Cross sectional population based study of testing menstrual blood for human papillomavirus during cervical cancer screening in China

Persistent infection with high-risk HPV is a key factor in the oncogenesis of cervical cancer. A cross sectional population-based study in four urban and three rural communities in the Hubei province, China, compared the diagnostic accuracy of minipad collected menstrual blood versus clinician collected cervical samples to test for HPV in the detection of CIN2+/CIN3+. The study included 3068 women aged 20-54 years with regular menstrual cycles. Minipad based HPV testing showed a sensitivity of 94.7% (95% CI 80.9-99.1) for CIN2+ detection, comparable to clinician based HPV testing (92.1%; 77.5-97.9; p=1.00). Although minipad HPV testing showed lower specificity than clinician HPV testing (89.1% versus 90.0%), the negative predictive value matched that of clinician HPV testing (99.9% versus 99.9%; p=1.00). Both collection methods had a similar positive predictive value (9.9% versus 10.4%; p=0.82) and screening efficiency (10.1 versus 9.6 referrals oer CIN2+ detected; p=0.82). The authors conclude that minipad collected menstrual blood showed comparable diagnostic accuracy to clinician collected cervical samples for HPV testing for detecting CIN2+.