2017 · European journal of obstetrics, gynecology, and reproductive biology · paywalled
First-void urine: A potential biomarker source for triage of high-risk human papillomavirus infected women
Van Keer et al.
The finding, in our words
The review concludes that first-void urine is a feasible source for molecular biomarkers, such as host and viral gene methylation, to triage high-risk HPV infections, offering a non-invasive and preferred method for women that may improve screening adherence.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
The study found that testing for ASCL1/LHX8 DNA methylation in at-home collected first-void urine can detect most cervical cancers and high-grade precancers, supporting a fully molecular screening pathway without a clinical visit.
Adding polyethylene glycol to first-void urine before centrifugation markedly improved cell-free DNA recovery in the pellet, whereas low-speed centrifugation alone removed cellular DNA while keeping cell-free DNA in the supernatant. Pseudovirions pelleted reliably under all conditions, but the study revealed substantial variation between self-collected samples, highlighting the need for standardised protocols in decentralised HPV screening programmes.
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.
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.
In first-void urine collected with Colli-Pee, the extraction method influenced HPV and human DNA yield more than the collected volume did: standardising processing matters at least as much as standardising volume.