The DETECT Study – Discovery and Evaluation of Testing for Endometrial Cancer in Tampons
Endometrial cancer is a growing public health concern, with approximately 61,880 new cases and 12,160 deaths occurring in 2019. Unlike most cancers, endometrial cancer incidence has been increasing over time, particularly for the more aggressive, non-endometroid (e.g., serous, clear cell) histologic subtypes. While these trends appear to be occurring in all racial and ethnic subgroups, non-Hispanic black women have been experiencing disproportionately greater increases. Moreover, while overall incidence rates of endometrial cancer are very similar between non-Hispanic white and non-Hispanic black women, mortality rates are nearly twice as high among non-Hispanic black women, making this one of the largest racial disparities observed for any cancer type.
Currently, there are no validated screening tests for endometrial cancer. Diagnostic workup is recommended for women with postmenopausal bleeding; however, clinical practice varies and often involves the use of expensive and invasive testing such as transvaginal ultrasound and endometrial biopsy. To improve endometrial cancer risk stratification, we and others have been engaged in biomarker discovery efforts that hold great promise for improving endometrial cancer early detection and management. In parallel to these efforts, we have conducted proof-of-principle studies demonstrating the acceptability and potential utility of using tampons for vaginal sampling to detect molecular markers with high accuracy for endometrial cancer detection. To-date, these studies have been conducted in predominantly white populations, and the size of these studies was too small for precise estimates of clinical accuracy. The DETECT Study will extend our ongoing efforts by enrolling a racially-diverse population of women undergoing hysterectomy for endometrial cancer and other benign uterine conditions to assess the acceptability and feasibility of tampon sampling in this population. This novel and innovative study will provide important groundwork for developing early detection strategies based on self-collected samples for endometrial cancer, with the potential to reduce racial disparities.
For more information, contact Dr. Megan Clarke.