The National Institute for Health and Care Excellence (Nice) has approved two rapid tests for endometriosis to be made available on the NHS in England and Wales, in a move described as a "gamechanger" for millions of women who often wait years for a diagnosis.
What are the tests?
The two tests are Endotest, a saliva-based test that detects microRNA markers, and EndoSure, which measures electrical signals in the gut using sensor pads on the abdomen. Endotest requires a saliva sample sent to a lab, with results returned to a GP. EndoSure involves fasting for six to eight hours, then drinking water during a 45-minute test that provides immediate results.
Impact on diagnosis time
Endometriosis affects one in 10 women of reproductive age, causing tissue similar to the womb lining to grow elsewhere, such as ovaries and fallopian tubes. Symptoms include painful periods, pain during bowel movements or urination, and pain during or after sex. Current diagnostic methods include ultrasound, MRI, or laparoscopy, but women in England and Wales typically wait up to a decade for a diagnosis. The UK average wait is nine years and four months, rising to 11 years for women from ethnic minority backgrounds.
Dr Anastasia Chalkidou, Nice’s healthtech programme director, 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." She added that delays cause chronic pain affecting 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."
How the tests work
Endotest analyzes saliva for microRNAs, which indicate endometriosis. EndoSure detects the condition by recording gut electrical activity after the patient drinks water. The tests are not standalone but are intended for women with suspected endometriosis after a normal clinical exam and negative or inconclusive imaging results, or when imaging has not been used.
Approval and next steps
The draft recommendation, published on Tuesday, approves the tests for three years, during which further evidence will be collected on their effectiveness. Nice will then decide on permanent NHS use. A third test, DotEndo, requires more research before approval.
Dr Gail Busby, a consultant gynaecologist at Manchester University NHS Foundation Trust, said: "These tests are a gamechanger because they give us answers much earlier, without the need for invasive surgery, and that means we can start the right treatment sooner. An earlier diagnosis doesn't just change one person's life, it frees up appointments and surgical slots for everyone waiting for care."
Emma Cox of Endometriosis UK welcomed the tests but stressed they should be accompanied by education for GPs and nurses to ensure prompt access and recognition of symptoms.
