TESTING menstrual blood for human papillomavirus (HPV) could offer a non-invasive alternative to traditional cervical screening, according to a large population-based study. Researchers in China report that HPV testing using self-collected menstrual blood demonstrated diagnostic accuracy comparable to clinician-collected cervical samples for detecting high-grade cervical lesions.
The cross-sectional study enrolled 3,068 women aged 20–54 years with regular menstrual cycles from four urban and three rural communities in Hubei Province between 2021 and 2025. Participants provided three types of samples: menstrual blood collected via a sterile “minipad” attached to a sanitary pad, a clinician-collected cervical sample for HPV testing, and cytology samples. Women with positive results were referred for colposcopy and biopsy to confirm cervical intraepithelial neoplasia grade 2 or worse (CIN2+), the main clinical endpoint.
Menstrual Blood Results Comparable to Clinician-Collected Cervical Samples
Investigators found that menstrual blood HPV testing achieved a sensitivity of 94.7% for detecting CIN2+, closely matching clinician-collected testing at 92.1%. Although specificity was slightly lower for the minipad method (89.1% versus 90.0%), both approaches showed identical negative predictive values of 99.9%, suggesting strong reassurance when results were negative. Positive predictive value and referral efficiency were also similar between the two methods.
HPV infection is responsible for the vast majority of cervical cancers, and screening programmes have significantly reduced disease incidence worldwide. However, barriers such as discomfort, stigma, and limited access can deter participation. Researchers suggest that menstrual blood sampling could expand screening uptake by allowing individuals to collect specimens at home during menstruation, potentially improving access in underserved populations.
Menstrual Blood Testing May Reshape Future Cervical Cancer Screening
The study also explored digital integration, with participants able to receive results and follow-up advice through a mobile app, highlighting the feasibility of combining self-sampling with telehealth support. Despite the promising findings, the authors caution that the observational design means further research is needed before widespread implementation. Prospective trials and validation across diverse populations will be essential to determine how menstrual blood testing could be incorporated into existing screening guidelines.
If confirmed, the approach could represent a shift towards more patient-centred cervical cancer prevention strategies, complementing clinician-based screening while reducing logistical and psychological barriers that currently limit participation.
Reference
Xun T et al. Testing menstrual blood for human papillomavirus during cervical cancer screening in China: cross sectional population based study. BMJ. 2026; 392:e084831.
