Diagnostic accuracy of menstrual blood for human papillomavirus detection in cervical cancer screening: A systematic review and meta-analysis

IF 2.5 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in medical sciences Pub Date : 2026-09-01 Epub Date: 2026-09-16 DOI:10.1016/j.advms.2026.09.004

Prayash Paudel, Asutosh Sah

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引用次数: 0

Abstract

Purpose

Cervical cancer is a major global health burden, disproportionately affecting women in low- and middle-income countries (LMICs), where access to traditional human papillomavirus (HPV) screening is limited. Menstrual blood (MB), a non-invasive and passively collectable biospecimen, may offer a culturally acceptable alternative. This review evaluates the diagnostic accuracy of MB-based high-risk HPV detection compared to clinician-collected cervical samples.

Methods

We included diagnostic accuracy studies and randomized controlled trials (RCTs) evaluating self-collected MB for high-risk HPV detection in asymptomatic women aged 25–65 years. Eligible studies reported sensitivity, specificity, or 2×2 data using clinician-collected cervical samples as the reference. We searched PubMed, Embase, and Google Scholar up to July 7, 2025. Risk of bias was assessed via QUADAS-3, and a bivariate random-effects model estimated pooled sensitivity and specificity. Certainty of evidence was assessed using GRADE.

Results

Seven studies (n = 1297 participants; 586 reference-positive, 711 reference-negative) met inclusion criteria. The pooled sensitivity and specificity of MB-based HPV testing were 0.86 (95% CI: 0.80–0.90) and 0.90 (95% CI: 0.72–0.97), respectively. The diagnostic odds ratio was 56 (95% CI: 19–166), and the area under the hierarchical SROC curve was 0.90 (95% CI: 0.87–0.92), indicating high overall diagnostic performance. However, high heterogeneity (I² = 94%) and threshold effects were observed. No significant publication bias was detected (Deeks’ p = 0.62).

Conclusions

MB-based HPV testing demonstrates high diagnostic accuracy and emerges as a non-invasive alternative for cervical cancer screening, especially in underserved settings. Further validation in diverse populations is warranted.

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经血在宫颈癌筛查中检测人乳头瘤病毒的诊断准确性：一项系统综述和荟萃分析。

目的：宫颈癌是一个主要的全球健康负担，对低收入和中等收入国家（LMICs）妇女的影响尤为严重，在这些国家，获得传统人类乳头瘤病毒（HPV）筛查的机会有限。经血（MB）是一种非侵入性和被动采集的生物标本，可能提供一种文化上可接受的替代方法。本综述评估了基于mb的高危HPV检测与临床采集宫颈样本的诊断准确性。方法：我们纳入了诊断准确性研究和随机对照试验（rct），评估25-65岁无症状女性自行采集的MB对高危HPV检测的影响。符合条件的研究报告敏感性、特异性或2×2数据，使用临床收集的宫颈样本作为参考。我们检索了PubMed， Embase和谷歌Scholar，截止日期为2025年7月7日。通过QUADAS-3评估偏倚风险，双变量随机效应模型估计合并敏感性和特异性。使用GRADE评估证据的确定性。结果：7项研究（n = 1,297名受试者，586例参考文献阳性，711例参考文献阴性）符合纳入标准。基于mb的HPV检测的总敏感性和特异性分别为0.86 （95% CI: 0.80-0.90）和0.90 （95% CI: 0.72-0.97）。诊断优势比为56 (95% CI: 19-166)，分层SROC曲线下面积为0.90 (95% CI: 0.87-0.92)，总体诊断效能较高。然而，观察到高异质性（I2 = 94%）和阈值效应。未发现显著发表偏倚（Deeks’p = 0.62）。结论：基于mb的HPV检测显示出较高的诊断准确性，并成为宫颈癌筛查的非侵入性替代方法，特别是在服务不足的环境中。有必要在不同人群中进一步验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in medical sciences 医学-医学：研究与实验

CiteScore

5.00

自引率

0.00%

发文量

审稿时长

25 days

期刊介绍： Advances in Medical Sciences is an international, peer-reviewed journal that welcomes original research articles and reviews on current advances in life sciences, preclinical and clinical medicine, and related disciplines. The Journal’s primary aim is to make every effort to contribute to progress in medical sciences. The strive is to bridge laboratory and clinical settings with cutting edge research findings and new developments. Advances in Medical Sciences publishes articles which bring novel insights into diagnostic and molecular imaging, offering essential prior knowledge for diagnosis and treatment indispensable in all areas of medical sciences. It also publishes articles on pathological sciences giving foundation knowledge on the overall study of human diseases. Through its publications Advances in Medical Sciences also stresses the importance of pharmaceutical sciences as a rapidly and ever expanding area of research on drug design, development, action and evaluation contributing significantly to a variety of scientific disciplines. The journal welcomes submissions from the following disciplines: General and internal medicine, Cancer research, Genetics, Endocrinology, Gastroenterology, Cardiology and Cardiovascular Medicine, Immunology and Allergy, Pathology and Forensic Medicine, Cell and molecular Biology, Haematology, Biochemistry, Clinical and Experimental Pathology.