Scientists seek new tests for a cancer on the rise

Associate Professor Cherie Blenkiron and Dr Sandra Fitzgerald are working to develop less invasive tests for womb cancer.

“Specialists at New Zealand hospitals are seeing many more women with womb cancer and there has been a huge increase in the number of younger women diagnosed.

“Womb cancer particularly affects Māori and Pacific Island women – Pacific women have one of the highest rates in the world,” says Blenkiron, who is head of the Department of Molecular Medicine and Pathology at Waipapa Taumata Rau, University of Auckland.

Women who are obese or have diabetes are more likely to develop cancer of the womb, say the researchers, who are affiliated with the University's Centre for Cancer Research.

“With the epidemic of obesity and diabetes, we’re also seeing an epidemic of womb cancer,” says Blenkiron.

A decade ago, about 600 new cases of womb cancer were detected in New Zealand each year, but that has risen rapidly to about 750 a year.

It used to be regarded as a disease affecting women after menopause, but these days women as young as 30 are being diagnosed.

The national cervical screening programme was picking up 25 to 30 percent of womb cancer cases, but it has been replaced by HPV tests that don’t detect womb cancer.

That means there’s an urgent need to develop new womb cancer screening tests, which are not currently widely available in New Zealand, says Blenkiron.

“Our dream is to provide an accurate, affordable test that can be done in a GP clinic, possibly by the woman herself,” she says.

If womb cancer is picked up early, most women survive.

However, some women make the fatal mistake of brushing away concerns about menstrual bleeding that is excessive or that occurs between periods or after menopause. Some don’t realise these are the primary symptoms of womb cancer, while others feel too shy to seek help.

In some cases, GPs struggle to know whether patients need a biopsy to determine whether they have womb cancer, says Fitzgerald.

“A less invasive test will help pick up cancers early, which will improve women’s chances of survival,” she says.

Without widespread screening tests in New Zealand, women generally have to go to hospital for a biopsy to test for the cancer.

Recently, overseas researchers have devised ways to test vaginal swab samples for DNA modifications that signal cancer to try to reduce the number of women sent for unnecessary biopsies.

“We said ‘look, in a number eight wire New Zealand way, let’s make that happen here’,” says Blenkiron.

The researchers are also working on ways to test biopsy samples to identify which type of womb cancer a patient has. These molecular tests would identify aggressive cancers that require chemotherapy and radiotherapy, as well as hysterectomy.

“We’ve got high hopes that test might be available for patients throughout New Zealand by next year,” says Blenkiron.

The researchers are also forging into new territory, looking at innovative ways to create world-leading tests.

The Cancer Society has just granted $250,000 for their research to identify DNA mutations that cause cancer. Blenkiron and Fitzgerald hope a swab test might be developed that is sensitive enough to detect traces of DNA mutations that have been shed from the uterus into the vagina.

Since 2021, the researchers have been looking at whether the microbiome in the vagina and uterus is different in women with cancer. They have created a test using vaginal and uterine swabs that is now being trialled on about 300 women at five hospitals in Auckland, Wellington and Christchurch.

This work is being carried out with a $175,000 grant from Auckland Medical Research Foundation and $80,000 from the Cancer Research Trust NZ.

In 2020, the Li Family Cancer Research Fund and the Centre for Cancer Research – Te Aka Mātauranga Matepukupuku granted $50,000 for the researchers to look at markers in blood samples that might point to womb cancer. This test is now being tried out on numerous samples from patients.

These potentially groundbreaking projects are likely to take longer, but the researchers hope tests might reach patients within the next 10 years.