Urine collection in cervical cancer screening - analytical comparison of two HPV DNA assays

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.

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., Cureus · source ↗

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

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

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.

Comparative efficacy, feasibility and acceptability of HPV DNA testing on first-void urine versus self-collected vaginal samples: a real-world study in a resource-limited setting — Bose et al., BMJ global health · source ↗

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

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.

Comparative performance of first-void urine and self-collected vaginal swabs against clinician-collected cervical samples using 2 HPV real-time assays in Indian women — A et al., Journal of gynecologic oncology (paywalled) · source ↗

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

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