Menstrual pad monitoring promising for HPV detection

The Q-Pad, a modified sanitary pad that passively collects menstrual blood, facilitates the self-collection of dried blood spot samples that can match clinician-collected cervical specimens (CCS) for the detection of human papillomavirus (HPV), reports a new study presented at the 2022 Annual Clinical & Scientific Meeting of the American College of Obstetricians and Gynecologists (ACOG 2022).

“In terms of this study focusing on screening for high-risk HPV (HR-HPV), we felt that if we are going to eliminate cervical cancer globally, then we need better access to screening modalities that are convenient, comfortable, cost-effective, and require relatively little initiative on the part of the patient,” said Dr Paul D. Blumenthal, professor emeritus of OB/GYN at the Stanford University in California, and co-author of the study.

“Passively collecting menstrual blood via the Q-Pad could meet a lot of these criteria, and in this preliminary report, it appears to be the case,” he added.

Of the 153 women enrolled in the study, 107 were able to provide both Q-Pad samples and CCS. Concordance values for HPV detection between both screening methods were high, ranging from 94 percent to 100 percent. [ACOG 2022, abstract A91]

In five women who were high-risk, HPV-positive, and had high-grade cervical dysplasia, the agreement between physician- and Q-Pad-collected samples was 100 percent. Moreover, 12 percent of patients who were positive for HR-HPV in Q-Pad appeared negative when their CCS were tested.

In terms of procedural preference, 30 percent of participants said they felt discomfort with swabbing and refused to provide self-collected cervical swab samples. Moreover, 94 percent of women recommended the Q-Pad over clinician-collected cervical swabs.

“We were pleasantly surprised that the correlation between the clinician-collected swabs and the Q-Pad finding among those who were HR-HPV positive was as high as it was, especially since this was the first time that a dried blood spot derived from menstrual blood had been used for this purpose,” said Blumenthal.

"Menstrual blood is a resource. This is a potential tool. It’s not just a waste product," he added.

For this study, researchers enrolled women who were presenting for either routine cervical cancer screening or those who had a positive history of HPV. Aside from CCS and Q-Pad specimens, women were also asked to provide self-collected swabs, all of which were subjected to the Roche Molecular Systems’ Cobas HPV test for virus detection.

Whereas traditional HR-HPV testing is typically conducted in clinic settings with active sample collection, the Q-Pad has a removable collection strip that allows women to passively collect dried blood spots. Such convenient sample self-collection can improve access to HPV screening while also reducing costs and the need for uncomfortable visits, the researchers pointed out.

Moreover, the present findings showed that menstrual blood, as collected by the Q-Pad, can be feasibly and accurately used to test for HR-HPV, while also proving to be highly acceptable to women, according to Blumenthal. “It shows promise as a screening approach that might be scalable,” he said.