Non-invasive DNA methylation-based testing for the diagnosis of endometrial cancer

Endometrial cancer is the most common gynaecological cancer in high-income countries, with an increasing incidence worldwide. 1 Lu KH Broaddus RR Endometrial cancer. N Engl J Med. 2020; 383: 2053-2064 Crossref PubMed Scopus (323) Google Scholar Survival is highly correlated with stage, making early detection and treatment essential. Although the number of cancers diagnosed among younger women is increasing, most endometrial cancers are still detected in perimenopausal or postmenopausal patients at an early stage when they present with abnormal uterine bleeding. Clinical evaluation includes pelvic examination, imaging, and endometrial biopsy. Pelvic ultrasound is the most used imaging test but has limited sensitivity and specificity for endometrial cancer. The gold standard for diagnosis remains endometrial sampling. 2 The American College of Obstetricians and GynecologistsThe role of transvaginal ultrasonography in evaluating the endometrium of women with postmenopausal bleeding. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/05/the-role-of-transvaginal-ultrasonography-in-evaluating-the-endometrium-of-women-with-postmenopausal-bleedingDate: 2018 Date accessed: September 30, 2023 Google Scholar , 3 National Institute for Health and Care ExcellenceHeavy menstrual bleeding: assessment and management. https://www.nice.org.uk/guidance/ng88Date: 2021 Date accessed: September 30, 2023 Google Scholar Both tests require specialist referrals and the use of painful and anxiety-provoking procedures. Patient and physician groups have begun advocating for methods that can expedite appropriate diagnosis and referral with less invasive approaches. 4 Burton S What women endure. The New York Times. https://www.nytimes.com/2023/07/30/briefing/the-retrievals-serial.htmlDate: 2023 Date accessed: September 30, 2023 Google Scholar Performance of the WID-qEC test versus sonography to detect uterine cancers in women with abnormal uterine bleeding (EPI-SURE): a prospective, consecutive observational cohort study in the UKThe WID-qEC test delivers fast results and shows improved performance compared with a combination of imaging index tests. Triage of women with abnormal uterine bleeding using the WID-qEC test could reduce the number of women requiring histological assessments for identification of potential malignancy and specifically reduce the false positive rate. Full-Text PDF Open Access