Cervical HPV urine test demonstrates accuracy

the Clinical Advisor take:

A simple urine test can routinely spot human papillomavirus (HPV), according to research published in The BMJ.

“Despite screening, cervical cancer is still the most common malignancy in women aged less than 35, and there has been a downward trend in coverage of screening in this population,” explained Neha Pathak, MBBS, of Queen Mary University of London, and colleagues in their report.

“This may partly be because the current screening by cervical cytology sampling is invasive, is time consuming, and requires a clinician.”

To assess the effectiveness of the HPV urine test, the investigators reviewed 16 published articles covering 14 different studies.

Urine detection of any HPV had a pooled sensitivity of 87% (95% CI: 78% to 92%) and specificity of 94% (95% CI: 82% to 98%). Urine detection of high risk HPV had a pooled sensitivity of 77% (68% to 84%) and specificity of 88% (58% to 97%). Urine detection of HPV 16 and 18 had a pooled sensitivity of 73% (56% to 86%) and specificity of 98% (91% to 100%).

“When cervical testing for HPV is sought, urine based testing should be an acceptable alternative to increase coverage for subgroups that are hard to reach,” concluded the researchers.

Cervical HPV urine test demonstrates accuracy

Human papillomavirus (HPV) is one of the commonest sexually transmitted infections. Up to 80% of sexually active women are infected at some point in their lives and 10-20% develop persistent infection.¹

Infection with specific strains of HPV has been associated with the development of cervical cancer,²a preventable and treatable disease for which routine screening using a cervical cytology based method is employed to detect precancerous cervical intraepithelial neoplasia (CIN).

Despite screening, cervical cancer is still the most common malignancy in women aged less than 35, and there has been a downward trend in coverage of screening in this population.^{3 4} This may partly be because the current screening by cervical cytology sampling is invasive, is time consuming, and requires a clinician.

The detection of HPV in the cervix is being piloted as a new method of cervical cancer screening and is recommended for secondary prevention.⁵ This is based on four randomised controlled trials and a pooled analysis of these, which showed that HPV detection is more protective against grade 3 CIN and invasive cervical cancer compared with current screening methods.^{6 7 8}

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Topics:

Hematology/Oncology Infectious Disease Sexually Transmitted Infections Women's Health

Cervical HPV urine test demonstrates accuracy

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