A urine test that detects the human papilloma virus could offer women a less invasive alternative to a cervical test, experts have said.
Offering a less time-consuming alternative could also increase screening uptake, they said.
The virus is one of the commonest sexually transmitted infections – up to 80% of sexually active women are infected at some point in their lives. While many strains of HPV are harmless, others can disrupt the normal functioning of cells and trigger cervical cancer.
Researchers said there has been a downward trend in uptake of the smear test and suggested this was because of the invasive nature of the examination and the time it takes.
They said the detection of HPV in the cervix is being tested as a new method for cervical cancer screening.
“A test with these qualities could considerably increase uptake”
But some tests for the virus share the same problems as a smear test and might not improve screening uptake rates, according to the researchers from Barts and The London School of Medicine and Dentistry.
So they decided to investigate the effectiveness of urine tests for the virus. The authors analysed data from 14 studies which held the data of 1,443 women
The study, published in The British Medical Journal, found that the tests that identified presence of HPV were 87% accurate, and 94% of tests that gave negative results gave the correct result.
Two strains of the virus, HPV 16 and HPV 18, have been found to cause around 70% of cervical cancer cases. And urine tests correctly identified 98% of negative tests and 73% of positive tests, the researchers found.
They concluded that urine tests have “good accuracy” for detection of HPV.
Urine test recommended for 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,” they wrote.
In an accompanying editorial in the journal, researchers at the University of Manchester said self-controlled HPV testing – involving a urine test or a vaginal swab – could provide a “a feasible alternative to HPV testing of cervical samples collected by health professionals”.
They added: “In well-resourced health systems, self-sampling could be used for women who are reluctant to attend for regular cervical screening.
“In lower income countries that lack infrastructure, self-sampling might even be beneficial and cost effective for all women who are eligible for screening.
“More research is now required to identify the true clinical performance and acceptability of urine testing for HPV in both settings.”
In England and Northern Ireland, women between the ages of 25 and 64 are invited for cervical screening, with those aged 25 to 49 screened every three years and those aged 50 to 64 screened every five years.
In Scotland, screening is routinely offered every three years to women aged between 20 and 60. This will be extended to the age of 64 from 2015.
In Wales, women between 20 and 64 are screened every three years.