Clinical Pathology Selected Abstracts, 2/15

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Use of urinary human papillomavirus testing for detecting cervical HPV

Human papillomavirus is the most common sexually transmitted disease in the United States. The spread of the virus is associated with development of cervical cancer, which is the most common malignancy in women under the age of 35. Cervical cancer is treatable; it can be prevented with routine screening using cervical cytology. However, this method is invasive, time consuming, and requires clinician involvement. A method for detecting human papillomavirus (HPV) in the cervix is being developed, but it has limitations similar to those of cervical cytology. Detection of HPV in urine would present a more accessible, noninvasive method that is acceptable to women. It could be used in populations where pelvic examination is not practical. The authors conducted a systematic review and meta-analysis to determine the accuracy of detecting HPV in urine compared with the cervix in sexually active women. Their review showed that urine can detect cervical HPV with a good degree of accuracy. Sensitivity was moderate for detection of any type of HPV, even high-risk HPV. The authors agreed with previous reviews that showed that heterogeneous methods of urine testing affect the interpretation of pooled accuracy measures and that a uniform method for detecting HPV in urine should be developed. They concluded that their analysis may help drive the development of standardized urine HPV testing. They noted, however, that the detection of urine HPV DNA and how it compares with cytology or biopsy outcomes must be further explored to define future testing accuracy.

Pathak N, Dodds J, Zamora J, et al. Accuracy of urinary human papillomavirus testing for presence of cervical HPV: systematic review and meta-analysis. BMJ. doi:10.1136/bmj.g5264.

Correspondence: J. Zamora at javier.zamora@hrc.es