Testing menstrual blood for HPV could be alternative to smear test, study finds

Testing period blood for human papillomavirus (HPV) could be a “robust alternative or replacement” for a smear test, researchers have said.

Using a regular sanitary pad topped with a blood sample strip, researchers were able to detect HPV, which causes 99.7 per cent of cervical cancer cases.

Currently, most women undergo cervical screening under the care of a medic, who collects a sample via a small brush inserted into the vagina, to test for the virus.

Some women are also using home testing kits though these are not routinely given out to everyone in the UK.

But not all women attend screening appointments for reasons including fear of pain, concerns about privacy and stigma, and lack of awareness.

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“It’s encouraging to see research exploring new ways to make cervical screening more accessible,” Sophie Brooks, health information manager at Cancer Research UK said.

“Testing menstrual blood for HPV is an interesting, non-invasive approach, and could potentially offer another option in the future.”

For the study published in the British Medical Journal (BMJ), researchers in China compared the diagnostic accuracy of menstrual blood versus samples collected by a clinician for detecting cervical cell abnormalities (CIN2 and CIN3), which can require treatment.

They tested the special sanitary pad on 3,068 women in an area of China, aged 20 to 54 with regular menstrual cycles, between 2021 and 2025.

Each woman provided three samples for testing: a menstrual blood sample collected using a sanitary pad and strip, a cervical sample collected by a clinician, and an additional sample collected by a health worker for processing in the lab.

Researchers assessed the sensitivity of the test, which indicates how well it picks up people who have a disease, as well as specificity, which picks up people without the disease.

The pad collected samples showed a sensitivity of 94.7 per cent for detecting CIN2 in comparison to the clinician collected samples which had a sensitivity of 92.1 per cent.

Although the pad samples performed less well on specificity, than clinician samples (89.1 per cent vs 90.0 per cent), the probability that a person with a negative test result truly did not have the disease was also identical for both collection methods.

Participants were also able to use WeChat mobile app which allowed them to access test results and advice from healthcare providers.

The study authors concluded: “The results of this large scale community based study show the utility of using minipad collected menstrual blood for HPV testing as a standardised, non-invasive alternative or replacement for cervical cancer screening.”

“The findings of this study support the integration of menstrual blood based HPV testing into national cervical cancer screening guidelines.”

However, these are observational findings so no firm conclusions can be drawn about cause and effect.

There are around 3,300 new cases of cervical cancer every year, but rates of the disease have decreased by a quarter since the early 1990s.

About 70 per cent of cases are prevented through cervical screening, according to cancer research, and the HPV vaccine is cutting cases of cervical cancer by 90 per cent.

Athena Lamnisos, chief executive of the Eve Appeal, welcomed the study and said existing cervical screening “can be difficult for some women for many reasons, like if they have had a bad previous experience, they are menopausal, they have a physical or learning disability, cultural barriers, or are a survivor of sexual violence”.

She added: “The ability to test for HPV in menstrual blood isn’t the answer for everyone though – people are eligible for screening until 64 and many will be menopausal.

“People have different barriers and concerns about screening, so being able to offer a choice of different methods could be very positive for some who are eligible for screening but don’t currently attend.”