Menstrual Blood Explored as Non-Invasive HPV Screening Method

Researchers have studied menstrual blood as a potential non-invasive sample for detecting high-risk human papillomavirus (hrHPV) in cervical cancer screening. Multiple studies have evaluated its diagnostic performance and compared it to traditional clinician-collected cervical samples.

A systematic review of five studies reported that menstrual blood testing for HPV detection showed sensitivity between approximately 82.8% and 97.7%, with specificity ranging from about 50% to 98%. These findings indicate varying accuracy depending on the study and testing method used.

In a cohort study involving 120 premenopausal women with hrHPV, menstrual-blood hrHPV capture sequencing achieved a concordance rate of 92.7% with clinician-collected cervical HPV testing. The same study found a sensitivity of 97.7% for the menstrual-blood method compared to the standard cervical test.

What the numbers show

• Menstrual blood HPV test sensitivity ranged from 82.8% to 97.7% across studies
• Specificity values for these tests varied from 50% to 98%
• A modified menstrual pad study found 94% concordance with clinician-collected samples

Another study that used a modified menstrual pad for self-collection reported a 94% concordance rate with clinician-collected cervical specimens for hrHPV detection. In the same research, 94% of participants stated a preference for the menstrual pad self-collection method over traditional sampling.

Additional research using an 'M-strip' for menstrual-blood self-sampling found complete agreement between hrHPV DNA results from menstrual blood and direct cervical smears in tested samples. A clinical trial at Stanford also investigated the feasibility of detecting hrHPV DNA and E6/E7 mRNA using a smart menstrual pad for self-collected samples.

In a pilot study with 19 women, menstrual-blood HPV testing showed a sensitivity of 87.5% and specificity of 45.5% for detecting cervical intraepithelial neoplasia grade 3 or worse. Another study with 235 patients reported a sensitivity of 82.8% and specificity of 93.1% for menstrual-blood HPV DNA testing in those with cervical intraepithelial neoplasia or condyloma.

Researchers stated that menstrual-blood hrHPV capture sequencing was able to identify additional hrHPV genotypes and true-negative samples that conventional cervical testing did not detect. These findings suggest that menstrual blood sampling may offer complementary information to existing screening methods.

* This article is based on publicly available information at the time of writing.