Objective: The objective of this study is to assess the clinical performance of a urine-based high-risk human papillomavirus (hrHPV) test for the detection of cervical intraepithelial neoplasia grade 2 or higher (CIN2+).
Methods: Between September and December 2021, women aged 20 to 65 years referred to colposcopy clinic were prospectively recruited at three clinical centers in China. Paired urine and cervical specimens from all enrolled women were obtained for hrHPV DNA fluorescence quantitative PCR test. The results of liquid-based cytology (LBC), colposcopy and diagnostic biopsies were collected. We evaluated the sensitivity and specificity for CIN and assessed the agreement/kappa value.
Results: A total of 732 women (median age, 40 years) with valid results were included in the study, and 130 (17.8%) women were histologically confirmed as CIN2+. The sensitivity of urine and cervical test for CIN2+ and CIN3+ were 87.69% and 85.45%, respectively. The specificity of urine test performed better than cervical test in women with <CIN 2. The overall agreement of hrHPV detection between urine and cervical specimens was 80.74%, with higher agreement for types 16 and 18 (91.67% and 96.58%).
Conclusion: The data suggested that the urine-based hrHPV test may be an alternative approach for cervical cancer screening.
Keywords: HPV testing; cervical intraepithelial neoplasia; diagnostic test accuracy; human papillomavirus; urine.
© 2023 Zhao et al.