Population-based self-sampling under primary care conditions - a possible approach for cervical cancer screening in Indonesia (IndoCerCa study)
Wenang et al.
The finding, in our words
Self-sampling for HPV testing using urine and swab devices achieved high DNA detection rates, 92.1-99.7%, and very high participant acceptance, 99.1%, in a primary care population, supporting decentralised screening in low-resource settings.
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 urine self-sampling for HPV detection had significantly lower sensitivity for high-grade lesions compared to vaginal and cervical samples, though specificity remained comparable. Despite the reduced diagnostic accuracy, the non-invasive and acceptable nature of urine sampling supports its use as a decentralised option to improve screening uptake.
Urine-based HPV testing showed broad variability in diagnostic performance, with sensitivity ranging from 44.8 to 98.6 per cent and specificity from 61 to 100 per cent against cervical specimens. High patient acceptability was reported, yet standardisation is needed before this self-collection approach can be approved for decentralised cervical cancer screening.
Urinary HPV testing showed lower sensitivity than cervical sampling for detecting CIN2+ (79% versus 93%) but higher specificity (58% versus 50%), and participants favoured urine self-collection. The authors conclude that while urine sampling may complement screening in resource-limited or culturally conservative settings, its suboptimal performance and absence of standardised protocols preclude its use for general population screening.
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.
Urinary HPV testing offers comparable detection to cervical samples and high patient acceptability, making it a viable noninvasive option for decentralised cervical cancer screening and vaccine surveillance. However, the absence of standardised protocols for sample collection and processing currently limits its widespread clinical adoption.