A review of urinary HPV testing for cervical cancer management and HPV vaccine surveillance: rationale, strategies, and limitations

Self-sampling for HPV testing using urine and swab devices achieved high DNA detection rates, 92.1-99.7%, and very high participant acceptance, 99.1%, in a primary care population, supporting decentralised screening in low-resource settings.

Population-based self-sampling under primary care conditions - a possible approach for cervical cancer screening in Indonesia (IndoCerCa study) — Wenang et al., Reproductive health · source ↗

• urine
• self-collection
• validation
• acceptability
• hpv
• sti

This meta-analysis found that urine self-sampling for HPV detection had significantly lower sensitivity for high-grade lesions compared to vaginal and cervical samples, though specificity remained comparable. Despite the reduced diagnostic accuracy, the non-invasive and acceptable nature of urine sampling supports its use as a decentralised option to improve screening uptake.

A systematic review and meta-analysis of diagnostic accuracy of urine self-sampling for human papillomavirus detection in cervical cancer screening — Nath et al., Journal of medical screening (paywalled) · source ↗

• acceptability
• sti
• self-collection
• hpv
• urine
• validation

Urine-based HPV testing showed broad variability in diagnostic performance, with sensitivity ranging from 44.8 to 98.6 per cent and specificity from 61 to 100 per cent against cervical specimens. High patient acceptability was reported, yet standardisation is needed before this self-collection approach can be approved for decentralised cervical cancer screening.

A Narrative Review of Urine-Based Human Papillomavirus Screening: Performance, Challenges, and Opportunities to Expand Access in the United States — Yang et al., Sexually transmitted diseases (paywalled) · source ↗

• urine
• self-collection
• validation
• acceptability
• hpv
• sti

Urinary HPV testing showed lower sensitivity than cervical sampling for detecting CIN2+ (79% versus 93%) but higher specificity (58% versus 50%), and participants favoured urine self-collection. The authors conclude that while urine sampling may complement screening in resource-limited or culturally conservative settings, its suboptimal performance and absence of standardised protocols preclude its use for general population screening.

Pooled performance of urinary human papillomavirus (HPV) testing for the presence of cervical HPV — Ye et al., Cancer (paywalled) · source ↗

• urine
• self-collection
• validation
• acceptability
• hpv
• sti

Urine-based HPV testing demonstrated 74% sensitivity and 52% specificity for detecting CIN2+, with performance improving when first-void collection and PCR-based assays were used. Although less sensitive than clinician-collected cervical samples, urine testing was preferred by over 90% of women, indicating potential as a complementary screening strategy to improve uptake.

Diagnostic Accuracy of Urine-Based HPV Testing Compared With Clinician-Collected Cervical Samples for Cervical Intraepithelial Neoplasia Grade 2 or Worse (CIN2+) Detection: A Systematic Review and Meta-Analysis — G et al., Cureus · source ↗

• urine
• first-void
• self-collection
• validation
• acceptability
• hpv
• sti