University of Manchester scientists have suggested that urine testing may be as effective as the smear test at preventing cervical cancer.
In their study, led by Dr Emma Crosbie and published in BMJ Open, it was found that urine testing was just as good as the cervical smear at picking up high-risk human papillomavirus (HPV).
Urine testing could play a particular role in the developing world, where cervical cancer is up to 15 times more common and smear testing largely non-existent.
Around 1 in 20 women show abnormal changes which might go on to become cancer and are referred for colposcopy, allowing abnormal areas to be seen, sampled and treated, before they ever cause cancer.
According to the team, cervical smear samples, self-collected vaginal samples and urine samples are all effective at picking up high risk HPV infection.
Cervical cancer is most common in women aged 30 to 35 years. But the precancerous stage is detectable in the 5-10 years before this, when up to a third of women fail to attend for their smear test.
“We’re really very excited by this study, which we think has the potential to significantly increase participation rates for cervical cancer screening in a key demographic group,” said Dr Emma Crosbie.
Of the 100 or so types of HPV, some are linked to cervical cancer, and some are linked to other conditions, like genital warts. Most cervical cancers are caused by high-risk types HPV-16 and HPV-18.
Altogether 104 women attending the colposcopy clinic at St Mary’s Hospital, Manchester participated in the study and were screened using two brands of HPV testing kits. Around two-thirds of the women tested positive for any high-risk HPV type, and a third for HPV-16 or HPV-18.
From the total, eighteen women had pre-cancerous changes to the cervix that needed treatment. Using the Roche HPV testing kit, urine, vaginal self samples and cervical smears picked up 15 of these and with the Abbott HPV testing kit, urine picked up 15 of these and vaginal self samples and cervical smears picked up 16.
Dr Crosbie said: “These results provide exciting proof of principle that urine HPV testing can pick up cervical pre-cancer cells, but we need to trial it on a greater number of women before it can be used in the NHS. We hope that is going to happen soon.
“Urine is very simple to collect and most hospitals in the developed and developing world have access to the lab equipment to process and test the samples.
“Let us hope this is a new chapter in our fight against cervical cancer, a devastating and pernicious disease.”
REFERENCE: Sargent et al: Cross-sectional study of HPV testing in self-sampled urine and comparison with matched vaginal and cervical samples in women attending colposcopy for the management of abnormal cervical screening. BMJ Open, 2019; https://bmjopen.bmj.com/content/9/4/e025388