Non-invasive endometriosis tests currently undergoing trials in the United Kingdom could eventually reduce diagnosis delays that often stretch for years, though researchers warn that current evidence does not yet support their widespread clinical use. According to Associate Professor Mathew Leonardi and clinical research assistant Narges Kalani writing in The Conversation, evaluating these new diagnostic tools requires looking closely at how they perform in typical general practice settings rather than controlled study environments.
Why Endometriosis Diagnosis Remains Difficult
Endometriosis occurs when tissue similar to the lining of the uterus grows outside the organ, frequently triggering severe pelvic pain, painful intercourse, bladder issues, and infertility. Traditional diagnosis relies on symptom assessment, physical examinations, and imaging, according to Leonardi and Kalani. While trained specialists can identify the condition using ultrasound or MRI scans, a normal scan cannot rule it out entirely, meaning patients often require a laparoscopy—a surgical procedure using a small camera inserted into the abdomen.
Did you know? Pelvic pain can stem from multiple overlapping sources, including bowel, bladder, and muscular issues, which makes clinical diagnosis uniquely challenging for general practitioners.
Saliva and Gut Tests in UK Trials
Two novel non-invasive tests are being evaluated across general practices in the United Kingdom over a three-year period. The first, called Endotest, examines saliva samples for microRNAs, which are tiny molecules that regulate gene behavior. A French multi-center study of 971 patients found the saliva test highly accurate, but Leonardi and Kalani note that most participants already had endometriosis. Because typical general practice patients present with diverse causes of pelvic pain, researchers remain uncertain whether the test maintains that accuracy in everyday clinical mixes.
The second option, EndoSure, measures electrical signals in the gut using abdominal sensor pads during a 45-minute appointment. An initial study of 154 women reported high sensitivity and specificity. However, most control participants in that research did not undergo confirmatory surgery to prove they were disease-free. Furthermore, recent unpublished data presented at a scientific meeting showed a specificity drop to 5%, meaning 95% of patients without endometriosis still returned a positive result.
Blood Tests and Diagnostic Context
Other non-invasive alternatives are emerging globally, including blood tests at various stages of development and validation. In the United States, EndomTest combines blood markers with clinical data, though the U.S. Food and Drug Administration has not approved it for widespread use. Published data shows high specificity but low sensitivity, meaning the test could miss numerous patients who actually have the disease.
In Australia, PromarkerEndo measures blood proteins by comparing patients with symptoms who ultimately tested negative during surgery. Meanwhile, the U.S.-developed DotEndo examines a panel of six microRNAs in blood and is currently undergoing evaluation in a large multi-center study involving approximately 750 patients.
Pro Tip: Experts emphasize that a negative non-invasive test result should never be used to dismiss persistent pelvic pain, as all chronic symptoms deserve thorough investigation regardless of a single screening outcome.
Frequently Asked Questions
What is endometriosis?
Endometriosis is a medical condition where tissue resembling the uterine lining grows outside the uterus, causing pelvic pain, period pain, and potential fertility complications.
Are the new saliva and gut tests available in Australia?
No. According to Leonardi and Kalani, tests such as Endotest and EndoSure are currently undergoing trials in the United Kingdom and are not available in Australia.
Can a normal ultrasound rule out endometriosis?
No. A normal scan performed by a specialist can help identify the disease, but it cannot rule it out completely, meaning doctors sometimes rely on surgical laparoscopy.
Will non-invasive tests replace surgery?
Not entirely. While screening tests may flag potential cases and prompt earlier specialist referrals, imaging and clinical mapping remain essential to determine disease location and extent.
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