Testing menstrual blood for human papillomavirus (HPV) shows promise as a non-invasive alternative to traditional cervical cancer screening, according to a recent large-scale study conducted in China. The research indicates that HPV testing using menstrual blood collected with a simple, self-administered method demonstrates diagnostic accuracy comparable to that of samples collected directly by clinicians.
The study, a cross-sectional analysis, involved 3,068 women aged 20 to 54 years with regular menstrual cycles. Participants were recruited from both urban and rural communities within Hubei Province between September 2021 and January 2025. Each woman provided three distinct samples: menstrual blood collected using a sterile cotton strip affixed to a sanitary pad – referred to as a “minipad” – a clinician-collected cervical sample for HPV testing, and cytology samples. Women who tested positive were then referred for colposcopy and biopsy to confirm the presence of cervical intraepithelial neoplasia grade 2 or worse (CIN2+), which served as the primary endpoint for evaluating the test’s effectiveness.
Menstrual Blood Testing Shows High Accuracy
The results revealed a high degree of correlation between the two testing methods. Menstrual blood HPV testing achieved a sensitivity of 94.7% in detecting CIN2+, closely mirroring the 92.1% sensitivity of clinician-collected testing. Sensitivity refers to the test’s ability to correctly identify those with the condition. While the specificity of the minipad method was slightly lower – 89.1% compared to 90.0% for the clinician-collected samples – both methods exhibited identical negative predictive values of 99.9%. This exceptionally high negative predictive value is particularly significant, as it indicates a strong assurance of a true negative result when the test is negative.
Positive predictive value and the efficiency of referrals for further investigation were also found to be similar between the two approaches. This suggests that using menstrual blood for HPV screening doesn’t necessarily increase the number of women unnecessarily referred for colposcopy.
HPV infection is a major cause of cervical cancer, and screening programs have been instrumental in reducing the incidence of this disease globally. However, participation in these programs can be hindered by factors such as discomfort associated with the traditional screening procedure, feelings of stigma, and limited access to healthcare facilities. Researchers believe that menstrual blood sampling could potentially overcome these barriers by allowing individuals to collect specimens privately at home during their menstrual period, thereby improving access to screening, particularly for underserved populations.
Potential for Wider Adoption and Digital Integration
The study also explored the potential for integrating technology into the screening process. Participants were able to receive their test results and follow-up advice through a mobile application, demonstrating the feasibility of combining self-sampling with telehealth support. This could streamline the screening process and provide more convenient access to care.
While the findings are encouraging, the study authors emphasize that the observational design necessitates further research before widespread implementation. Prospective trials and validation studies across diverse populations will be crucial to determine how menstrual blood testing can be effectively incorporated into existing cervical cancer screening guidelines. These future studies will need to assess the long-term impact of this approach on cervical cancer incidence and mortality.
The development of this method could represent a significant shift towards more patient-centered cervical cancer prevention strategies. It has the potential to complement, rather than replace, clinician-based screening, while simultaneously reducing logistical and psychological barriers that currently limit participation in screening programs. This is particularly relevant given that a significant proportion of women do not adhere to recommended screening schedules.
According to the BBC, the current NHS test involves a nurse or doctor taking a sample of cells from the cervix, but approximately one-third of women invited for screening do not attend. Finding new and potentially gentler ways of testing for the disease is therefore seen as a positive step.
The study, published in The BMJ, adds to a growing body of evidence supporting the use of non-invasive sampling methods for cervical cancer screening. A similar study, reported by Scientific American on February 5, 2026, also demonstrated the reliability of HPV detection from menstrual blood collected on a sanitary pad.
Researchers estimate that cervical cancer will be responsible for approximately 4,200 deaths in the United States this year, highlighting the importance of continued efforts to improve screening rates and develop more accessible screening methods.
Reference
Xun T et al. Testing menstrual blood for human papillomavirus during cervical cancer screening in China: cross sectional population based study. BMJ. 2026; 392:e084831.
