Key Summary
- Endometriosis affects around 1 in 10 women of reproductive age in the UK.
- Endotest analyses saliva sample to diagnose endometriosis.
- EndoSure measures electrical signals in the gut using sensor pads to detect endometriosis.
The National Institute for Health and Care Excellence (NICE) has issued draft early-use healthtech guidance for two new non-invasive diagnostic technologies for endometriosis.
The two technologies - named EndoSure and Endotest - will be funded through core NHS funding over a three-year evidence-generation period while long-term data is collected on how well they work.
Endometriosis affects around 1 in 10 women of reproductive age in the UK, yet the average time to receive a diagnosis is more than 9 years.
Currently, the only way to definitively confirm an endometriosis diagnosis is through a diagnostic laparoscopy - keyhole surgery performed under general anesthetic where a surgeon inserts a small camera through a tiny incision in the abdomen.
This process is invasive, costly, and carries inherent surgical risks. Alternatively, current primary care diagnostic accuracy can be limited by the availability of other tests and variations in specialist expertise.
The newly recommended technologies offer a less invasive, faster approach that does not rely on ultrasound operator expertise, potentially enabling earlier decision-making and reducing unnecessary surgical investigations.
Early economic modelling suggests that both tools could be highly cost-effective, and they will be funded through core NHS funding while long-term data is collected.
Endotest analyses a saliva sample for tiny biological markers called microRNAs, which can indicate whether endometriosis is likely present, with results sent to the treating clinician.
EndoSure detects endometriosis by measuring electrical signals in the gut using sensor pads on the abdomen, after the patient fasts and drinks water during the 45-minute test.
A third technology, DotEndo, requires more research before NICE can recommend the NHS to fund early use of it.
Both approved tools are intended to be used by healthcare professionals alongside standard clinical practice to support diagnosis, referral, and management. They are not standalone diagnostic tests; they should only be used if endometriosis is still suspected despite a normal clinical examination and either negative or inconclusive imaging results.
Delays in care typically result from late initial presentation, variation in traditional transvaginal ultrasound expertise, fragmented referral pathways, and long waiting times for gynaecology services.
According to a survey of over 10,000 women conducted by the All-Party Parliamentary Group (APPG) on endometriosis, over half of the respondents reported visiting their GP more than 10 times before getting a diagnosis, and over half had attended an emergency department because of their symptoms.
Patients describe these diagnostic delays as contributing to increased suffering, prolonged ill health, and disease progression that becomes harder to treat.
