Project 461578

Endometrial cancer is the most common gynecological cancer in Canada and the developed world. Individuals with a uterus experience changes in bleeding as they age, that can be the first sign of endometrial cancer. Abnormal bleeding is common in those approaching menopause (1 in 3). To rule out cancer, a painful and invasive endometrial biopsy is needed. Given that less than 10% of women with abnormal bleeding have cancer, we need novel, less-invasive tools to distinguish symptoms of cancer from normal aging. In this project, we consider patterns in risk factors, biological, and digital app-collected data (menstrual, sleep, activity) to predict who is at higher risk of endometrial cancer. We want to understand whether digital tools, used in combination with biological information from at-home tests (DNA from tampons, microbial community from vaginal swabs, or hormones from saliva), can be used by individuals with elevated risk of cancer as a way to self-monitor. We will collect data from individuals referred to a gynecologist to undergo a biopsy for abnormal bleeding. Participants will complete a questionnaire on risk factors and complete an at-home sample collection. We will use this information to discern who is most likely to have cancer. A subset of participants who have DNA mutations associated with endometrial cancer 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 a second time-point for comparison. We want to see what biological changes persist over time and may be cause for concern. If successful, self-testing and self-tracking apps could integrate with standard health care to increase awareness around what to expect with aging, to be proactive with respect to personal and medical choices, and provide a less-invasive alternative to endometrial biopsies to monitor changes for those without pathology, but with increased risk for endometrial cancer.