A service evaluation of the Gen-Probe APTIMA nucleic acid amplification test for Trichomonas vaginalis: should it change whom we screen for infection?

Routine clinic-based cervical sampling generated 3670 g CO2e per sample, whereas vaginal self-sampling produced 423 g CO2e and first-void urine collection produced 570 g CO2e. Decentralised self-collection approaches substantially lowered emissions by eliminating primary care clinic visits.

A comparison of the carbon footprint of alternative sampling approaches for cervical screening in the UK: A descriptive study — Whittaker et al., BJOG : an international journal of obstetrics and gynaecology (paywalled) · source ↗

• urine
• first-void
• self-collection
• economics
• hpv
• sti

First-void urine self-sampling for HPV screening cost £38.57 per complete screen compared with £56.81 for clinician-collected samples, with potential NHS savings of £19.2 million annually if uptake improved among non-attenders. This shows self-sampling is substantially cheaper and could expand screening reach to under-screened women, supporting decentralised diagnostic programmes.

Two self-sampling strategies for HPV primary cervical cancer screening compared with clinician-collected sampling: an economic evaluation — Huntington et al., BMJ open · source ↗

• urine
• first-void
• self-collection
• economics
• hpv
• sti

This meta-analysis found that HPV testing using self-collected vaginal and urine samples showed sensitivities of 88.6% and 81% for detecting cervical precancer. Using a standardised device for first-void urine increased sensitivity to 86.6%, supporting decentralised patient-centric screening, though data on specificity and specific commercial devices were not consistently reported.

Diagnostic Performance of HPV Testing Using Self-Collected Urine and Vaginal Samples for Detecting Cervical Precancer or Worse: A Meta-Analysis — Hsiao et al., The journal of obstetrics and gynaecology research (paywalled) · source ↗

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

A study of 2500 women found 99.0% agreement between first-void urine and vaginal self-sampling for HPV detection using Cobas4800, with 98.1% of participants preferring urine. Although conducted in a resource-limited setting which may limit generalisability, these results support urine as a viable sample type for decentralised, patient-centric screening.

Comparative efficacy, feasibility and acceptability of HPV DNA testing on first-void urine versus self-collected vaginal samples: a real-world study in a resource-limited setting — Bose et al., BMJ global health · source ↗

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

This study found that self-collected vaginal swabs and first-void urine yielded comparable detection rates for vaccine-targeted high-risk HPV types, supporting the use of both patient-centric methods for decentralised surveillance. Vaginal swabs showed higher sensitivity for non-vaccine types, whereas urine sampling offers a non-invasive alternative.

Comparison of self-collected vaginal swabs and first-void urine for detection of human papillomavirus in sexually active girls and women in three South Asian countries — Telele et al., PloS one · source ↗

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