Thousands of women could be spared having a painful intrusive exam for suspected cancer thanks to a new AI-powered blood test being trialled by the NHS.
Around 90,000 postmenopausal women a year in England are referred by their GP to be investigated for possible womb cancer because they are bleeding a lot.
Around 10,000 women a year in England are diagnosed with the disease – which is also known as uterine or endometrial cancer – and 2,700 die from it.
However, the PinPoint blood test could save one in five of those women – 18,000 a year – from needing to undergo a diagnostic procedure called a transvaginal ultrasound scan, which measures the thickness of the lining of their womb, and many find uncomfortable or painful.
Avoiding having that test unnecessarily has become a realistic prospect because, although 20% of women referred turn out not to have the disease, under the current NHS system of diagnosing cancers of the reproductive system, all have a pelvic examination involving an ultrasound scan. If doctors still suspect cancer, women potentially then have a tissue sample taken during a biopsy and a further examination called a hysteroscopy.
The blood test is being introduced by several NHS hospitals after a trial involving 16,481 patients. These patients were referred by GPs at 170 practices in Yorkshire for nine different forms of cancer. All had the test, including 3,313 women who were referred because their bleeding aroused concern that they may have womb cancer.
The results showed that the test had a 99% accuracy rate in both detecting the gynaecological cancers found among the 3,313 women and also ruling out its presence – a higher success rate than conventional testing. About one in ten of the 90,000 referred because of heavy bleeding turned out to have cancer.
The findings have prompted Mid Yorkshire NHS teaching trust to plan to start using the test for the six types of gynaecological cancer or upper gastrointestinal cancer. Leeds teaching hospitals NHS trust will do the same for gynaecological cancer.
The test has been developed by Leeds-based firm PinPoint Data Science, which specialises in statistical analysis of medical data. It uses machine learning to analyse whether someone is at low, elevated or high risk of cancer, based on its analysis of 30 blood markers.
Prof Sean Duffy, the firm’s chief medical officer – an ex-NHS England national clinical director for cancer – said the test’s 99% accuracy for womb cancer “is remarkable by any clinical standards”.
“But equally, its value lies in safely ruling out very low-risk women. This has the potential to spare thousands of patients from painful invasive procedures they do not need.”
Dr Jacinta Walsh, a GP at King’s Medical Practice in Normanton, West Yorkshire, said: “It often takes up to six visits to a GP before we’re able to rule out cancer.
“PinPoint will help shortcut that process to deliver peace of mind earlier and free up our capacity to see other patients.”
Brent Kilmurray, the chief executive of the Mid Yorkshire trust, said there is an “especially compelling” case for hospitals to start using the PinPoint test to detect gynaecological cancers.
Tracy Jackson, a consultant gynaecologist and cancer unit lead at the Leeds trust, said women referred by GPs have a transvaginal scan and then, if needed, a hysteroscopy. She added: “But the reality is that most women we see do not have cancer and we are acutely aware that the investigations can be uncomfortable and, for some, distressing.”
The Pinpoint test “gives us a way to triage more intelligently. If we can confidently rule out low-risk women in primary care, we reduce unnecessary invasive procedures and shorten our waiting lists,”she said.
“That means the women who do have cancer can be seen, diagnosed and treated earlier, which is exactly where our focus should be.”
Cancer Research UK said the PinPoint test appears “promising”. The charity’s spokesperson, Samantha Harrison, added: “Spotting cancer early saves lives, but right now patients are not being diagnosed quickly enough.
“This test could help to rule out endometrial cancer in some women, through a simple blood test, without the need for further testing.
“More research is needed to understand the benefits for patients and the NHS, but the results of this study are promising.”
