Diagnostic Accuracy of Urine and Vaginal Self-Sampling for Detection of High-Risk Human Papillomavirus: A Systematic Review and Meta-Analysis
Rakhat & Aimagambetova
The finding, in our words
Vaginal self-sampling achieved higher pooled sensitivity and specificity than urine self-sampling for detecting high-risk HPV, making it the preferred option, while urine self-sampling remains a useful non-invasive choice for under-screened populations.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
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.
This meta-analysis found that self-collected urine samples for HPV testing had lower sensitivity for detecting high-grade lesions compared to physician-collected cervical specimens. The use of a first-void collection device such as Colli-Pee was associated with marginally higher sensitivity than general urine sampling.
For decentralised testing, a study found dry vaginal self-samples using Copan FLOQSwabs stored up to two weeks at room temperature maintain DNA quality. However, first-void urine collected with the Colli-Pee device may be less sensitive for HPV detection, showing lower positivity and higher cycle threshold values, median Ct 30 versus 27 for other samples.
The Phase HPV Urine Test detected 14 high-risk HPV types from first-void urine samples, showing 93 per cent concordance with the Roche cobas 4800 reference assay after sequencing adjudication. The test demonstrated high precision, a low limit of detection, and ten-day stability at ambient temperature, supporting non-invasive, self-collected screening to improve access and participation.
First-void urine self-collection achieved almost perfect agreement with clinician-collected cervical samples for high-risk HPV detection (prevalence-adjusted kappa 0.95 for HPV16). The method showed comparable sensitivity and specificity ratios for identifying cervical intraepithelial neoplasia grade two or worse, supporting its use as a decentralised screening alternative.