The incidence of endometrial cancer is rising worldwide, and early detection is crucial for a good prognosis. Cancer Center Amsterdam researchers report good news in the International Journal of Cancer: endometrial cancer can be detected by DNA methylation analysis with high accuracy using samples self-collected at home, including urine and cervicovaginal self-samples.

Endometrial cancer is a type of cancer that affects the inner lining of the uterus. The number of new endometrial cancer cases per year is rising worldwide, with 2,000 annual cases in the Netherlands.

A common symptom of endometrial cancer is postmenopausal blood loss. Luckily, this bleeding symptom is related to endometrial cancer in only 5-10% of women. Endometrial cancer is currently diagnosed by the collection and analysis of endometrial tissue. Therefore, most women with postmenopausal blood loss undergo a painful biopsy procedure to rule out cancer.

“In this study, we tested whether endometrial cancer can be detected using patient-friendly methods,” says Birgit Wever, PhD student in the Pathology Department and co-first author. “We did this by testing for DNA methylation markers in patient-friendly material, including urine and vaginal swabs collected at home, and compared those to cervical scrapes collected by a clinician.”

This approach could offer a more convenient and less invasive diagnostic test to screen women at risk for endometrial cancer.
Prof. Renske Steenbergen
Department of Pathology, Cancer Center Amsterdam.

DNA methylation is a process that involves adding a chemical group - called a methyl group (-CH3) - to one of the four building blocks that make up DNA. This molecular "tagging” can modify the function of the DNA molecule, affecting how genes are expressed, and regulating important cellular processes. In many cancers, including endometrial cancer, aberrant DNA methylation patterns are common.

“We showed that endometrial cancer can be detected in all at-home self-collected samples using DNA methylation marker testing,” says Rianne van den Helder, co-first author and resident Obstetrics and Gynecology at Amsterdam UMC. “Moreover, the correct detection rate in home-based samples was excellent (>89%), comparable to the diagnostic performance of cervical scrapes taken in the clinic.”

This high accuracy of at-home testing can help distinguish between women who need a
biopsy  and those who do not.
Dr. Maaike Bleeker
Pathologist, Department of Pathology, Cancer Center Amsterdam.

For more information, contact Birgit Wever, check out a summary on MedScape, or read the paper:

Wever, BMM, van den Helder, R, van Splunter, AP, et al. DNA methylation testing for endometrial cancer detection in urine, cervicovaginal self-samples and cervical scrapes. Int J Cancer. 2023; 1- 11. doi:10.1002/ijc.34504

People involved at Amsterdam UMC

Birgit M.M. Wever 1

Rianne van den Helder 1

Annina P. van Splunter

Mignon D.J.M. van Gent

Jenneke C. Kasius

Lisanne Verhoef

Daniëlle A.M. Heideman

Birgit I. Lissenberg-Witte

Renske D.M. Steenbergen 1

Maaike C.G. Bleeker 1

1 Birgit and Rianne contributed equally as first authors, Renske and Maaike contributed equally as senior authors.

Funding: Hanarth Foundation and Stichting De Weijerhorst.

This article was created for Cancer Center Amsterdam.

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