{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:19:10Z","timestamp":1792685950478,"version":"4.5.0"},"reference-count":35,"publisher":"Royal College of General Practitioners","issue":"761","license":[{"start":{"date-parts":[[2019,2,12]],"date-time":"2019-02-12T00:00:00Z","timestamp":1549929600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Gen Pract"],"accepted":{"date-parts":[[2025,6,9]]},"published-print":{"date-parts":[[2025,12,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cervical screening uptake is decreasing in the UK, with only 67.5% of those eligible under 50 years old attending in 2022. Barriers include restricted access to screening appointments and poor acceptability of the speculum examination. Urine self-sampling is an alternative cervical screening method that has the potential to improve uptake.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To determine the clinical performance and acceptability of human papillomavirus (HPV)-tested urine for cervical screening in a UK general screening population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and setting<\/jats:title>\n                    <jats:p>Prospective, cross-sectional diagnostic test accuracy study in North-West England.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Urine was self-collected using a first-void urine (FVU) collection device (DNA Genotek Colli-Pee\u00ae 10 ml with urine conservation medium) before obtaining matched routine cervical screening samples. HPV testing used Roche Cobas\u00ae 8800 at cervical sample thresholds. A questionnaire evaluated urine self-sampling acceptability. HPV-positive cervical samples underwent reflex cytology, managed under standard NHS protocols, and clinical outcomes were collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 1517 participants provided matched urine and cervical samples. There were 207 of 1517 (13.6%) cervical and 245 of 1517 (16.2%) urine samples that were HPV positive with a 1.6% (\n                      <jats:italic>n<\/jats:italic>\n                      = 25\/1517) incidence of cervical intraepithelial neoplasia (CIN)2+ following colposcopic assessment (\n                      <jats:italic>n<\/jats:italic>\n                      = 80). The specificity of urine was non-inferior (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.0004) to the specificity of cervical samples at 85.19% (95% confidence interval [CI] = 83.28 to 86.95) versus 87.80% (95% CI = 86.03 to 89.42), giving a relative specificity of 0.97 (95% CI = 0.95 to 0.99). Urine detected 24 of 25 (96.0%) participants with CIN2+. In the future, 41.6% (\n                      <jats:italic>n<\/jats:italic>\n                      = 575\/1382) of participants would prefer current cervical screening, compared with 30.0% (\n                      <jats:italic>n<\/jats:italic>\n                      = 414\/1382) with no preference and 28.4% (\n                      <jats:italic>n<\/jats:italic>\n                      = 393\/1382) preferring urine self-sampling.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>HPV-tested urine showed non-inferior specificity to cervical samples in a general screening population. Urine self-sampling was acceptable to current attenders but some prefer traditional screening, making choice an important consideration for policymakers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3399\/bjgp.2025.0105","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T16:05:19Z","timestamp":1757952319000},"page":"e853-e861","source":"Crossref","is-referenced-by-count":6,"title":["Urine human papillomavirus testing for cervical screening in a UK general screening population: a diagnostic test accuracy study"],"prefix":"10.3399","volume":"75","author":[{"given":"Jennifer 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