Diagnostic Accuracy of Urine-Based HPV Testing Compared With Clinician-Collected Cervical Samples for Cervical Intraepithelial Neoplasia Grade 2 or Worse (CIN2+) Detection: A Systematic Review and Meta-Analysis
G et al.
The finding, in our words
Urine-based HPV testing demonstrated 74% sensitivity and 52% specificity for detecting CIN2+, with performance improving when first-void collection and PCR-based assays were used. Although less sensitive than clinician-collected cervical samples, urine testing was preferred by over 90% of women, indicating potential as a complementary screening strategy to improve uptake.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
First-void urine self-collection for HPV testing showed good agreement with cervical samples using the COBAS assay (kappa 0.66) but only moderate agreement with CLART (kappa 0.47). The COBAS assay achieved 63.9% sensitivity and 96.5% specificity with far fewer invalid results than CLART (1.8% versus 26.9%), and 42% of women preferred urine sampling, indicating that urine-based HPV testing is an acceptable decentralised option but requires improved analytical performance before implementation for non-participants.
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.
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.
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.
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.