Grant: Project Grant - PA: Equity in Cancer Prevention and Control

Endometrial cancer (EC) is the most common gynecological cancer in Canada and the developed world. As females age, they experience normal changes that can also be signs of cancer. Abnormal bleeding is often the first symptom of EC, but is quite common in females approaching menopause (1 in 3). An EC diagnosis must be confirmed by a painful and invasive endometrial biopsy. Given that less than 10% of those with abnormal bleeding have cancer, we need novel, less-invasive tools to distinguish symptoms of cancer from normal aging. Our research project considers patterns in risk factors, biological, and digital app-collected data (menstrual, sleep, activity, hormone imbalance symptoms) to predict which females are at higher risk of EC. We want to understand whether digital tools, used in combination with biological information from at-home tests (tampon, vaginal swabs, or saliva), are acceptable to those with elevated risk of cancer as a way to self-monitor. In our study, we will collect data from females 40 years and older in the general population, as well as those referred to a gynecologist to undergo a biopsy for abnormal bleeding. Everyone will complete a questionnaire on risk factors and a subset will undergo at-home tests. We will use this information to see if we can discern who is most likely to have cancer. A subset of participants who show changes in their endometrium will be selected to continue self-tracking for 6 months, providing weekly app-collected data, as well as self-testing via tampon, saliva, and vaginal swabs at two time-points for comparison, to see what changes persist over time and may be cause for concern. If successful, self-tracking apps could integrate with standard health care to empower females to become more aware of what to expect as they age and be proactive with respect to their personal and medical choices, and clinicians could offer less-invasive alternatives than endometrial biopsies to those with low predicted risk for EC.