Urine Tests Identify High-Risk HPV as Effectively as DIY Vaginal Swabs

Urine tests can detect strains of human papillomavirus (HPV), linked to cervical cancer, with accuracy comparable to that of self-administered vaginal swabs.

Historically, cervical cancer screening involved healthcare professionals collecting cell samples from the cervix to test for abnormal cells or HPV strains. HPV 16 and 18 are the most common culprits.

In nations like the US and Canada, individuals can now opt for self-collected vaginal swabs that avoid direct contact with the cervix. This approach is similarly being adopted in the UK as part of a new strategy. Such swabs have been linked to increased screening uptake, although they may still be invasive and uncomfortable for some individuals.

Previous research indicates that HPV DNA can be identified in urine. To explore this further, Julia Lynch from the International Vaccine Institute in Seoul, along with her colleagues, surveyed 753 sexually active women aged 18-25, asking them to provide urine samples at any time and to perform vaginal swabs in clinical settings across Bangladesh, Pakistan, and Nepal.

The results revealed that the capacity of the tests to identify seven high-risk HPV strains was strikingly similar, with 5.3% of self-collected swabs testing positive for one or more of these strains compared to 5% of urine samples. For HPV 16 and 18 specifically, the figures were nearly identical—2.3% for swabs and 2.4% for urine.

Urine samples were also preferred by many participants. “We operate in regions with diverse social contexts, and vaginal swabs were less accepted among certain age groups in some countries,” Lynch notes.

The World Health Organization set elimination goals for cervical cancer in 2018, primarily hinging on the success of HPV vaccinations. However, maintaining screening uptake remains critical, as the effects of vaccination programs may take years to be evident on a population level, according to Lynch.

Several types of HPV vaccines protect against all strains 16 and 18. Nonetheless, the data concerning HPV risks generally originates from North America and Europe, as Lynch states. Thus, this research could provide insights into the circulating strains in various regions globally to inform vaccine strategies.

The study focused solely on young women, which means the findings may not apply to broader demographics. Beverly Green from Kaiser Permanente Washington Health Research Institute mentioned that the current study is a part of a wider project aimed at determining HPV prevalence in eight low- and middle-income countries throughout South Asia and Africa, with additional studies within the same project assessing a sample of older women.