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Urine HPV test ‘could offer alternative to smear test’

A urine test for HPV could offer a non-invasive alternative to conventional cervical cytology and improve screening uptake, researchers have reported in the BMJ.

The team, from London and Madrid, analysed the results of 14 studies involving 1,443 sexually active women where HPV detection in urine samples was compared with that in cervical samples obtained via the smear test.

Urine HPV testing had an overall sensitivity of 87% and a specificity of 94%. Urine testing for ‘high risk’ HPV types 16 and 18 – both linked with cervical cancer – had a sensitivity of 73% and a specificity of 98%.

The study authors concluded: ‘Our review shows that detection of HPV DNA in urine has a good accuracy for the presence of cervical HPV. Sensitivity was moderate for detection of any HPV, high-risk HPV, and HPV 16 and 18.

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‘The specificity for detection of HPV in urine was especially high for any HPV and the most oncogenic strains, HPV 16 and 18.’

Although they stressed their results should be interpreted with caution, due to variation between individual studies, the team said that ‘when cervical HPV detection is considered difficult in particular subgroups, urine testing should be regarded as an acceptable alternative’.

BMJ 2014; available online 17 September

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