Urine testing may have similar sensitivity in detecting HPV as cervical smear testing, a study has found, which may provide an alternative option for women who are anxious about cervical screening.
The researchers found that the sensitivity of HPV testing from cervical and vaginal samples – the proportion of positive results that were true positives – was 89%. By comparison, in urine samples the sensitivity was 83%.
Because of the similarity in sensitivity between the two tests, they suggested that urine testing could increase uptake and save time in primary care.
The study from the University of Manchester looked at just under 80 women attending a colposcopy clinic for management of abnormal cervical screening. The women were asked to self-collect a urine sample and a vaginal swab, and had a cervical sample collected by a practitioner.
Acceptability questionnaires also found that the majority of women who provided a urine sample said that they preferred it to having a sample taken by a healthcare professional and would be happy to do it in the future.
The researchers noted that preservative would need to be added to the urine samples for the best results, which would prevent samples from being taken at home and posted in for analysis.
But they added that ‘it would not preclude self-collection within primary care, where preservative can be safely added shortly afterwards.’
The authors said in the paper: ‘Barriers to cervical screening include embarrassment, fear, inconvenience and the view held by some women that they are not at risk. Offering an alternative means of cervical screening can encourage non-attenders to be screened, either by ‘nudging’ them to undergo cervical sampling or by facilitating self-sampling at home. Urine-based testing is already widely used for the detection of chlamydia and is generally trusted and acceptable to women.
‘Urine-based testing may also be cheaper than standard cervical screening tests because it does not require an appointment, a practitioner or any special equipment and it lends itself to high throughput testing. It could also be suitable in resource-poor settings where the infrastructure required to underpin screening by cervical cytology is lacking.’
The findings come after PHE launched a new campaign in March to tackle the 20-year low in cervical screening uptake.