A systematic review and meta-analysis of diagnostic accuracy of urine self-sampling for human papillomavirus detection in cervical cancer screening
A partir d'une revue systématique de la littérature publiée entre 2013 et 2023 (13 études), cette méta-analyse évalue la sensibilité et la spécificité des échantillons urinaires auto-prélevés pour détecter les papillomavirus humains dans le cadre du dépistage du cancer du col de l'utérus
Objective : This review assessed the diagnostic accuracy of urine self-sampling for human papillomavirus (HPV) detection compared with clinician-collected cervical and vaginal samples.
Methods : A systematic search of PubMed, and Embase (January 2013–October 2023) identified full-text English studies evaluating urine-based HPV testing conducted in clinical settings and compared with provider-collected samples. Data were extracted using a standardised form, with sensitivity and specificity as primary outcomes. Risk of bias was assessed using QUADAS-2 and QUADAS-C tools. The review followed PRISMA-P guidelines and was registered in PROSPERO (CRD42024511154). A random-effects meta-analysis summarised diagnostic accuracy.
Results : Of 1657 citations, 13 studies met the inclusion criteria. Urine sampling showed lower sensitivity for detecting high-risk HPV and high-risk HPV-associated high-grade squamous intraepithelial lesions (HSIL) than vaginal samples, although specificities were comparable (87% for urine vs. 88% for vaginal samples). Sensitivity for detecting high-risk HPV-HSIL was 75% for urine, compared with 92% for vaginal and 95% for cervical samples. Cervical samples demonstrated the highest diagnostic accuracy, followed by vaginal samples, while urine samples performed the lowest on the summary receiver operating characteristic (ROC) curve.
Conclusion : Urine self-sampling is a non-invasive and acceptable option but demonstrates reduced sensitivity compared with vaginal and cervical sampling. Despite lower accuracy, its convenience may support screening among women who might otherwise not participate.
Journal of Medical Screening , résumé, 2026