Testing menstrual blood for human papillomavirus (HPV) may offer a viable alternative to traditional cervical cancer screening methods, according to new research from China published in The BMJ.
The study suggests that collecting menstrual blood using a minipad is both convenient and non-invasive, allowing women to collect samples at home. This approach could help increase access to cervical cancer screening, particularly among women who may avoid clinic visits due to concerns about pain, privacy, stigma, or lack of awareness.
Researchers conducted the study with 3,068 women aged 20-54 years from both urban and rural communities in Hubei Province. Each participant provided three types of samples: a menstrual blood sample collected via minipad, a clinician-collected cervical sample for comparison, and an additional cervical sample for laboratory analysis.
Participants also had access to test results and healthcare advice through the Early Test mobile app on WeChat. This integration was noted by the authors as enhancing communication and streamlining the process for large-scale implementation.
The main outcomes measured were diagnostic sensitivity and specificity. Sensitivity refers to how well a test identifies those with disease, while specificity measures how well it identifies those without disease.
The results showed that minipad-collected samples had a sensitivity of 94.7% for detecting high-grade cervical lesions (CIN2+), similar to clinician-collected samples at 92.1%. Specificity was slightly lower for minipad samples (89.1%) compared to clinician samples (90.0%). However, both methods had an identical negative predictive value of 99.9%, indicating strong reliability in ruling out disease when test results are negative.
Positive predictive values and referral rates for further testing were also comparable between the two collection methods.
While these findings are observational and have certain limitations, the authors state: "The results of this large scale community based study show the utility of using minipad collected menstrual blood for HPV testing as a standardised, non-invasive alternative or replacement for cervical cancer screening."
They add: "The findings of this study support the integration of menstrual blood based HPV testing into national cervical cancer screening guidelines."
