The Utility of Urine-Based Sampling for Cervical Cancer Screening in Low-Resource Settings

Sasidharanpillai Sabeena, Santhosh Kuriakose, Damodaran Binesh, Jazeel Abdulmajeed, Giselle Dsouza, Amrutha Ramachandran, Bindu Vijaykumar, Sushama Aswathyraj, Santhosha Devadiga, Nagaraja Ravishankar, Govindakarnavar Arunkumar

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


Background: WHO has recommended Visual Inspection with Acetic acid (VIA) or Human Papillomavirus (HPV) DNA testing if feasible, for cervical cancer screening in low income countries. However, the number of women undergoing screening is very low as a result of limited information, inadequate infrastructure and invasive nature of sampling. Methods: A cross sectional study was carried out comparing HPV DNA detection by Polymerase Chain Reaction (PCR) in paired cervical and urine samples procured from histologically confirmed cervical cancer cases. Results: Amongst the samples collected from 114 cervical cancer cases, HPV DNA was tested positive in cervical samples of 89 (78.1%) and urine samples of 55 (48.2%) patients. The agreement between the two sampling methods was 66.7% and the kappa value was 0.35 indicating a fair agreement. The sensitivity of HPV detection using urine samples was 59.6% (95% confidence interval 49.16%-69.15%) and the specificity was 92% (95% confidence interval 75.0%-97.8%). Conclusion: Even though not acceptable as an HPV DNA screening tool due to low sensitivity, the urine sampling method is inexpensive and more socially acceptable for large epidemiological surveys in developing countries to estimate the burden.

Original languageEnglish
Pages (from-to)2409-2413
Number of pages5
JournalAsian Pacific journal of cancer prevention : APJCP
Issue number8
Publication statusPublished - 01-08-2019

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Oncology
  • Public Health, Environmental and Occupational Health
  • Cancer Research


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