Human papillomavirus (HPV) is responsible for nearly 90% of cervical cancer cases globally. Early identification of high-risk HPV strains is central to cervical cancer prevention strategies. A large observational study published in The BMJ evaluated whether HPV DNA could be reliably detected from menstrual blood collected on a sanitary pad and compared its diagnostic performance with clinician-collected cervical samples.1
The study was conducted by researchers in China and included 3,068 women aged 20 to 54 years from both urban and rural areas of Hubei Province. Participants were recruited through community-based screening programs, reflecting real-world cervical cancer screening conditions rather than hospital-only settings.1
Participant enrollment occurred between September 2021 and January 2025. Each participant provided menstrual blood using a sterile minipad during menstruation and also underwent standard cervical sampling performed by trained clinicians. Both sample types were tested for HPV DNA using established molecular testing methods. Researchers then compared sensitivity, specificity, and predictive values for detecting high-grade cervical lesions, including cervical intraepithelial neoplasia grade 2 or worse (CIN2+).1
Athena Lamnisos, CEO, The Eve Appeal, said in a blog on the eve appeal website,
It’s exciting to see new, more acceptable and potentially gentler ways of offering what could be a life-saving test to prevent cervical cancer from developing. The ability to test for HPV in menstrual blood isn’t the answer for everyone though. People have different barriers and concerns about screening, so being able to offer a choice of different methods could be very positive for some who are eligible for screening but don’t currently attend.Athena Lamnisos, CEO, The Eve Appeal
Menstrual blood testing showed a sensitivity of 94.7% for detecting CIN2+ lesions, compared with 92.1% for clinician-collected cervical samples. Specificity was similar between the two methods, and both demonstrated a negative predictive value of 99.9%, indicating that a negative test result reliably excluded high-grade disease. Referral rates for further diagnostic evaluation, such as colposcopy, were comparable between both sampling approaches.1
Despite advances in HPV testing, cervical cancer screening uptake remains suboptimal in many regions due to limited access to healthcare, social stigma, and discomfort associated with pelvic examinations. Non-invasive approaches could help address these barriers and improve participation in screening programs, particularly in underserved populations.1
The authors of the study said, "Compared with clinician collected sampling and invasive self-sampling, non-invasive menstrual blood sampling enhances acceptability and feasibility for large scale screening. These findings support the integration of menstrual blood based HPV testing into national cervical cancer screening guidelines."
The study included only menstruating women with regular cycles, limiting applicability to post-menopausal individuals or those with menstrual irregularities. Researchers emphasized the need for further validation across different populations and healthcare systems before this approach can be considered for integration into routine screening guidelines.1
HPV vaccination and regular screening remain the cornerstone of cervical cancer prevention. Menstrual blood-based HPV testing is not intended to replace clinician-collected samples but may serve as an additional option to improve screening coverage where participation is low.
Current evidence suggests that menstrual blood-based HPV testing performs comparably to conventional cervical sampling for detecting clinically significant precancerous lesions. With further research and validation, this method may contribute to expanding access to cervical cancer screening and improving early detection worldwide.
1. BMJ. 2025. “HPV Testing Using Menstrual Blood Collected on a Sanitary Pad: Observational Study.” BMJ 392: bmj-2025-084831. https://www.bmj.com/content/392/bmj-2025-084831
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