How Is Womb Cancer Diagnosed? Current Methods and the Promising New Alternative

Hannah Hunt
Jul 18
2 min read

When a patient presents with abnormal uterine bleeding, particularly during or after menopause, one of the first concerns clinicians must rule out is endometrial (womb) cancer.

The methods used to diagnose womb cancer often involve a trade-off of accuracy versus invasiveness. This is why when a patient presents with symptoms which arouse suspicions of womb cancer, clinicians will first use a less accurate, but less invasive test to triage the patient and decide if their risk of womb cancer is high enough to warrant more invasive testing.

But how is womb cancer diagnosed, and are current methods serving patients as well as they could? Here, we look at the standard triage tests clinicians use today —and why many are now turning to a new, less invasive alternative with high accuracy: the WID-easy test .

What Are the Traditional Methods for Diagnosing Womb Cancer?

1. Transvaginal Ultrasound (TVUS)

TVUS measures the thickness of the endometrium and can identify abnormalities.

How accurate is it? It has high sensitivity (90.9%) when using a 4mm endometrial thickness cutoff.⁴ This means if you have cancer, it is very likely to detect this.
What are the drawbacks? It has a very low positive predictive value (PPV) of just 8.7%—meaning most women who test “positive” don’t actually have cancer.⁴ This can lead to unnecessary anxiety and further invasive testing.

2. Endometrial (Pipelle) Biopsy

A Pipelle biopsy is often the first-line diagnostic tool. It involves inserting a thin, flexible tube into the uterus to collect a tissue sample.

How accurate is it? It has high sensitivity (81–99%) and specificity (98%) for detecting endometrial cancer.¹
What are the drawbacks? Fewer than 50% of samples yield unambiguous results, meaning half of all patients will need to have another biopsy or alternative test.² ³ It can also cause pain, infection, or (rarely) perforation of the uterus.

A New Alternative

The WID-easy test is a new diagnostic tool developed by researchers at University College London (UCL).

What Is the WID-easy Test?

WID-easy (cited as WID-qEC in the literature) is a triage tool for patients aged 45 years + presenting with abnormal uterine bleeding. It involves a simple vaginal swab that collects a DNA sample from the upper vaginal region. The sample is sent to a UK laboratory, which returns an objective, positive or negative result.

How Does It Compare?

Accuracy: Sensitivity of 90.9% and specificity of 97.3%⁴
Certainty: 98% of results are unambiguous, reducing the need for repeat testing.⁴
Higher PPV: The test has a PPV of 50%, six times higher than TVUS at a 4mm threshold.⁴
Less invasive: The test only requires a swab, meaning no pain and no risk of uterine perforation.