New ‘game-changer’ tests for endometriosis given green light on NHS

In a bid to dramatically cut the time it takes for women to be told whether they have the condition, the National Institute for Health and Care Excellence (Nice) has given the green light to EndoSure and Endotest on the NHS. With Endotest, women give a saliva sample which is then sent off to the lab to check for tiny biological markers called microRNAs. This indicates the presence of endometriosis.

Meanwhile, EndoSure can detect the condition by measuring electrical signals in the gut using sensor pads on the abdomen. Women fast for six to eight hours beforehand and then drink water for 45 minutes during this test. Endometriosis is a painful condition where cells similar to those in the lining of the womb (uterus) grow in other parts of the body.

The condition affects around one in 10 women of reproductive age in the UK, but the average time it takes to get a diagnosis is more than nine years. The new draft recommendation approves the two tests for three years in the NHS, during which time additional evidence will be collected on how well they work. Final approval could then be given. A third technology, DotEndo, requires more research, Nice said, before it can be approved.

None of the tests are designed to act as standalone diagnostic tests but should ensure women receive a diagnosis and treatment much faster. In a survey of more than 10,000 women in the UK conducted by the All-Party Parliamentary Group on endometriosis, more than half reported visiting their GP more than 10 times before receiving a diagnosis. More than half of women surveyed also said they had been to A&E because of their symptoms. Delays in diagnosis can occur due to a variety of factors, including the expertise of medics in using transvaginal ultrasounds and long waiting times for hospital gynaecology services.

Current tests for endometriosis include ultrasound scans, MRI or a laparoscopy – where a camera is inserted through a tiny cut in the stomach.

Dr Anastasia Chalkidou, healthtech programme director at Nice, said: “A diagnosis of endometriosis can for some women take the best part of a decade, with the UK average standing at nine years and four months, and rising to 11 years for those from ethnically diverse communities.

“That delay means living with chronic pelvic pain that affects daily life, relationships and work. These technologies have the potential to change that by giving primary care professionals better non-invasive tools to identify endometriosis earlier, allowing earlier and better treatment. Our draft guidance reflects our commitment to getting promising innovations to patients quickly, while making sure the evidence to support their wider use is built in a rigorous way.”

Ami Robertson experienced symptoms of endometriosis from the age of 16 but was repeatedly told she had irritable bowel syndrome.

The 23-year-old Pilates instructor from Glasgow said: “I spent years being told my pain was something else entirely. I started to doubt myself, wondering if it was all in my head.

“When I finally had the test, it took less than an hour and gave me something I’d never had before: concrete evidence I could take to my doctor. For the first time, I was believed, and I could finally get the help I needed.

“Today my quality of life is night and day compared to before. No one should have to wait years to be believed.”