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How two non-invasive diagnostic technologies can be used to speed up the diagnosis of endometriosis
This month, Endometriosis has returned to the spotlight after NICE recommended two novel diagnostic technologies for further evaluation within the NHS: a saliva-based microRNA test and a non-invasive bioelectrical impedance test.
The development coincides perfectly with the recent renewal of the Women's Health Strategy, marking a transition from standalone policy to a foundational pillar of the broader 10-Year Health Plan and addressing the priority of reducing inequalities in diagnosis and care.
Endometriosis remains one of the most challenging conditions encountered in primary care. Affecting an estimated one in 10 women, it is associated with chronic pelvic pain, dysmenorrhoea, infertility and a significant impact on quality of life. Yet despite its prevalence, diagnosis is often delayed and is rarely straightforward.
Symptoms can overlap with irritable bowel syndrome, urinary conditions, pelvic inflammatory disease and other gynaecological disorders, while normal examination findings do not exclude the disease. Although imaging can identify some forms of endometriosis, many patients still require referral to secondary care and historically laparoscopy has been the definitive diagnostic test.
As a result, patients frequently experience prolonged journeys before receiving a diagnosis so anything which helps identify patients earlier or provides greater confidence when referring has the potential to make a meaningful difference.
The first technology being evaluated analyses microRNAs (miRNAs) in a saliva sample. These small molecules regulate gene expression, and early research suggests that people with endometriosis have distinctive microRNA patterns that may be detectable through saliva.
The second uses bioelectrical impedance, measuring changes in the body's electrical properties via sensors placed on the skin. The premise is that tissue changes associated with endometriosis may produce measurable electrical differences.
Whilst neither have currently been approved for routine NHS use, the technologies have entered NICE's Early Value Assessment Programme to allow further evidence collection on their diagnostic accuracy, clinical impact and cost-effectiveness.
Intended to be used alongside standard clinical practice rather than as standalone diagnostic tests, these emerging technologies represent one of the most promising advances for supporting primary care professionals in endometriosis diagnosis, management, referrals and supporting patients’ quality of life.