NIHR | Manchester Biomedical Research Centre

Urine Test Could Prevent Cervical Cancer

Urine testing may be as effective as the smear test at preventing cervical cancer, according to new research led by BRC Cancer Early Detection Programme Lead Dr Emma Crosbie.

Emma’s finding’s, recently published in BMJ Open journal, found that urine testing was just as good as the cervical smear at picking up high-risk human papillomavirus (HPV), the virus that causes cervical cancer.

The research – supported by the Manchester NIHR Biomedical Research Centre (BRC) – indicates that a urine test could help increase the numbers of women who are screened for cervical cancer, which affects more than 3,000 women every year in the UK. Urine testing could also have a role in the developing world, where cervical cancer is up to 15 times more common and smear testing largely non-existent.

The NHS cervical screening programme tests for so called ‘high-risk’ types of human papillomavirus (HPV) and the health of the cells of the cervix in women who test high-risk HPV positive. Around 1 in 20 women show abnormal changes which might go on to become cancer and are referred for colposcopy, where the cervix is examined under magnification, allowing abnormal areas to be seen, sampled and treated, before they ever cause cancer.

Dr Emma Crosbie

According to the team, cervical smear samples, self-collected vaginal samples and urine samples are all effective at picking up high risk HPV infection.

Cervical cancer is most common in women aged 30 to 35 years. But the precancerous stage is detectable in the 5-10 years before this, when up to a third of women fail to attend for their smear test.

Dr Crosbie, who is also a Senior Lecturer and Honorary Consultant Gynaecological Oncologist at Saint Mary’s Hospital and the University of Manchester, said:


We’re really very excited by this study, which we think has the potential to significantly increase participation rates for cervical cancer screening in a key demographic group.

“Many younger women avoid the NHS cervical cancer screening programme because they find it embarrassing or uncomfortable, particularly if they have gynaecological conditions like endometriosis.”

“Campaigns to encourage women to attend cervical screening have helped – the brilliant campaign by the late Jade Goody increased numbers attendance by around 400,000 women – but sadly, the effects aren’t long lasting and participation rates tend to fall back after a while. We clearly need a more sustainable solution.”

104 women attending the colposcopy clinic at St Mary’s Hospital, Manchester participated in the study and were screened using conventional HPV testing kits. Of these, 18 women were identified as having pre-cancerous changes to the cervix that needed treatment.

With the Roche HPV testing kit, urine, vaginal self-samples and cervical smears picked up 15 of these; and with the Abbott HPV testing kit, urine picked up 15 of these and vaginal self-samples and cervical smears picked up 16.

Dr Crosbie said: “These results provide exciting proof of principle that urine HPV testing can pick up cervical pre-cancer cells, but we need to trial it on a greater number of women before it can be used in the NHS. We hope that is going to happen soon.”

“Urine is very simple to collect and most hospitals in the developed and developing world have access to the lab equipment to process and test the samples. Let’s hope this is a new chapter in our fight against cervical cancer, a devastating and pernicious disease.”