New study published in The BMJ claims that a simple urine test for human pappillomavirus – the main cause of cervical cancer – could increase screening uptake among women by offering them a non-invasive option.
Researchers say a urine-based HPV test could offer an effective, non-invasive screening option for women.
The most common screening method for human papillomavirus (HPV) is a Papanicolaou (Pap) test, also known as a smear test. This involves a doctor or nurse scraping cells from the opening of a woman’s cervix, before sending them to a laboratory to be analyzed for abnormalities.
The American Cancer Society claim that between 1955 and 1992, death rates from cervical cancer fell by almost 70% due to increased Pap testing. But despite this success, screening uptake in recent years has been low.
Current screening recommendations from the US Preventive Services Task Force (UPSTF) state that women between the ages of 21 and 65 should have a Pap test every 3 years. However, figures show the percentage of women following these recommendations stands at 83% – well below the target of 93%. In the UK, cervical screening rates have fallen below 80%.
According to the researchers of this latest study – including Dr. Neha Pathak of the Women’s Health Research Unit at the Blizard Institute of Barts and the London School of Medicine and Dentistry in the UK – past studies have indicated that an alternative to Pap testing could be to test urine for signs of HPV. But they note the accuracy of such testing has been unclear.
Urine HPV testing ‘should be an acceptable screening alternative’
With this in mind, Dr. Pathak and colleagues set out to compare the accuracy of urine HPV testing against the collection of cervical samples.
To do this, they analyzed the results of 14 studies that looked at both forms of testing, involving a total of 1,443 women who were sexually active.
They found that on average, the sensitivity of urine HPV testing – the proportion of positive results correctly identified – was 87%, while specificity – the proportion of negative results correctly identified – stood at 94%, compared with collection of cervical samples. When using urine HPV testing to identify HPV types 16 and 18 – the primary causes of cervical cancer – sensitivity was 73% and specificity was 98%.
