The current gold standard to detect pre-cancerous changes in the cervix, brought on by HPV is by having regular smears done. This is obviously quite an invasive and uncomfortable procedure. Current UK guidelines are that all women between the ages of 25 and 64 get screened in this way. In the states they start screening at the age of 21. Some women are put off by the actual procedure and in the UK alone screening rates have dropped below 80%, so researchers are looking at other ways of screening to try and increase the uptake to the target 93%

A new study in The BMJ as suggested that a urine test for HPV , might be a suitable alternative to screening in the future. This has been suggested before, but this study was the first to explore if this would be feasible and to test the accuracy.

The study, conducted by Dr Pathak and colleagues, compared the accuracy of urine testing for HPV against results from smear samples. They analysed results from over 14 studies involving 1443 sexually active women.

They found that the sensitivity of urine testing was 87% (sensitivity is the proportion of positive results correctly identified) and the specificity (proportion of negative results correctly identified) was 94%, when compared with cervical samples

When looking specifically at HPV types 16 and 18, the primary causes of cervical cancer the sensitivity was 73% and specificity 98%

They concluded that urine testing for HPV is very accurate and that it should be an acceptable alternative to increase testing in subgroups that are hard to reach as it could potentially allow for home testing and will catch those women who are reluctant to attend for regular smears

There were some issues with the study that will require further clarification, such as the large variation between individual studies for participant characteristics, the large variation in estimates of test sensitivity and specificity between individual studies and so forth, so clearly further studies will be needed

In my opinion, for now at least, HPV urine testing can be used as an adjunct to cervical screening but not as a replacement