Detection of <i>Chlamydia trachomatis</i> infections by polymerase chain reaction in asymptomatic pregnant women with special reference to the utility of the pooling of urine specimens

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

A service evaluation of the Gen-Probe APTIMA test at a UK sexual health clinic found Trichomonas vaginalis prevalence of 1.4% in men and 3.6% in women. Asymptomatic men provided self-collected first-void urine and asymptomatic women self-collected vulvovaginal specimens, and the study concluded that targeted screening of high-risk asymptomatic groups is more cost-effective than universal screening, supporting decentralised STI testing strategies.

A service evaluation of the Gen-Probe APTIMA nucleic acid amplification test for Trichomonas vaginalis: should it change whom we screen for infection? — Hathorn et al., Sexually transmitted infections (paywalled) · source ↗

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

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