Comparative performance of hrHPV testing and PAX1/ZNF671 methylation in triaging women with abnormal cytology: a study of paired urine, vaginal and cervical scrape samples
Wang et al.
The finding, in our words
In women with abnormal cytology, hrHPV testing and PAX1/ZNF671 methylation were assessed across paired self-collected urine and vaginal samples versus clinician cervical scrapes. Methylation markers showed high area under the ROC curve for CIN3+ and strong correlation with lesion severity, and the optimal PAX1/ZNF671 panel achieved high sensitivity for CIN2+ in cervical samples but lower sensitivity in urine and vaginal samples, indicating cervical samples are optimal for methylation testing while urine and vaginal self-collection may be useful for hrHPV triage.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
This literature review found that DNA methylation markers on self-collected urine or cervicovaginal swabs detected cervical intraepithelial neoplasia as well as cytology. The combination could improve screening uptake and reduce loss to follow-up, particularly in low- and middle-income countries, though more evidence is needed to identify the most efficacious methylation tests.
Sumiec et al., Infectious agents and cancer · source ↗
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.
Hsiao et al., The journal of obstetrics and gynaecology research (paywalled) · source ↗
DNA methylation markers in first-void urine effectively detect high-grade cervical lesions in HPV-positive women, with results similar to clinician-collected samples in those over 30. This enables reliable cervical cancer screening using self-collected urine, reducing the need for invasive follow-up procedures in decentralised settings.
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.
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.