Hernández López, RubíHermosillo, LuisLeón Maldonado, LeithVelázquez Cruz, RafaelTorres Ibarra, LeticiaLazcano Ponce, EduardoLorincz, Attila TiborWheeler, Cosette M.Bosch José, Francesc Xavier, 1947-Cuzick, JackRivera Paredez, BereniceNedjai, BelindaSalmerón, Jorge2021-09-132021-09-132021-07-211932-6203https://hdl.handle.net/2445/179962Introduction: Urine self-sampling for human papillomavirus (HPV)-based cervical cancer screening is a non-invasive method that offers several logistical advantages and high acceptability, reducing barriers related to low screening coverage. This study developed and evaluated the performance of a low-cost urine self-sampling method for HPV-testing and explored the acceptability and feasibility of potential implementation of this alternative in routine screening. Methods: A series of sequential laboratory assays examined the impact of several pre-analytical conditions for obtaining DNA from urine and subsequent HPV detection. Initially, we assessed the effect of ethylaminediaminetetraacetic acid (EDTA) as a DNA preservative examining several variables including EDTA concentration, specimen storage temperature, time between urine collection and DNA extraction, and first-morning micturition versus convenience sample collection. We further evaluated the agreement of HPV-testing between urine and clinician-collected cervical samples among 95 women. Finally, we explored the costs of self-sampling supplies as well as the acceptability and feasibility of urine self-sampling among women and healthcare workers. Results: Our results revealed higher DNA concentrations were obtained when using a 40mM EDTA solution, storing specimens at 25°C and extracting DNA within 72 hrs. of urine collection, regardless of using first-morning micturition or a convenience sampling. We observed good agreement (Kappa = 0.72) between urine and clinician-collected cervical samples for HPV detection. Furthermore, urine self-sampling was an affordable method (USD 1.10), well accepted among cervical cancer screening users, healthcare workers, and decision-makers. Conclusion: These results suggest urine self-sampling is feasible and appropriate alternative for HPV-testing in HPV-based screening programs in lower-resource contexts.15 p.application/pdfengcc by (c) Hernández López, Rubí et al, 2021http://creativecommons.org/licenses/by/3.0/es/Papil·lomavirusAnàlisi d'orinaPapillomavirusesUrine--Analysisinfo:eu-repo/semantics/article2021-09-10info:eu-repo/semantics/openAccess34288949