Study: Menstrual Cups an Effective, More Comfortable Method of Diagnosis for Endometrial Cancer

A study presented at the Society of Gynecologic Oncology 2020 Annual Meeting on Women’s Cancer showed menstrual cups may provide a novel, less invasive, and more comfortable approach to the diagnosis of endometrial cancer.

In the study, researchers were able to prove that endometrial pathology was detectable through the use of menstrual cups in patients who were not actively bleeding during sample collection. The current sampling techniques used to assess endometrial pathology are invasive and uncomfortable for patients and require a level of expertise among those performing the techniques.

However, menstrual cups have the potential to collect vaginal, cervical, and endometrial secretions for both cytological and pathological analysis without the same level of expertise needed to obtain the sample.

The researchers’ hypothesis had been that the endometrial cells collected by menstrual cups could allow for the screening of endometrial cancer. They also hypothesized that patients would prefer this technique due to it being less invasive and less uncomfortable. Ultimately, the objectives of the study were to evaluate whether menstrual cups were valuable in diagnosing endometrial cancer, to compare patient-reported comfort and preference, and to obtain preliminary data that would support a larger study.

In order to conduct the study, the researchers approached patients with biopsy-confirmed endometrial cancer who were scheduled to undergo hysterectomy, requesting that they wear a menstrual cup for 3 hours. The researchers then conducted a cytologic and molecular analysis of the cup contents, with those results being compared with pathology from the original biopsy and final hysterectomy specimen. Finally, participants answered a survey following the completion of the process on the comfort and acceptability of the use of the menstrual cup.

In total, 6 patients with biopsy-confirmed endometrial cancer were enrolled. They all had an average age of 56.8 years and an average BMI of 32.6. Out of the 6 patients, 67% of them were postmenopausal with all of them reporting recent bleeding, although only 2 reported bleeding on the day of the study’s collection.

During the study, the original method of diagnosis was endomyocardial biopsy (EMB) in 5 participants and dilation and curettage (D&C) in 1. Based on the results, 4 participants had abnormal cells that were identified on cytology following collection in the menstrual cup, whereas the other 2 participants had results consistent with final pathology. For the 2 participants with adenocarcinoma identified on menstrual cup pathology, neither reported having bleeding during the collection process.

On a scale of 0 being no discomfort and 10 being extreme discomfort, the average response of participants for the discomfort level of the insertion and removal of the menstrual cup was 2.8. However, the average discomfort noted by participants following either EMB or D&C was 5.8. In total, 67% of the participants said they preferred the menstrual cup method to the EMB and D&C methods.

The researchers noted that the study recruitment and molecular analysis of samples are still ongoing with more results to come upon the assessment of the data.

REFERENCE

Gotimer K, Chen H, Kennedy V. Feasibility of using menstrual cups to detect endometrial pathology. In: Proceedings from the Society of Gynecologic Oncology 2020 Annual Meeting. Presented March 29, 2020. sgo.confex.com/sgo/2020/meetingapp.cgi/Paper/16248. Accessed June 22, 2020. Abstract 103.