title: HPV Testing from Dried Urine Spots as a Tool for Cervical Cancer Screening in Low-Income Countries.
abstract: Nowadays, several screening strategies are available to prevent cervical cancer, but inadequate resources, sociocultural barriers, and sampling issues impede their success in low-income countries. To overcome these issues, this study aimed to evaluate the performance of human papillomavirus (HPV) testing from dried urine spots (DUS). Eighty-eight urine samples (including 56 HPV DNA positive specimens) were spotted on filter paper, dried, and stored in paper-bags. HPV DNA was detected from the DUS after 1 week and 4 weeks of storage using a polymerase chain reaction (PCR) assay. The sensitivity, specificity, and concordance of the DUS-based HPV test were evaluated by comparing the results with those of HPV testing on fresh urine samples as the gold standard. The sensitivity of the test was 98.21% (95% CI: 90.56-99.68) for DUS stored for 1 week and 96.42% (95% CI: 87.88-99.01) for DUS stored for 4 weeks. The specificity was 100% (95% CI: 89.28-100) at both time points. The concordance between DUS and fresh urine HPV testing was "almost perfect" using the κ statistic. These preliminary data suggest that a DUS-based assay could bypass sociocultural barriers and sampling issues and therefore could be a suitable, effective tool for epidemiological surveillance and screening programs, especially in low-income countries.
authors.affiliation: Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy.
authors.forename: Elena Rosanna
authors.initials: ER
authors.lastname: Frati
authors.affiliation: Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy.
authors.forename: Marianna
authors.initials: M
authors.lastname: Martinelli
authors.affiliation: Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy.
authors.forename: Ester
authors.initials: E
authors.lastname: Fasoli
authors.affiliation: Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Colzani
authors.affiliation: Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Bianchi
authors.affiliation: Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Binda
authors.affiliation: NAGA Onlus, 20136 Milan, Italy.
authors.forename: Pierfranco
authors.initials: P
authors.lastname: Olivani
authors.affiliation: Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Tanzi
mesh_terms: D000328:Adult; D052685:Alphapapillomavirus; D004279:DNA, Viral / Q000652:urine*; D003906:Developing Countries; D005260:Female; D006801:Humans; D008403:Mass Screening; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000652:urine*; D016133:Polymerase Chain Reaction / Q000379:methods; D014556:Urine / Q000821:virology*; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000652:urine*
chemical_list: D004279:DNA, Viral