Doctors have developed a new, simple test that could help identify whether a woman with postmenopausal bleeding might have womb cancer, potentially reducing the need for more invasive procedures. Womb cancer, also known as endometrial cancer, is the most common type of gynaecological cancer in women. Postmenopausal bleeding is a common symptom that prompts urgent medical evaluation, but only about 5% to 10% of women who report this symptom actually have cancer. This new test, developed by researchers at the University of Manchester and Manchester University NHS Foundation Trust, uses cells from urine and vaginal fluid to detect cancer markers. It is less costly and more comfortable than current diagnostic methods, which include internal ultrasounds, biopsies, and hysteroscopy—a procedure in which a small camera is inserted into the womb. In a study involving 1,864 women from seven hospitals in north-west England, all of whom had postmenopausal bleeding, participants provided urine and vaginal fluid samples before undergoing routine tests. Of these women, 99 were later diagnosed with womb cancer through biopsy or surgery. When the new test was used, it correctly identified 80 of the 99 cancers. Additionally, it accurately ruled out cancer in 93% of the women who did not have the disease. The test’s results were published in the journal Lancet Obstetrics, Gynaecology, & Women’s Health. Researchers emphasized that while the test is promising, it is not yet accurate enough to be used alone to confirm or rule out cancer. Instead, it could help prioritize women at higher risk for further testing, while sparing others from unnecessary invasive procedures if their symptoms persist. The study also found that the test was particularly effective in detecting aggressive forms of cancer. It identified 95.8% of high-grade tumours and 96.4% of cancers that had already spread beyond the uterus. The test was 100% accurate in identifying cancers in Black women. Vaginal fluid samples performed slightly better than urine alone in detecting cancer. Researchers noted that the study was conducted by highly trained specialists, and it is not yet known if the same level of accuracy can be achieved in other healthcare settings. Additionally, the test has not yet been evaluated in women without symptoms. Prof Emma Davidson, one of the researchers involved, said that postmenopausal bleeding is often alarming for women, as it can be a sign of cancer. However, the majority of women who undergo testing do not have the disease. She said the new test could help identify those most at risk of cancer while providing reassurance to others earlier in the diagnostic process. If future studies confirm the test’s effectiveness in routine use, it could significantly improve the care of thousands of women each year, reducing stress and healthcare costs.