New Cervicovaginal Epigenetic Test for Screening of Suspected Endometrial Cancer

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As reported in the Journal of Clinical Oncology, Herzog et al have developed a simple noninvasive test for screening for suspected endometrial cancer—the Women’s Cancer Risk Identification-Quantitative Polymerase Chain Reaction Test for Endometrial Cancer (WID-qEC)—that has shown accuracy in detecting disease.

Study Details

The WID-qEC is a three-marker test evaluating DNA methylation in gene regions of GYPC and ZSCAN12 developed using 726 cervical smear samples from patients with and without endometrial cancer. The test was validated using cervicovaginal samples from 562 patients using cervical smear collection (n = 248), vaginal swab collection (n = 63), and self-collection (n = 251) in four settings: a case-control cohort of 388; a cohort of 63 presenting with postmenopausal bleeding; a cohort of 25 high-risk patients with Lynch syndrome; and a nested case/control cohort of 86 from a screening cohort with samples taken up to 3 years before endometrial cancer diagnosis.

Key Findings

In the validation cohort, the sensitivities for endometrial cancer detection for cervical smear samples (n = 137; 71 cases, 66 controls), self-collected samples (n = 251; 131 cases, 120 controls), and vaginal swab samples (n = 63; 8 cases, 55 controls) from symptomatic patients were 97.2% (95% confidence interval [CI] = 90.2%–99.7%), 90.1% (95% CI = 83.6%–94.6%), and 100% (95% CI = 63.1%–100%), respectively. Specificities were 75.8% (95% CI = 63.6%–85.5%), 86.7% (95% CI = 79.3%–92.2%), and 89.1% (95% CI = 77.8%–95.9%), respectively.

Test performance was similar in analyses by menopausal status, age, stage, grade, ethnicity, and histology.  

Among the 32 cases in the cohort of 86 patients (54 controls) with samples taken up to 3 years before endometrial cancer diagnosis, the WID-qEC identified 90.9% (95% CI = 70.8%–98.9%) of cases in samples taken within 1 year prior to diagnosis; the identification rate was 20% for samples taken at ≥ 1 year prior to diagnosis.

The investigators concluded, “The WID-qEC is a noninvasive reliable test for triage of women with symptoms suggestive of endometrial cancers. Because of the potential for self-collection, it could improve early diagnosis and reduce the reliance for in-person visits.”

Martin Widschwendter, MD, of the European Translational Oncology Prevention and Screening (EUTOPS) Institute, Universität Innsbruck, Austria, is the corresponding author for the Journal of Clinical Oncology article.  

Disclosure: The study was supported by the European Union’s Horizon 2020 European Research Council Program, European Union’s Horizon 2020 research and innovation program, and others. For full disclosures of the study authors, visit

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