Detection of Endometrial Cancer Through Risk Modelling
The goal of this study is to combine information on risk factors from health questionnaires with minimally invasive biological tests (vaginal DNA and microbiome swabs, pH, hormones) to predict the risk of endometrial cancer (EC), better understand progression of the disease, and identify opportunities for intervention.

This study will recruit patients who are already scheduled to undergo diagnostic evaluation for abnormal uterine bleeding via endometrial biopsy. In Part A, consented participants will be asked to fill out an online risk factor questionnaire. Samples will be collected by the gynecologist at the biopsy appointment. After biopsy results are obtained, all samples from participants diagnosed with EC or precursors, plus a random subset with benign results, will be selected to be sequenced and analyzed.

In Part B, that subset of selected non-malignant participants, based on biopsy, will be invited to take part in lifestyle tracking using a Fitbit, questionnaires, and to provide another round of at-home vaginal samples to identify any persistent genetic mutations or microbiome alterations 6-8 months later.
- EligibilityCriteria: Inclusion Criteria:  Study Part A:  40 years and older Experiencing unexplained abnormal uterine bleeding (i.e., not from IUD, etc.) Have an intact uterus Referred for an endometrial biopsy  Study Part B:  Those selected for sequencing (from Part A) and who retained their uterus.  Exclusion Criteria:  Study Part A:  Endometrial sampling, pelvic radiation, or vaginal infection (vaginosis, yeast) in the past 3 months Started hormone therapy (HRT, birth control, IUD) in the past year (with the exception of tamoxifen) Intercourse, vaginal product use, or douching in the past 48 hours  Study Part B:  Same as Study Part A EC or EIN, or anyone who is recommended a hysterectomy - HealthyVolunteers: Accepts Healthy Volunteers - Gender: Female - MinimumAge: 40 Years - StdAgeList: Adult, Older Adult - StudyPopulation: The study investigators will have 10-15 study gynecologists across British Columbia, Canada, who will be recruiting study participants from patients who are referred to them for an endometrial biopsy due to abnormal uterine bleeding. The investigators aim to recruit ~1000 participants in Study Part A in order to achieve their target sample size of n=50 EIN/EC and n=150 EH.  Sequenced participants will be invited to participant in Study Part B and provide additional samples. - SamplingMethod: Non-Probability Sample