Characterization of the vaginal microflora in health and disease

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

First-void urine and self-collected vaginal swabs showed similar sensitivity and specificity to clinician-collected cervical samples for high-risk HPV detection across two real-time PCR assays, supporting their use as decentralised, patient-collected alternatives; most women preferred first-void urine for regular cervical screening.

Comparative performance of first-void urine and self-collected vaginal swabs against clinician-collected cervical samples using 2 HPV real-time assays in Indian women — A et al., Journal of gynecologic oncology (paywalled) · source ↗

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

First-void urine samples showed significantly higher detection rates of HPV-specific IgG antibodies compared to midstream urine, confirming the necessity of capturing the initial stream. The study found no significant difference between 10 mL and 20 mL collection volumes, indicating flexibility in device specifications for self-collection.

The importance of first-void urine for assessing HPV-specific antibodies: A comparison with midstream urine — Van Caesbroeck et al., Human vaccines & immunotherapeutics · source ↗

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