Diagnostic Performance of HPV Testing Using Self-Collected Urine and Vaginal Samples for Detecting Cervical Precancer...

Self-collection models are regarded as a potential strategy to facilitate HPV testing for cervical cancer screening. HPV testing using urine specimens offers certain advantages, including its noninvasiveness. This characteristic has the potential to eliminate discomfort. Concerns regarding the accuracy of this method persist. Thus, the present meta-analysis aims to verify the accuracy of HPV testing using self-collected urine samples and vaginal samples.

A literature search was conducted in the PubMed, Embase, and Cochrane Library databases to identify eligible studies. The inclusion criteria were as follows: studies that evaluated the diagnostic accuracy of HPV testing for high-grade squamous intraepithelial lesion or worse (HSIL+) with self-collected urine samples and vaginal samples. Additionally, studies that provided sufficient data for conducting a meta-analysis were assessed.

The meta-analysis was conducted using a bivariate random-effects model. A total of 11 articles were identified. These articles included 3534 self-collected urine specimens and 3523 vaginal specimens. The meta-analysis yielded a pooled sensitivity of 81% for HPV testing with self-collected urine specimens for HSIL+. A further meta-analysis yielded a pooled sensitivity of 88.6% for HPV testing with self-collected vaginal specimens detecting HSIL+. For specimen type, pooled sensitivity was 86.6% in the subgroup of papers using first void urine (FVU) via a standardized device to evaluate HPV testing.

Our meta-analysis suggests that HPV testing using both self-collected urine and vaginal specimens achieves high sensitivity for detecting HSIL+. Another potential benefit of HPV testing employing FVU collected with a standardized device is the capacity for heightened sensitivity.