Diagnostic accuracy of self-collected menstrual blood for high-risk human papillomavirus testing for cervical intraepithelial neoplasia and cervical cancer: a systematic review and meta-analysis

Ji X; Ji X; Chen S; Wang X; Liu X

doi:10.3389/fmicb.2026.1782917

The fieldHPV

Diagnostic accuracy of self-collected menstrual blood for high-risk human papillomavirus testing for cervical intraepithelial neoplasia and cervical cancer: a systematic review and meta-analysis

Ji X, Ji X, Chen S, et al.Frontiers in Microbiology · 2026DOI 10.3389/fmicb.2026.1782917

In plain language

A systematic review and meta-analysis of seven studies with 1,672 women in China, India and South Korea that tested self-collected menstrual blood, on sanitary pads or cloth, for high-risk HPV and confirmed cervical disease by biopsy. Pooled sensitivity for CIN and cervical cancer was 0.96 and pooled specificity 0.53, with very high heterogeneity between studies.

Key numbers

7 / 1,672: Studies / women pooled
0.96: Pooled sensitivity for CIN and cervical cancer
0.53: Pooled specificity

What it means

Menstrual blood HPV testing rarely missed cervical disease in these studies but gave many false positives, partly because most studies counted mild CIN1 as disease. A separate 2026 meta-analysis that compared menstrual blood with clinician-collected HPV tests, rather than with biopsy, found a pooled sensitivity of 0.86 and specificity of 0.90.

What it does not show

Only seven mostly small, hospital-based studies were included, with very high heterogeneity (I² of 86% for sensitivity and 98% for specificity). The search ended in October 2024, so more recent and larger studies are not included.

Figures

Figure 4 from Meta-analysis of menstrual blood HPV tests: Summary ROC curve pooling seven studies of menstrual blood HPV testing against biopsy results, with an area under the curve of 0.93 for detecting cervical precancer (CIN) and cervical cancer. — **Figure 4.** Summary ROC curve pooling seven studies of menstrual blood HPV testing against biopsy results, with an area under the curve of 0.93 for detecting cervical precancer (CIN) and cervical cancer.Figure 4 from Ji et al., Frontiers in Microbiology (2026), CC BY 4.0.

Figure 3 from Meta-analysis of menstrual blood HPV tests: Sensitivity and specificity of menstrual blood HPV testing in each of the seven included studies: pooled sensitivity was 0.96, while pooled specificity was 0.53 and varied widely between studies. — **Figure 3.** Sensitivity and specificity of menstrual blood HPV testing in each of the seven included studies: pooled sensitivity was 0.96, while pooled specificity was 0.53 and varied widely between studies.Figure 3 from Ji et al., Frontiers in Microbiology (2026), CC BY 4.0.

Figures reproduced unchanged from Ji X et al., Frontiers in Microbiology, 2026, under CC BY 4.0. Captions written by Qvin.

How to cite

Ji X, Ji X, Chen S, Wang X, Liu X. Diagnostic accuracy of self-collected menstrual blood for high-risk human papillomavirus testing for cervical intraepithelial neoplasia and cervical cancer: a systematic review and meta-analysis. Frontiers in Microbiology. 2026;17:1782917. doi:10.3389/fmicb.2026.1782917