title: Accuracy of urinary human papillomavirus testing for the presence of cervical human papillomaviruses and higher grades of cervical intraepithelial neoplasia.
abstract: Although urine-based testing for human papillomavirus (HPV) is being explored as a practical approach for cervical cancer screening, whether the results differ by age, race, or indicators of excess body weight or in populations exposed to HPV vaccines has not been documented by previous studies. The purpose of this study was to determine the accuracy of urinary HPV testing for the presence of cervical HPVs and high-grade cervical intraepithelial lesions (grade 2 and 3 cervical intraepithelial neoplasia [CIN]) by the aforementioned population characteristics.
  
  
  
  The study population consisted of 502 women diagnosed with different grades of CIN. HPV testing was performed with paired urine and cervical cell DNA with the Roche Diagnostics Linear Array test. Agreement coefficient 1 and probabilities were calculated to determine the accuracy of urinary HPV testing for the presence of cervical HPVs and CIN lesions.
  
  
  
  Substantial to almost perfect agreement (0.66-0.83) was observed in the detection of any HPV genotype in urine specimens versus cervical specimens, regardless of the population characteristics. Although the positive predictive value for the detection of CIN lesions was relatively low, the negative predictive value for CIN-3 was high (≥90%) among women positive for any of the urinary or cervical high-risk human papillomavirus (HR-HPV) genotypes or HPV genotypes not included in currently available HPV vaccines.
  
  
  
  The results demonstrate that urinary HPV testing provides highly satisfactory results for excluding the possibility of any cervical HPV infections, including HPV types not included in vaccines and CIN lesions associated with any HR-HPV, regardless of a woman's age, race, or excess body weight. Cancer 2016. © 2016 American Cancer Society. Cancer 2016;122:2836-2844. © 2016 American Cancer Society.
authors.affiliation: Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Chandrika J
authors.initials: CJ
authors.lastname: Piyathilake
authors.affiliation: Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Suguna
authors.initials: S
authors.lastname: Badiga
authors.affiliation: Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Chambers
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Ilene K
authors.initials: IK
authors.lastname: Brill
authors.affiliation: Department of Obstetrics and Gynecology, Morehouse School of Medicine, Atlanta, Georgia.
authors.forename: Roland
authors.initials: R
authors.lastname: Matthews
authors.affiliation: Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Edward E
authors.initials: EE
authors.lastname: Partridge
mesh_terms: D000328:Adult; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000652:urine* / Q000821:virology*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000652:urine* / Q000821:virology*; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000652:urine* / Q000821:virology*
keywords: accuracy; cervical intraepithelial neoplasia (CIN); cervix; human papillomavirus (HPV); urine