Urine Test Works for HPV Screening

Urine-based screenings for human papillomavirus (HPV) should be considered a viable alternative to pap smears, a meta-analysis found. But don't abandon the Pap test just yet.

In reviewing 14 studies involving a total of 1,443 sexually active women, researchers from London and Spain found “high quality” evidence supporting using urine tests as a way to potentially boost HPV screening rates.

Key Findings

- A urine test could be a viable alternative to Pap smears as researchers look for ways to improve screenings for HPV.

- A meta-analysis of 14 studies showed urine tests to be an accurate way to detect HPV.

“The detection of HPV in urine is non-invasive, easily accessible, and acceptable to women, and a test with these qualities could considerably increase uptake," the authors wrote.

When compared with pap smears, urine HPV testing correctly identified positives 87% of the time and had a specificity of 94%. When it came to identifying the HPV types that cause the majority of cervical cancer, the overall sensitivity dropped to 73% but the specificity jumped to 98% compared with cervical samples.

The meta-analysis, recently published in BMJ, also found that accuracy of urine tests was highest when the test was conducted using the first urine of the day upon waking.

While the analysis shows promise for a future urine test, more research is needed to develop a standardized clinical application, including on how to best collect the sample to maximize accuracy, the authors note. The authors also caution that the analysis did not look at the ability of urine tests to correctly diagnose cervical disease and instead focused on the detection of HPV.