produced the strongest overall results reported in the study.

The possibility of using samples that are relatively simple to collect is one reason researchers believe the approach could have practical potential.

If future research confirms the findings in larger and more varied groups of patients, such a test could potentially become another step in the diagnostic pathway for women experiencing concerning symptoms.

What are the symptoms of womb cancer?

Postmenopausal bleeding is one of the main symptoms associated with womb cancer, but it is not the only possible warning sign.

According to the NHS, symptoms can include:

• Bleeding or spotting from the vagina after menopause
• Periods that become unusually heavy
• Bleeding between periods
• Changes in vaginal discharge
• A lump or swelling in the abdomen or pelvis
• Pain in the lower back or pelvis
• Pain during sex
• Changes in how frequently you urinate or have bowel movements

Having one of these symptoms does not automatically mean that a person has womb cancer. Many symptoms can have other causes.

Nevertheless, unusual bleeding, particularly after menopause, should be discussed with a healthcare professional so that the appropriate investigations can be arranged.

What could happen next?

The new research provides evidence that urine and vaginal cell testing could have a role in womb cancer diagnosis, but it is not yet a replacement for established investigations.

Further studies will be needed to determine how accurately the test performs in routine clinical settings and whether it can safely be introduced into healthcare systems.

Researchers will also need to establish how the test could fit alongside existing diagnostic methods and which patients would benefit most from it.

Professor Emma Davidson of the University of Manchester and an honorary consultant in gynaecological oncology at Manchester University NHS Foundation Trust said the findings could potentially help identify women most likely to have cancer while providing earlier reassurance to many others.

The prospect of a simpler test is significant because cancer investigations can be physically and emotionally demanding. A reliable test that could help doctors decide who needs additional procedures could potentially change the experience for many patients.

A potentially important step in diagnosis

The research does not mean that womb cancer can now be diagnosed through a simple urine or vaginal sample alone.

Instead, it represents an early but potentially important step towards developing less invasive diagnostic pathways.

For women experiencing postmenopausal bleeding, the key message remains that medical assessment is important. At present, established investigations remain an essential part of determining the cause of symptoms.

If future research confirms the performance reported in this study, however, urine and vaginal cell testing could eventually become a useful tool for helping clinicians decide which patients require further investigation.

For thousands of women who undergo cancer investigations every year, a reliable preliminary test could potentially make the process faster, less invasive and less stressful.

Sources

The Independent, published on 23 September 2026, and the research study published in The Lancet Obstetrics, Gynaecology & Women’s Health. Additional symptom information is attributed to the NHS.

Medical disclaimer

This article is for general information and educational purposes only. It is not intended to provide medical advice, diagnosis or treatment. A new diagnostic test discussed in research should not be considered a replacement for established medical investigations. Anyone experiencing unusual vaginal bleeding, bleeding after menopause, or other concerning symptoms should speak with a qualified healthcare professional. Always follow advice from your doctor or other healthcare provider.