Urine HPV-DNA detection for cervical cancer screening: prospects and prejudices.
Oncogenic types of human papilloma viruses (HPVs) have been established to be the causative agents for cervical cancers and high-grade squamous intraepithelial lesions (HSILs). The clinical application of molecular tests for HPV detection for screening purposes has been of considerable interest. DNA amplification methods allow the use of self-collected samples (including urine) from material collected away from the original disease site. For screening of cervical pathology, detection of HPV-DNA in urine would be useful only if it represents cervical HPV infection and/or HPV-related cervical pathology. We conducted a review of the literature in order to ascertain: (1) if urine is an adequate sample for HPV-detection; (2) whether sensitive techniques are available for HPV-detection in urine and (3) if detection of HPV in urine truly represents cervical infection/pathology. The review process consisted of assembling facts and analysing the published literature on the following facts: anatomical considerations of the lower genital and the lower urinary tract, biological behaviour of HPV and its shedding behaviour, technical issues regarding sample collection, processing and HPV-DNA assay systems, concordance rates of HPV-DNA detection and their type specificity in the paired samples (urine and cervical scrapes) obtained in different clinico-epidemiological settings and comparative detection rates of HSILs in the paired samples.
Sehgal
A
A
Division of Epidemiology and Biostatistics, Institute of Cytology and Preventive Oncology (ICMR), Noida, India. sehgalashok54@yahoo.co.in
Gupta
S
S
Parashari
A
A
Sodhani
P
P
Singh
V
V
D004279:DNA, Viral / Q000652:urine*; D005260:Female; D006801:Humans; D008403:Mass Screening; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000652:urine* / Q000821:virology; D013048:Specimen Handling; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000652:urine* / Q000821:virology; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000652:urine* / Q000821:virology
D004279:DNA, Viral