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Diagnostic accuracy of cytology for the detection of endometrial cancer in urine and vaginal samples

Author

Listed:
  • Helena O’Flynn

    (University of Manchester, St Mary’s Hospital)

  • Neil A. J. Ryan

    (University of Manchester, St Mary’s Hospital)

  • Nadira Narine

    (Manchester Cytology Centre, Manchester University NHS Foundation Trust)

  • David Shelton

    (Manchester Cytology Centre, Manchester University NHS Foundation Trust)

  • Durgesh Rana

    (Manchester Cytology Centre, Manchester University NHS Foundation Trust)

  • Emma J. Crosbie

    (University of Manchester, St Mary’s Hospital
    Manchester Academic Health Science Centre)

Abstract

Postmenopausal bleeding triggers urgent investigation by sequential invasive tests that are avoidable for the 90–95% of women who do not have endometrial cancer. A simple, non-invasive tool that accurately identifies cancer and safely reassures healthy women could transform patient care. Here we report, in a cross-sectional diagnostic accuracy study of 103 women with known cancer and 113 with unexplained postmenopausal bleeding, that urine and vaginal cytology has a combined sensitivity of 91.7% (95% CI 85.0%, 96.1%) and specificity of 88.8% (81.2%, 94.1%) for gynecological cancer detection. Cytology identifies 91 endometrial, two fallopian tube and one cervical cancer from 103 known cancer cases. In women with unexplained postmenopausal bleeding, cytology identifies all four endometrial cancers and three others (cervical, ovarian and bladder), for a 12/107 (11.2%) false positive rate. We show proof-of-principle that endometrial cancer can be detected in urine and vaginal fluid. Prospective validation of these findings will support incorporation of this non-invasive test into clinical practice.

Suggested Citation

  • Helena O’Flynn & Neil A. J. Ryan & Nadira Narine & David Shelton & Durgesh Rana & Emma J. Crosbie, 2021. "Diagnostic accuracy of cytology for the detection of endometrial cancer in urine and vaginal samples," Nature Communications, Nature, vol. 12(1), pages 1-8, December.
    • Handle: RePEc:nat:natcom:v:12:y:2021:i:1:d:10.1038_s41467-021-21257-6
    DOI: 10.1038/s41467-021-21257-6
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