Academic articles, August
HPV Testing from Urine
Assoc. Prof. Chumnan Kietpeerakool ,M.D.
Department of Obstetrics and Gynecology Faculty of
Medicine Khonkaen University
Human Papillomavirus (HPV) can infect various parts of the body, such as the mouth, throat, and genitals. Most sexually active individuals have likely been infected with HPV at some point, but the majority of infections resolve on their own. High-risk HPV can cause abnormal cervical cells and may lead to cervical cancer(1).
Cervical Cancer Screening
The current standard methods for cervical cancer screening are cervical cytology or high-risk HPV testing from vaginal secretions. Cervical cytology requires a pelvic examination and collection of cervical cells by a healthcare professional. High-risk HPV testing can involve collection of vaginal secretions during a pelvic exam by a healthcare professional or self-collection using a sampling device.
What is HPV testing from urine?
HPV testing from urine is a cervical cancer screening method that involves collecting a urine sample to be sent to a laboratory to test for high-risk HPV, the types that can potentially cause cervical cancer(2).
Accuracy of HPV testing from urine
High-risk HPV testing from urine is nearly as accurate as testing samples collected from the cervix or vaginal secretions(2-5). Although it may not yet completely replace standard screening methods, it serves as an alternative, especially for women who avoid standard methods that require a pelvic exam or insertion of a device into the vagina, women in remote areas, or those who have difficulty finding time for an examination(2).
Procedure for collecting urine for HPV testing
A urine sample of approximately 10-50 ml should be collected in the provided container. It is important to collect the first-void urine (the initial stream). You should hold your urine for at least 1-2 hours before collection and avoid cleaning the genital area prior to collection(2,4,6). The collected urine sample will then be sent to the laboratory for testing.
Follow-up after detecting HPV in urine
Individuals found to have a high-risk HPV infection will require further testing, such as a cervical cytology or colposcopy. However, HPV testing from urine may not be available at all healthcare facilities, so it is advisable to inquire with the facility beforehand. Additionally, some women may still need to undergo standard screening methods based on their physician’s assessment.
Conclusion
HPV testing from urine is an easier and less invasive method compared to conventional methods. Moreover, its accuracy is nearly comparable to that of tests using cervical or vaginal secretion samples. This approach could serve as an alternative for cervical cancer screening, potentially increasing cervical cancer screening rates.
References
Thobias AR, Patel M, Vaghela C, Patel PS. Attributes of HPV associated cancers. Clin Transl Oncol 2025. doi: 10.1007/s12094-025-03959-1.
Cheng L, Wang R, Yan J. A review of urinary HPV testing for cervical cancer management and HPV vaccine surveillance: rationale, strategies, and limitations. Eur J Clin Microbiol Infect Dis 2024;43:2247-58. doi: 10.1007/s10096-024-04963-z.
Khunamornpong S, Settakorn J, Sukpan K, Lekawanvijit S, Katruang N, Siriaunkgul S. Comparison of Human Papillomavirus Detection in Urine and Cervical Samples Using High-Risk HPV DNA Testing in Northern Thailand. Obstet Gynecol Int 2016;2016:6801491. doi: 10.1155/2016/6801491.
Tranberg M, Van Keer S, Jensen JS, Nørgaard P, Gustafson LW, Hammer A, et al. A. High-risk human papillomavirus testing in first-void urine as a novel and non-invasive cervical cancer screening modality-a Danish diagnostic test accuracy study. BMC Med 2025;23(1):327. doi: 10.1186/s12916-025-04149-0.
Li DM, Liu QY, Xue SL, Zeng X, Qie MR, Lian R. Accuracy analysis of cervical cancer screening using urine and vaginal self-sampling versus clinician-collected samples: A systematic review and meta-analysis. Int J Gynaecol Obstet 2025. doi: 10.1002/ijgo.70207.
Davies JC, Sargent A, Pinggera E, Carter S, Gilham C, Sasieni P, et al. Urine high-risk human papillomavirus testing as an alternative to routine cervical screening: A comparative diagnostic accuracy study of two urine collection devices using a randomised study design trial. BJOG 2024;131:1456-64. doi: 10.1111/1471-0528.17831.
