The potential of urine for human papillomavirus-related cervical cancer prevention

Plain language summary The global strategy of cervical cancer elimination from the world includes regular screening of women for the detection of treatable precancer. The conventional screening method relies on a cervical sample that is taken by a clinician in a health facility to detect the human papillomavirus (the virus that causes cervical cancer) and to investigate the presence of abnormal cells (that might lead to cancer). Current efforts to generalize cervical screening and encourage women to participate include the alternative of detecting human papillomavirus in urinary samples. In this article, we discuss the potential of this alternative and its challenges. Cervical cancer is one of the most preventable cancers. The introduction of human papillomavirus (HPV) vaccines and the adaptation of regular screening programs are key actions that need to be generalized globally to achieve the goal of cervical cancer elimination. However, it is still challenging to achieve satisfactory coverage rate, and many women are reluctant to participate in gynecologic examination. In this article, we review the research on the application of HPV detection in urine samples for cervical cancer screening and vaccine monitoring, as well as discuss the technical challenges and new technological advancements in urine-based tests. HPV detection in urine is an excellent noninvasive alternative that is widely accepted by women, relatively affordable, and provides the potential to reach women without the necessity for clinical visits. Thus, it is an attractive tool for both cervical cancer screening and vaccine monitoring.