Menstrual Blood Sequencing Effective for HPV Screening

By Reuters Staff

January 26, 2022

(Reuters Health) - Screening for human papillomavirus (HPV) in high-risk individuals may be done effectively and noninvasively using menstrual blood testing with target-capture sequencing, a clinical study suggests.

The researchers collected 137 sanitary pads with menstrual blood from 120 women who had already had high-risk HPV detected using a traditional method, cervical HPV GenoArray testing. Researchers completed target capture sequencing of menstrual blood samples to identify high-risk HPV genotypes and see if these findings were concordant with cervical HPV GenoArray results.

Overall, the concordance rate between menstrual blood sample sequencing and cervical HPV GenoArray testing was 92.7%, the authors report in JAMA Network Open.

These results suggest that sanitary pads with menstrual blood might be a feasible and accurate alternative method to screen for HPV, the study team writes. Senior study authors Dr. Chen Cao of Tongji Medical College and the Huazhong University of Science and Technology, in Wuhan, and Dr. Zheng Hu of the First Affiliated Hospital and Sun Yat-sen University in Guangzhou, China, didn't respond to emails seeking comment.

There were 24 menstrual blood samples that had incomplete concordance or discordant results when compared with cervical tissue samples. This included 11 samples that had additional high-risk HPV genotypes, 5 true-negative samples, and 2 samples with high-risk HPV genotypes correctly identified by target-capture screening.

When researchers looked at outcomes based on different menstrual cycle days used for blood sample collection, the found detection of high-risk HPV was similar on different cycle days.

The menstrual blood high-risk HPV positivity rate was 96.4% on menstrual cycle day 1, 91.2% on menstrual cycle day 2, and 96.4% on menstrual cycle day 3. All four samples from menstrual cycle day four were positive as well.

In addition, the sensitivity of high-risk HPV screening based on sequencing of menstrual blood samples was 97.7%

"With the obvious convenience of this method, menstrual blood high-risk HPV capture sequencing may be associated with decreased stigma of gynecological examination and increased participation in cervical cancer screening," the study team writes.

Testing menstrual blood also resulted better detection of additional high-risk HPV infections and multiple high-risk HPV infections when compared with cervical tissue sample testing.

Beyond this, menstrual blood screening was also superior to cervical tissue sample testing for the identification of true negative events and high-risk HPV genotypes, the study team notes.

Beyond its small size, one limitation of the study is that the self-collection of menstrual blood samples can only be done during the menstrual period, a timing that may not always be optimal, the researchers point out. In addition, the study only focused on women with high-risk HPV, limiting generalizability to widespread screening in the general population.

SOURCE: JAMA Network Open, online December 23, 2021.