Screening Tool For Cervical Cancer Research Articles

The Potential of Urine for Human papillomavirus-related Cervical Cancer Prevention

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.

126 Use of the aptima mrna high risk hpv assay combined with liquid based cytology as primary screening tool for cervical cancer (PRELIMINARY RESULTS)

Introduction: During the last decades many countries have established national screening programs that include co-testing (HPV DNA and cytology). The addition of HPV testing to cytology resulted in an increased detection of CIN3+, permitting a longer interval between screens. In Greece there are not specific guidelines and cervical screening is based mostly on cytology. Our aim was to estimate the impact of using Aptima mRNA test combined with liquid based cytology in a primary HPV cervical screening program.

Study protocol of the ACCESS trial: a randomised trial to evaluate the effectiveness of human papillomavirus testing by self-sampling in cervical cancer screening uptake and precancer detection

IntroductionRecently, the incidence of cervical cancer has increased in Japan, probably because of an interruption in human papillomavirus (HPV) vaccination and a low cervical cancer screening rate. There is a...

Targeted Next Generation Sequencing for Human Papillomavirus Genotyping in Cervical Liquid-Based Cytology Samples.

Simple SummaryTesting for Human Papillomavirus (HPV) is currently being implemented as part of cervical cancer (CC) screening in several countries. However, infections with all but one of the HPV types classified as possibly carcinogenic cannot be detected by the assays used for CC screening today. The aim of our study was to demonstrate the use of a targeted next generation sequencing (NGS) HPV panel for CC screening—both general practitioner-collected samples and self-samples. We here show that the targeted HPV panel can detect HPV with a sensitivity and specificity similar to commercial HPV assays, one of which is used for CC screening today. However, the targeted HPV panel possess several advantages compared to the screening assays, as it enables specific detection of all relevant HPV types and can identify viral integration, variants in the HPV genome, and dominant HPV types in multi-infected cases.At present, human papillomavirus (HPV) testing is replacing morphology-based cytology as the primary tool for cervical cancer screening in several countries. However, the HPV assays approved for screening lack detection for all but one of the possibly carcinogenic HPV types and do not genotype all included HPV types. This study demonstrates the use of a targeted HPV next generation sequencing (NGS) panel to detect and genotype all 25 carcinogenic, probably carcinogenic, and possibly carcinogenic HPV types as well as the low-risk types HPV6 and HPV11. The panel was validated using a cohort of 93 paired liquid-based cytology samples (general practitioner (GP)-collected cervical samples and cervico-vaginal self-samples (SS)). Overall, the targeted panel had a sensitivity (GP = 97.7%, SS = 92.1%) and specificity (GP = 98.0%, SS = 96.4%) similar to the commercial HPV assays, Cobas® 4800 HPV DNA test (Roche) and CLART® HPV4S assay (GENOMICA). Interestingly, of the samples that tested positive with the NGS panel, three (6.4%) of the GP-collected samples and four (9.1%) of the self-samples tested positive exclusively for HPV types only included in the NGS panel. Thus, targeted HPV sequencing has great potential to improve the HPV screening programs since, as shown here, it can identify additional HPV positive cases, cases with HPV integration, variants in the HPV genome, and which HPV type is dominant in multi-infected cases.

How Liquid Based Cytology Surpasses Conventional Cytology - A Review Article

Pap smear is the most widely used test for screening of cervical cancer and precancerous lesions. Liquid-based cytology is a cervical cancer screening technology that inspects cells by dissolving them in liquid and is used as a main screening tool for invasive cervical cancer. The purpose of this article is to demonstrate how fluid-based cytology has surpassed conventional cytology in the interpretation of cervical smear biopsy results in order to identify early cervical lesions in a more efficient and convenient manner, allowing for early diagnosis and treatment of cervical cancer patients and thus improving patient wellbeing.

Perception and knowledge of human papillomavirus (HPV) vaccine for cervical cancer prevention among fully vaccinated female university students in the era of HPV vaccination: a cross-sectional study

ObjectiveTo assess the perception and knowledge of cervical cancer prevention among fully vaccinated female university students in the era of human papillomavirus (HPV) vaccination.DesignCross-sectional using a validated questionnaire.SettingFace-to-face interview at...

HPV16 Load Is a Potential Biomarker to Predict Risk of High-Grade Cervical Lesions in High-Risk HPV-Infected Women: A Large Longitudinal French Hospital-Based Cohort Study.

Simple SummaryThis study aimed at assessing HPV16 and HPV18 viral loads to predict the development of cervical high-grade lesion. Among 885 women positive for hrHPV and presenting no or mild cytological abnormalities, HPV16 and HPV18 prevalence was 25.9% and 8.4%, respectively. Of those women, 135 developed a high-grade lesion during the follow-up. Considering an HPV16 viral load cut-off set at 3.2 log10 GE/103 cells a subgroup of women at high risk of developing high-grade cervical lesion (HR = 2.67; 95% CI 1.80–3.97 p ≤ 0.0001) has been identified. Moreover, a composite score based on HPV16 load, cytology and hrHPV detection allowed for CIN2+ risk stratification. To conclude, HPV16 load is a relevant biomarker to identify women at high risk for developing precancerous lesions of the cervix. High-risk HPV (hrHPV) testing has been implemented as a primary screening tool for cervical cancer in numerous countries. However, there is still a need for relevant triage strategies to manage hrHPV positive women to avoid excessive referral to colposcopy. The objective of this study was to assess, in women infected by hrHPV and presenting no or mild cytological abnormalities, HPV16 and HPV18 viral loads to predict the development of cervical high-grade lesion. Among 2102 women positive for hrHPV, 885 had no lesion or mild cytological abnormalities at baseline and had at least one follow-up (FU) visit. HPV16 and HPV18 prevalence was 25.9% and 8.4%, respectively. Of those women, 15% developed a high-grade lesion during the FU. An HPV16 viral load cut-off set at 3.2 log10GE/103 cells permitted to identify a subgroup of women at high risk of developing high-grade cervical lesion (HR = 2.67; 95% CI 1.80–3.97; p ≤ 0.0001). No specific HPV18 viral load threshold could have been defined in regard to the present study. In multivariate analysis, HPV16 load (absence/log10GE/103 cells < 3.2 vs. ≥3.2), RLU/PC 239 (1–100 pg/mL vs. >100 pg/mL) and cytology (normal vs abnormal) were independently associated with a significant increased risk of high-grade lesion development and were used to construct the prognostic score. In conclusion, HPV16 load is a relevant biomarker to identify women at high risk for developing cervical precancerous lesions.

Liquid Biopsy in Cervical Cancer: Hopes and Pitfalls.

Simple SummaryCervical cancer is the fourth most common cancer in women worldwide, and its incidence is variably distributed between developed and less-resourced countries, in which socio-economic issues and religious beliefs often limit the widespread diffusion and the access to screening campaigns. In the “liquid biopsy” era, the application of non-invasive and repeatable techniques to the identification of diagnostic, prognostic, and predictive biomarkers might facilitate the management of this disease and, hopefully, improve its outcome. The purpose of this review is to explore the progress status of liquid biopsy in cervical cancer patients. Several methods are described, which include the analysis of circulating tumor cells, the search for pathogenic mutations on circulating tumor DNA, as well as the identification of circulating RNAs, focusing on their potential clinical applications and current limitations.Cervical cancer (CC) is the fourth most common cancer in women worldwide, with about 90% of cancer-related deaths occurring in developing countries. The geographical influence on disease evolution reflects differences in the prevalence of human papilloma virus (HPV) infection, which is the main cause of CC, as well as in the access and quality of services for CC prevention and diagnosis. At present, the most diffused screening and diagnostic tools for CC are Papanicolaou test and the more sensitive HPV-DNA test, even if both methods require gynecological practices whose acceptance relies on the woman’s cultural and religious background. An alternative (or complimentary) tool for CC screening, diagnosis, and follow-up might be represented by liquid biopsy. Here, we summarize the main methodologies developed in this context, including circulating tumor cell detection and isolation, cell tumor DNA sequencing, coding and non-coding RNA detection, and exosomal miRNA identification. Moreover, the pros and cons of each method are discussed, and their potential applications in diagnosis and prognosis of CC, as well as their role in treatment monitoring, are explored. In conclusion, it is evident that despite many advances obtained in this field, further effort is needed to validate and standardize the proposed methodologies before any clinical use.

Development and utilization of a novel cervical visualization tool, the Callascope, for home-based self-exams

<h3>Objectives:</h3> Invasive cervical cancer is preventable yet it affects 500,000 women annually. Barriers to screening include lack of awareness of cervical cancer, fear of the speculum, and lack of affordable screening technologies. We developed a low-cost, cervical imaging device, the Callascope, as an alternative to the traditional speculum and colposcope to enable self-cervical visualization. In this study, we sought to access women's perceptions and ability to independently use the Callascope for self-cervix imaging at home. This is an important step in our development of the Callascope as a home-based tool for cervical cancer screening. <h3>Methods:</h3> This Duke IRB approved self-exam study under written informed consent involved training healthy volunteers to use the Callascope and usage of the device over a one-week period to assess ease-of-use and feasibility of imaging the cervix at home without physician guidance. This involved (1) on-site training at the Duke Clinic with initial self-imaging of the cervix, and (2) repeated self-imaging at home. (1) On-site training and initial cervix imaging. Healthy volunteers (n=12), were given a user kit containing a Callascope, an android phone and phone charger, Sani wipes, vaginal wipes, lubricating jelly, printed user guide, and audio reflection guide. After watching the tutorial, participants proceeded to capture an image of their cervix with the Callascope in a private room. After the self-exam, participants were asked to indicate ease of use and their level of discomfort on a Likert scale. (2) Home self-exam. After completing their on-site training and initial self-imaging session, the participants were sent home with the Calla user kit for a week to capture images of their cervix, and complete surveys and an audio reflection. <h3>Results:</h3> 10 out of 12 (83%) of participants were able to visualize their cervix with the Callascope on the first try during on-site training, and 100% at home following the on-site exam. Results from the pre-insertion survey found that 50% of participants found to speculum to be a barrier to cervical cancer screening. Based on appearance only, more women were ‘very/extremely willing' to use the Callascope over the speculum for a self-exam (100% vs 25%). Most of the participants found the instructions easy to use and half of the participants found it extremely easy to slightly easy to find their cervix and this improved with repeat insertions at home (fig 1.). They also mentioned feeling empowered and having improved cervix awareness by being able to visualize their reproductive anatomy themselves, which they did not have previously. Key words associated with use of the Callascope include ‘comfortable', ‘tampon-like', ‘easy to use', ‘empowering', and ‘fascinating'. <h3>Conclusions:</h3> We have developed a device, the Callascope for comfortable, low-cost and portable visualization of the cervix. The Callascope has the potential to reduce loss to follow-up rates, encourage cervical cancer screening and reduce mortality from the disease. Since it enables cervix visualization, it can also potentially be used by women in the comfort of their homes to view the cervix and vaginal walls for infections, IUD strings, labor dilations and reproductive anatomy education. Future studies will investigate contrast agent administration. The Callascope has the potential to increase cervical cancer screening rates through reducing barriers including cost, discomfort, lack of awareness and stigma, particularly in among underrepresented minorities and rural populations.

Computer-aided diagnosis tool for cervical cancer screening with weakly supervised localization and detection of abnormalities using adaptable and explainable classifier

While pap test is the most common diagnosis methods for cervical cancer, their results are highly dependent on the ability of the cytotechnicians to detect abnormal cells on the smears using brightfield microscopy. In this paper, we propose an explainable region classifier in whole slide images that could be used by cyto-pathologists to handle efficiently these big images (100,000x100,000 pixels). We create a dataset that simulates pap smears regions and uses a loss, we call classification under regression constraint, to train an efficient region classifier (about 66.8% accuracy on severity classification, 95.2% accuracy on normal/abnormal classification and 0.870 KAPPA score). We explain how we benefit from this loss to obtain a model focused on sensitivity and, then, we show that it can be used to perform weakly supervised localization (accuracy of 80.4%) of the cell that is mostly responsible for the malignancy of regions of whole slide images. We extend our method to perform a more general detection of abnormal cells (66.1% accuracy) and ensure that at least one abnormal cell will be detected if malignancy is present. Finally, we experiment our solution on a small real clinical slide dataset, highlighting the relevance of our proposed solution, adapting it to be as easily integrated in a pathology laboratory workflow as possible, and extending it to make a slide-level prediction.

Conventional Pap Smear Cytology in a Tertiary Care Center

Abstract:&#x0D; Background: Cervical cancer is the fourth most common cancer in women with high mortality. Since it is a preventable cancer, screening for cervical cancer with Papanicolaou test (Pap Test) is considered as the stepping stone in its cure by detecting at its premalignant state. The two methods of acquiring the sample for cytology are Conventional method and liquid based cytology.&#x0D; Methods: The Pap test results of the patients who visited the outpatient clinic of the Gynecologic Department of Gandaki Medical College and Teaching Hospital from January 2012 to December 2017 were reviewed and analyzed from the medical records. The findings of Pap test results were tabulated and categorized as per Bethesda system of classification (2001).&#x0D; Results: A total of 2004 Pap tests were taken. All of the patients in the study were married with mean age of 39.7±10.3 years. A total of 1291(64.42%) Pap tests were normal or negative for intraepithelial lesion whereas 578(28.84%) were inflammatory smears while 37(1.85%) were inadequate for evaluation. There was a presence of low grade intraepithelial lesion in 4(0.2%) and high grade intraepithelial lesion in 15(0.75%). Atypical squamous cell of undetermined significance (ASCUS) was noted in 11(0.55%) and frank malignancy was noted in 1(0.05%) of total Pap test samples.&#x0D; Conclusion: In a developing country like Nepal, Pap test is still the preferred cervical cancer screening tool. All women should undergo the screening test for cervical cancer with any feasible available test.&#x0D; Key words: Bethesda system; cervical cancer; HPV; Pap Test.

Evaluation of Cervical Cancer Screening Tools; INNO-LiPA® HPV Genotyping Extra-II Assay versus E7/E6 oncoproteins, How is reliable and practical?

Background: High-Risk Human papillomavirus (HR-HPV) has been well established as the cervical cancer (CC) risk factor. In recent years, various diagnostic methods of human papillomaviruses (HPV) have been developed to promote sensitivity and specificity of CC screening which leads to a low mortality rate. This study aimed to compare diagnostic test metrics of two HPV diagnostic techniques, including Western blot and INNO-LiPA HPV Genotyping Extra II assay methods in asymptomatic or subclinical patients, among the South-Eastern Iranian women. Methods: 323 women were referred to the Pathology and Stem Cell Research Center, from February 2018 to January 2020. HPV-DNA with the INNO-LiPA HPV Genotyping Extra-II Assay kit and the western blot assays for HPV E7 and E6 assessment were employed. Results: Overall, 163 (50.4%) samples were dysplastic pap smear, the specificity of the HPV DNA test by INNO-LiPA HPV Genotyping Extra-II Assay test was significantly higher than the E7/E6 oncoproteins finding (67.3 vs. 49.9%), and the sensitivity was lower (96.6 vs. 74.8%), respectively. Conclusions: HR-HPV E7/E6 oncoproteins expression was evaluated as a possible novel biomarker for CC screening in pap smear as the preliminary test with satisfactory diagnostic values for HR-HPV types 16 and 18. The corresponding diagnostic values may be further improved by combining HPV DNA tests with the INNO-LiPA HPV Genotyping Extra-II test. Also, they may prove helpful for HR-HPV infection diagnosis in cases that the patients are asymptomatic or subclinical. Keywords: Cervical Cancer; Human Papillomavirus (HPV); Diagnostic Screening Programs; Oncogene Proteins

Turkish and Moroccan Dutch women's views of using a self-sampling kit for human papillomavirus testing as a tool for cervical cancer screening: What are the barriers and the motivators?

Objective:This study explores barriers and motivators to use self-sampling kits for human papillomavirus testing for cervical cancer screening as perceived by Dutch women of Turkish and Moroccan origin living in the Netherlands.Methods:A total of 11 in-depth semi-structured interviews were conducted and structured according to the theory of planned behavior.Results:Findings suggest that self-sampling may lift important barriers hampering traditional cervical cancer screening, such as those related to shame and chastity. However, self-sampling raises its own barriers too. Most importantly, some women fear that self-sampling may harm virginity. Some women also do not feel confident about their ability to properly use the self-sampling kit, but fears about the inability to properly use it often fade away upon having seen the self-sampling kit. Moreover, results show that knowledge about cervical cancer and its origin is limited, which may undermine women’s willingness to participate in a screening program.Conclusions:These results suggest that communication strategies to encourage using self-sampling kits among women of Turkish and Moroccan origin could benefit from culturally sensitive approaches, for example, by placing emphasis on issues such as virginity and chastity. Consistent with a recent advice of the Health Council of the Netherlands, the kit could furthermore be sent to eligible women as a standard procedure, rather than upon request. This could reduce hassle and doubts about women’s ability to use the self-sampling kit. Finally, educating women about the importance of screening to prevent cervical cancer is needed to foster informed decision-making.

The value of HPV E6/E7 mRNA quantitative analysis in distinguishing high-grade cervical squamous intraepithelial lesions from low-grade cervical squamous intraepithelial lesions

A quantitative assay for HPV E6/E7 mRNA may be a valuable tool for cervical cancer screening. The purpose of this study is to compare the expression levels of HPV E6/E7 mRNA in high-grade cervical squamous intraepithelial lesion (HSIL) and low-grade squamous intraepithelial lesions (LSIL) and to determine a new method that can be used to distinguish cervical squamous intraepithelial lesions. Routine cytology, HR-HPV E6/E7 mRNA, histology, and p16 immunohistochemistry were performed in tissues from 142 patients with cervical squamous intraepithelial lesions. Significant differences were observed between the E6/E7 mRNA copy number values between the LSIL and HSIL cases (Mann–Whitney U‐test, P < 0.001). The optimal cut-off value (≥9,222.00 copies/mL) was determined using the receiver operating characteristic curve to predict diagnostic performance. Out of the 161 samples tested in this study, four cases were classified cytologically as HSIL but had normal histology. The E6/E7 copy numbers in these cases were all higher than 9,222 copies/mL. Therefore, a quantitative assay for HPV E6/E7 mRNA may be a valuable tool that can be used to distinguish HSIL and LSIL, especially for those with HSIL, for which samples are not obtained by biopsy, or when HSIL is difficult to distinguish by morphology and p16 immunohistochemistry.

HrHPV testing vs liquid-based cytology in cervical cancer screening among women aged 50 and older: a prospective study

IntroductionEvidence supports high-risk human papilloma virus (HPV) testing as the primary cervical cancer screening tool. However, benefits and harms should be carefully considered before replacing liquid-based cytology. In women age...

Evaluation of folate receptor-mediated tumor detection as a triage tool in cervical cancer screening.

To evaluate the efficacy of folate receptor-mediated tumor detection (FRD) for identifying high-grade intraepithelial squamous lesions (HSIL) in the triage of women who are positive for human papillomavirus (HPV), and those with cytology findings of atypical squamous cells of undetermined significance (ASCUS). A secondary analysis of prospectively collected data from 1504 women who had abnormal results during primary cervical cancer screening at 13 hospitals in Beijing, China, between November 2014 and August 2015. The detection accuracy of FRD was evaluated among HPV-positive women and women with ASCUS referred for colposcopy examination. Among 1338 women with HPV, the percentage coincidence with pathology findings was higher for FRD (66.7%) than for cytology of ASCUS or higher (51.5%). The rate of colposcopy referral for cytology and FRD as a triage tool was 969 (72.4%) and 736 (55.0%), respectively. Thus, 233 (17.4%) fewer women would be referred for colposcopy by FRD. Among 476 women with cytology of ASCUS, the percentage coincidence with pathology findings was higher for FRD (63.4%) than for HPV (35.9%). FRD was found to be a promising triage tool for women who are HPV-positive and those with cytology findings of ASCUS.

Abnormal Pap Smear

Since the Papanicolaou (Pap) smear became implemented as a screening tool for cervical cancer, the mortality from cervical cancer has sharply declined in the United States. The discovery of the human papillomavirus (HPV) as the causative agent in the progression from dysplasia of the cervix to cervical cancer has changed the types of screening offered to women and the management of abnormal Pap smears. The management of abnormal Pap smears has changed depending on the age of the woman, with women under the age of 24 years being managed more conservatively given the low rates of cervical cancer in this age group and the high rates of regression of HPV and cytologic abnormalities. Colposcopy remains the first line in evaluation of an abnormal Pap smear, with excisional treatment reserved for high-grade dysplasias with a high risk of progression to cervical cancer. Treatment for cervical dysplasia is highly effective, but even after treatment, there is an increased risk of recurrence or progression to cervical cancer for up to 25 years, and these women should be followed closely. This review contains 18 figures, 3 tables, and 43 references. Key words: cervical cancer screening, high-grade cervical dysplasia, human papillomavirus, low-grade cervical dysplasia, management of abnormal Pap smears, Pap smear, recurrence of cervical dysplasia, treatment of dysplasia

The clinical performance of human papillomavirus genotyping using PANArray HPV chip: Comparison to ThinPrep cytology alone and co-testing

Recently, a high-risk human papillomavirus (HR-HPV) detecting assay alone could be used as a first-line screening tool for cervical cancer, although the test system has been limited to the Cobas 4800 HPV test. However, the screening efficiency of the HPV chip, which is widely used in Eastern Asia because of the high prevalence of non16/18 HR-HPV genotypes, has not been well elucidated. After selecting 300 women who were co-tested using the PANArray HPV chip and the ThinPrep assay and had confirmed histological diagnoses, we evaluated the diagnostic accuracy of the PANArray HPV test based on direct sequencing and clinical performance compared to the ThinPrep alone and co-testing. HR-HPVs were identified in 212 (70.7 %) patients by the PANArray HPV test. The results of the PANArray HPV test and direct sequencing for detecting HR-HPVs were in almost perfect agreement, consistent in 95.3 % of the cases (k = 0.89). HR-HPVs were more commonly detected by the PANArray HPV assay in patients with high-grade squamous intraepithelial lesions (HSILs) or worse (p < 0.001, both) by cytological and histological examinations. The PANArray HPV test had higher sensitivity (91.7 %) than the ThinPrep (52.6 %) but co-testing increased the sensitivity for predicting HSIL or worse cervical lesions to 99.2 %. In conclusion, the PANArray HPV test accurately detected HR-HPVs determined by cytological and histological examinations to be HSIL or worse cervical lesions. The PANArray HPV assay alone was more sensitive than the ThinPrep alone for detecting HSIL or worse cervical lesions, however, co-testing enhanced the sensitivity. Co-testing is more useful for screening HSIL or worse lesions than use of either the ThinPrep or PANArray HPV genotyping alone.

The yield of pap smears and its characteristics in a community based setting in Saudi Arabia.

Objectives:To assess the yield of Papanicolaou tests (pap smears), including the characteristics of abnormal pap smears.Methods:In this record-based cross-sectional study, we reviewed pap smears of patients seen at the Family Medicine clinics, King Faisal Specialist Hospital and Research Center from January 2002 to January 2017. All women between the ages of 21 and 65 were included. Study-specific case report form was developed to capture patient demographics, pap smear histopathology (Bethesda III System), human papilloma virus polymerase chain reaction (HPV PCR), and the parity status.Results:A total of 3346 patients were included; 2.2% had abnormal pap smear. Most frequent abnormalities were atypical squamous cells of undetermined significance (2%), followed by glandular cell abnormalities (0.8%). Human papilloma virus infection was detected in 6.5% and all other infections were identified in 9.2% of all screened Pap smears.Conclusion:Pap smears remain an effective tool for cervical cancer screening. Low yields of pap smears compared to other developed countries could be attributed to lower risk factors for cervical cancer in Saudi Arabia. Routine screening especially among high risk women is strongly recommended.

Urinary HPV DNA testing as a tool for cervical cancer screening in women who are reluctant to have a Pap smear in France

In France, cervical cancer screening is based on human papillomavirus (HPV) testing on cervical samples (women aged 30-65) and cytological examination of Pap smears (25-29), but screening coverage is unsatisfactory. The CapU3 study aimed to propose urinary HPV testing on 13,535 women aged 35 to 65 who had not had a Pap smear since 2010. High-risk HPV (HR-HPV) detection was performed using a real-time PCR (Anyplex II HPV 28 Detection, Seegene®). Women with HR-HPV positive results were encouraged to have a cervical smear as soon as possible to detect the presence of cervical lesions. The participation rate was 15.4%. Out of the 1,915 analyzed specimens, 1,711 and 190 were negative and positive, respectively, for at least 1 HR-HPV genotype. HR-HPV genotypes other than HPV-16 or HPV-18 were mostly detected as HPV-53 (23.7%) and HPV-68 (14.2%). A satisfactory gynecological follow-up was observed for HPV-positive women (92.1%). 23 abnormal smears were observed and eight high-grade cytological lesions after colposcopy and biopsy were diagnosed. As home HPV urinary testing is non-invasive and does not require medical attention, this method may be an alternative for women who are reluctant to have a Pap smear and thus extend screening coverage.