Vaccination and improved screening access are highly effective against HPV 16 and 18, but their full impact will take years to show. Until then, easy and acceptable screening tools are vital.
South Korea: Urine tests may be just as effective as vaginal swabs in detecting high-risk strains of the human papillomavirus (HPV) – including HPV 16 and 18, which cause most cervical cancer cases.
Human papillomavirus (HPV) is a common sexually transmitted infection caused by a DNA virus, with over 200 types, some of which cause warts (low-risk) and others cancer (high-risk) of the cervix, anus, mouth, and other areas.
Traditionally, cervical cancer screening requires a healthcare professional to collect cell samples directly from the cervix. While accurate, the procedure can be uncomfortable and is one reason many women skip screening. To improve uptake, countries like the US, Canada, and soon the UK have introduced self-collected vaginal swabs, which are easier but still not acceptable for everyone.
Researchers are now exploring urine testing as a simpler alternative. Previous studies suggested HPV DNA can be found in urine, and a new study led by Julia Lynch at the International Vaccine Institute in Seoul, South Korea, strengthens this evidence.
Her team worked with 753 sexually active women aged 18–25 in Bangladesh, Pakistan, and Nepal. Each participant provided a urine sample and also carried out a self-collected vaginal swab in a clinic. The results showed:
- 5.3% of swabs tested positive for at least one of seven high-risk HPV strains, compared with 5% of urine samples.
- For the most dangerous strains, HPV 16 and 18, the results were nearly identical: 2.3% for swabs vs. 2.4% for urine tests.
Many women also found urine collection more acceptable. “In some cultural and social contexts, vaginal swabs are less acceptable, especially for younger women,” Lynch explains.
Urine Test Could be a Game Changer
The World Health Organization (WHO) has set a global target to eliminate cervical cancer, relying on widespread HPV vaccination and improved screening access. Vaccines are highly effective against HPV 16 and 18, but their full impact will take years to show at the population level. Until then, easy and acceptable screening tools are vital.
Urine testing could be a game changer in low- and middle-income countries, where barriers to traditional screening remain high. It may also help identify which HPV strains are circulating outside North America and Europe, where most HPV risk data currently comes from.
However, experts caution that this study only involved young women, so more research is needed in older age groups. Lynch notes that this trial is part of a larger project examining HPV prevalence in eight countries across South Asia and Africa.
If future results confirm its accuracy across wider groups, urine testing could transform cervical cancer prevention worldwide—making screening less invasive, more accessible, and potentially saving millions of lives.
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