A less invasive method for cervical cancer screening may be on the horizon. Researchers have found that testing menstrual blood for signs of the human papillomavirus (HPV) is comparable in accuracy to traditional methods that require a clinician to collect a cervical sample.
Persistent infection with certain types of HPV is the primary cause of cervical cancer, making HPV testing a crucial component of screening programs. However, participation in these programs isn’t universal. Many individuals decline screening due to factors such as fear of pain, concerns about privacy, stigma, or a lack of information. This has prompted a search for alternative screening methods that are more accessible and acceptable.
A study conducted in China investigated the diagnostic accuracy of HPV testing using menstrual blood compared to clinician-collected cervical samples. The goal was to determine if menstrual blood could reliably detect high-grade cervical lesions – specifically CIN2+ or CIN3+ – which typically require treatment.
How the Study Was Conducted
The research involved 3,068 women aged 20 to 54 with regular menstrual cycles, recruited between September 2021 and January 2025 from both urban and rural communities in Hubei Province, China. Each participant provided three samples: a menstrual blood sample collected using a “minipad” – a sterile cotton strip attached to a sanitary pad – a cervical sample collected by a clinician, and an additional cervical sample for laboratory processing.
Participants also had access to a WeChat mobile application called “Early Test,” which provided test results and health recommendations from professionals. This integration aimed to streamline communication and support patient care.
The study focused on two key metrics: sensitivity and specificity. Sensitivity measures a test’s ability to correctly identify individuals with the disease, while specificity measures its ability to correctly identify those without the disease.
Study Findings
The HPV testing performed on menstrual blood samples collected with the minipad demonstrated a sensitivity of 94.7% for detecting CIN2+ lesions. This was comparable to the sensitivity of the clinician-collected cervical samples, which was 92.1%.
Specificity was slightly lower for the menstrual blood samples, at 89.1%, compared to 90.0% for the cervical samples. However, the negative predictive value – the probability that a negative test result accurately indicates the absence of disease – was identical for both methods, at 99.9%.
There were also no significant differences in positive predictive value (9.9% for minipad vs. 10.4% for cervical samples) or the rate of referral to colposcopy, a procedure to further examine the cervix, between the two methods.
Researchers noted that the integration of the mobile application facilitated communication of results and counseling, potentially easing wider implementation of this screening approach.
The study’s authors emphasize that the findings support the use of menstrual blood analysis with a minipad as a non-invasive and standard alternative for cervical cancer screening. They suggest that these results warrant consideration for inclusion in national cervical cancer screening guidelines.
The study, published on , in The BMJ, is an observational study, and the authors acknowledge certain limitations. Nevertheless, they conclude that the data obtained supports the use of menstrual blood collected with a minipad as a viable alternative for cervical cancer screening.
This research builds on earlier findings. A preliminary study, published in December 2021, also suggested the feasibility and accuracy of menstrual blood testing for HPV detection using capture sequencing. This earlier research indicated that menstrual blood-based HPV testing could be a self-collected approach to cervical cancer screening.
Currently, in the UK, cervical screening is offered to all women and individuals with a cervix every five years between the ages of 25 and 64. The current NHS test involves a nurse or doctor taking a sample of cells from the cervix. However, approximately one-third of those invited for screening do not attend. The NHS is also implementing at-home test kits, initially for those who have missed several appointments, which involve a vaginal swab.
Finding new and potentially gentler ways to test for cervical cancer is encouraging, particularly as barriers to traditional screening – including fear, pain, discomfort, and cultural factors – can disproportionately affect younger women, individuals with disabilities, and those from ethnic minority communities and LGBTQ+ groups.
