Three new non-invasive technologies are poised to make gynaecological diagnoses quicker and less painful.

Three new simple technologies are poised to make the diagnosis process easier for thousands of UK women with gynaecological symptoms. 

Firstly, the National Institute for Health and Care Excellence (NICE) has, through its draft early use health-tech guidance, recommended EndoSure and Endotest. These technologies can be used in the NHS for three years while additional evidence is collected on their functioning. 

The news is promising as the tests can be used to diagnose endometriosis in primary care. Usually, diagnosing endometriosis, a common condition in women of reproductive age, requires the invasive and costly surgical procedure of laparoscopy and takes more than nine years to confirm.

Endotest analyses a saliva sample for tiny biological markers called microRNAs, which can indicate whether endometriosis is likely present and sends results to a doctor.

EndoSure detects endometriosis by measuring electrical signals in the gut using sensor pads on the abdomen, after the patient fasts and drinks water during a simple 45-minute test.

“A diagnosis of endometriosis can, for some women, take the best part of a decade, with the UK average standing at nine years and four months, and rising to 11 years for those from ethnically diverse communities. That delay means living with chronic pelvic pain that affects daily life, relationships and work,” said Anastasia Chalkidou, healthtech programme director at NICE. 

Charities and campaigners in the community have welcomed the development, after previous slow growth for developments in the speciality. 

The public and stakeholders can comment on NICE’s draft guidance until the end of July.

Pressing need

Meanwhile, a large NHS evaluation has found that a blood test can identify more than 99% of gynaecological cancers. Known as PinPoint, it uses machine-learning to analyse 30 routinely collected blood markers, as well as age and sex.

Its study is among the largest real-world assessments of AI-enabled cancer triage in the NHS. If embedded into gynaecology services, PinPoint could spare thousands of women from often painful and more invasive transvaginal procedures.

It is also simple and affordable, totalling under £30 each time.

The study looked into 16,481 urgent suspected cancer referrals, including 3,313 women on the gynaecological pathway. In this pathway, which sees most referrals for post-menopausal bleeding, PinPoint correctly identified 99.1% of cancers as elevated or high risk and delivered a negative predictive value of 99.8% for women in the lowest-risk group. 

Now, the study leads feel this could allow one in five symptomatic women to be safely ruled out in primary care, which should help alleviate the pressure on already-overstretched hospital services.

This is also encouraging news as endometrial cancer is the most common gynaecological cancer among women in the UK, in addition to being the fourth most common cancer overall. Cases have risen 58% since the 1990s, with around 10,000 diagnoses and 2,700 deaths annually. Crucially, approximately 90,000 women are referred annually with post-menopausal bleeding, yet only an average of 10% will have cancer, meaning most withstand the procedures despite being low risk.

“PinPoint’s strong, clinically meaningful evidence shows that a single, affordable blood test can support clinicians’ decision-making – helping clinicians prioritise patients by biological urgency rather than the typical first-come, first-served appointment systems,” commented Sean Duffy, the firm’s chief medical officer. Previously national clinical director for cancer at NHS England, he noted that this is particularly compelling within gynaecology.

However, the test, developed in Leeds, also looks likely to detect other cancers where initial ultrasound findings were normal, such as peritoneal cancer. This is a rare type near the womb that doesn’t yet have a screening method.

The findings sit in line with the National Cancer Plan, which called for AI-driven triage tools to help prioritise patients by biological urgency rather than first-come, first-served appointments.

The government renewed the Women’s Health Strategy earlier this year.