Testing self-collected menstrual blood for human papillomavirus offers a convenient, noninvasive option for cervical cancer screening, with accuracy comparable to clinician-collected cervical samples, researchers in China have found.

A cross-sectional study involving 3068 women aged 20-54 years found minipad-based HPV testing detected moderate precancerous cervical changes with 94.7% sensitivity and severe changes with 92.9% sensitivity, closely matching clinician-collected samples (92.1% and 85.7%, respectively), according to the study.

“The results of this large-scale community-based study show the utility of using minipad-collected menstrual blood for HPV testing as a standardized, noninvasive alternative or replacement for cervical cancer screening,” the researchers reported in BMJ.

“This could be a practice-shifting study with important implications for cervical cancer screening and equity,” said Sharyn N. Lewin, MD, director of the Gynecologic Oncology Division at Holy Name Medical Center in Teaneck, New Jersey, who was not involved in the study.

Menstrual Blood Testing via Minipad

Cervical cancer is a leading cause of death among women worldwide, yet two thirds of women have never been screened. Traditional Pap smears and clinician-collected HPV tests, while effective, require clinic visits and trained personnel and can be uncomfortable or stigmatizing for many women.

Previous research has shown women tend to embrace self-collected HPV sampling, including vaginal swabs and menstrual blood, and that these methods can increase screening rates. However, evidence in real-world, community-based populations remains limited.

To address this gap, the Chinese researchers conducted a study from September 2021 to January 2025, enrolling women with regular menstrual cycles, prior sexual activity, and an intact cervix. Participants self-collected menstrual blood at home using minipads, which were returned to the lab within 3 months, while clinicians collected cervical samples for HPV testing and ThinPrep cytology (a liquid-based Pap test).

Of 3068 participants, 337 tested positive for HPV using clinician-collected samples. Women with positive results or abnormal cytology were referred for biopsy. Histopathologic analysis confirmed a total of 90 cases of abnormal cervical tissue.

Key Findings

Minipad-based HPV testing closely matched clinician-collected samples in detecting high-grade cervical lesions. Minipad testing was slightly less specific, identifying women without moderate lesions 89.1% of the time and without severe lesions 88.5% of the time compared with 90% and 89.4%, respectively, for clinician-collected testing.

However, both methods were highly reliable, with a negative predictive value of 99.9% for moderate precancerous changes and 100% for severe changes. The positive predictive value was similar (9.9% vs 10.4% for minipad vs clinician-collected samples), according to the researchers. Overall, both methods detected the same HPV type in 97.7% of cases, with complete agreement in 96.2% of participants.

The study also integrated minipad testing with the Early Test mobile app via WeChat, which allowed women to register samples, track results, receive real-time notifications, and communicate securely with healthcare providers. Such digital integration could streamline follow-up and make large-scale screening more feasible, especially in rural or underserved areas, the researchers noted.

Joshua G. Cohen, MD, medical director of the Gynecologic Cancer Program at City of Hope in Irvine, California, who was not involved in the study, called the results promising but preliminary.

“This self-collection method is a novel, noninvasive approach that could complement existing screening programs,” Cohen told Medscape Medical News. “If validated in larger studies and diverse populations, it may be helpful for patients who delay or avoid screening due to discomfort, limited access, cultural concerns, or prior trauma.”

Lewin agreed that this method removes the pelvic exam as a barrier and could expand screening in rural areas, low-resource countries, and among underscreened women. She also noted that collecting HPV from menstrual blood may be easier and more acceptable than vaginal self-swabs because it avoids insertion, mailing, and sampling anxiety.

But Cohen cautioned the method is not a replacement for standard-of-care screening. “Patients with abnormal results would still need in-office evaluation, which could include a Pap test, HPV testing, or colposcopy,” he said.

Lewin added this test is only for women who are menstruating and excludes postmenopausal women. “HPV affects both younger and older women, so that’s an important limitation,” she told Medscape Medical News.

Cohen also emphasized that cervical cancer prevention depends on HPV vaccination, regular screening, and timely management of precancerous changes. “Healthcare professionals should continue to advocate for vaccination among eligible patients, which remains the most effective way to prevent disease,” he said.

The study was supported by the Key Technology R&D Programme of Hubei and the Academician Expert Workstation of the Central Hospital of Wuhan, Wuhan, China.

Isha Ishtiaq is a health journalist based in Pakistan. She holds a bachelor’s in Biotechnology and a master’s in Biological Sciences.