Urine test could replace cervical smear

If deployed as part of the cervical cancer screening programme, urine tests could be offered as an alternative for women who were reluctant to have a smear test, experts said. Photo / Thinkstock

A simple urine test could offer women a less invasive alternative to the smear test, which screens for cervical cancer.

New research published today reveals urine tests are an accurate and efficient way of screening for the human papilloma virus (HPV). Doctors behind the study say the test could help reverse a fall in the number of young women being screened for possible cancer.

HPV is one of the most common sexually transmitted infections and as many as 80 per cent of women become infected at some point in their lives.

Usually the virus is harmless but in some cases it can cause changes to cells, which can develop into cancer.

Currently, all women in England aged between 24 and 64 are invited for regular smear tests to detect abnormal cells, which could point to a possible cancer. Those aged 25 to 49 are screened every three years; women aged between 50 and 64 are invited every five years.

The process can be time-consuming and invasive, factors which are believed to have contributed to a fall in uptake of the test to below 80 per cent, with a particular decline among young women.

Urine tests that could screen for possible cancer without the discomfort and embarrassment associated with a smear have been considered before but their accuracy has been in doubt.

However, in an analysis of 14 studies involving 1,433 sexually active women, researchers from Barts and The London School of Medicine and Dentistry observed encouraging results.

Although lacking the proven accuracy of cervical screening, urine tests did detect 87 per cent of positive HPV cases, and 94 per cent of negative cases. Urine tests specifically targeted to detect two strains of the virus ? HPV 16 and HPV 18 ? which have been found to cause 70 per cent of cervical cancers, were also successful.

Results varied between the 14 studies but, while urging caution, researchers said they were confident that urine testing "should be considered as an accurate and acceptable alternative that could increase screening coverage".

However, more comprehensive trials would have to be carried out before the urine tests could be considered as part a national screening programme, researchers added.

If deployed as part of the cervical cancer screening programme, urine tests could be offered as an alternative for women who were reluctant to have a smear test, experts said.

Urine tests could also help detect more cancers in poorer countries where medics struggle to carry out a comprehensive smear test screening programme.

In the UK, the success of the NHS screening programme means that cervical cancer remains rare, with around 3,000 cases detected each year.

Liz Engel, spokesperson for the Eve Appeal, which campaigns for better detection and treatment of gynaecological cancers said: "We will be following the development of this encouraging research closely.

"A urine test, which is much less invasive and embarrassing than the current cervical screening test, or smear, will undoubtedly have a positive effect on the number of women being tested.

"Currently, approximately 20 per cent of eligible women invited for cervical screening fail to attend and anything that can be done to encourage more women to be screened should save lives."

- Independent