Evolving HPV diagnostics: current practice and future frontiers

First-void urine is established as a reliable self-collected specimen for human papillomavirus screening, triage, and post-vaccination surveillance. The use of specialised collection devices and advanced molecular assays supports the integration of non-invasive sampling into routine cervical cancer prevention strategies.

Testing for Human Papillomaviruses in Urine, Blood, and Oral Specimens: an Update for the Laboratory — Poljak et al., Journal of clinical microbiology · source ↗

• first-void
• blood
• sti
• self-collection
• hpv
• liquid-biopsy
• urine
• validation
• saliva

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.

The current state of DNA methylation biomarkers in self-collected liquid biopsies for the early detection of cervical cancer: a literature review — Sumiec et al., Infectious agents and cancer · source ↗

• urine
• self-collection
• validation
• hpv
• sti
• biomarkers
• liquid-biopsy

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

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.

Accuracy of HPV Testing Using Self-collected Urine Compared With Physician-collected Cervical Specimen for HSIL or Worse — Chen et al., Journal of lower genital tract disease (paywalled) · source ↗

• urine
• first-void
• colli-pee
• self-collection
• validation
• hpv
• sti

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.

Diagnostic Accuracy of Urine and Vaginal Self-Sampling for Detection of High-Risk Human Papillomavirus: A Systematic Review and Meta-Analysis — Rakhat & Aimagambetova, Viruses · source ↗

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