The possibility of collect urine samples at home e material vaginal for detecting the human papillomavirus (HPV) may become an important strategy in preventing cervical cancer. A study led by researchers at the University of São Paulo (USP) and published in the journal Clinics indicates that these forms of autocoleta They are viable, reliable and perform very similarly to cervical collection performed by healthcare professionals.
Although it is highly preventable through testing and screening, it still causes thousands of deaths in the country. According to the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo), every minute a person in the world is diagnosed with cancer associated with this virus. In Brazil, around 19 women die every day due to the disease, and it is the cancer that kills the most women up to 36 years of age in the country.
To evaluate alternatives that increase access to screening, researcher Lara Termini, from the Cancer Institute of the State of São Paulo (Icesp), in partnership with gynecologist Gustavo Maciel, from the Hospital das Clínicas of the Faculty of Medicine of USP (HCFMUSP), recruited 100 women over 21 years of age. The majority were between 30 and 39 years old and had been referred by Basic Health Units (UBS) for colposcopy, due to the presence of high-risk lesions or those already identified as cancer.
In total, three sequential collections were carried out: urine and vaginal material, carried out by the participants themselves, and cervical collection, conducted by a doctor. Before the procedure, everyone watched an educational video with detailed instructions and answered a questionnaire to ensure understanding of the steps and increase adherence to the study.
The samples obtained were analyzed to detect high oncogenic risk HPV. The results show that both self- and vaginal urine collection showed very high agreement with the traditional collection carried out by doctors, including for the identification of HPV16, one of the types most associated with cervical cancer. “Our findings indicate that self-collection represents a more inclusive and accessible strategy, as it allows anyone with a uterus to perform the collection independently, outside the clinical environment”, says Lara Termini. Factors such as fear, difficulty accessing healthcare systems, lack of time, cultural and religious aspects are among those that prevent many people from taking the exam.
Among the participants, urine collection was the best accepted methodology, associated with greater comfort and less embarrassment. Even so, both self-collection methods had high acceptability when compared to conventional gynecological examination, reinforcing the potential of these strategies to reach people who currently do not undergo screening regularly.
Vaginal self-collection, in particular, has already been used in a structured way in several countries with organized tracking programs. The Netherlands, Australia, Sweden and Denmark are among the nations that have incorporated the strategy into their national health systems, with a proven positive impact on expanding population coverage. There is still no forecast of when it will be available in Brazil.
“This type of initiative is very relevant, as there is a movement by the World Health Organization [OMS] and other institutions that aim to eradicate cervical cancer by 2030 based on high vaccination coverage, diagnostic and treatment capacity”, highlights gynecologist Renato Moretti, from Einstein Hospital Israelita.
Tracking in Brazil
In August 2025, the Unified Health System (SUS) began to incorporate the molecular test for HPV detection as a cervical cancer screening strategy. According to the Ministry of Health, this technology is considered innovative because it allows the identification of precursor changes up to ten years earlier than the Pap smear test. The new methodology is being implemented gradually and, in the future, should replace the traditional cytopathological examination.
The idea is that vaginal self-collection is also a tool to expand access and coverage of tests in the country. The strategy can benefit women with less access to health services, as long as it is accompanied by well-defined flows for the care of patients with altered results. “This study opens the door for new investigations carried out in appropriate environments and opens up space for women with less access to cervical cancer screening methods”, comments Moretti.
The WHO estimates that, without preventive actions, the tumor could become responsible for around 411,000 deaths worldwide by 2030. The tumor usually evolves silently in its early stages, which means that many women do not seek medical care early. Therefore, prevention is fundamental and involves different strategies.
The main one is vaccination against HPV, offered free of charge by the SUS for girls and boys aged 9 to 19. Using condoms during sexual intercourse, adopting healthy lifestyle habits, such as avoiding smoking and alcohol consumption, and undergoing regular gynecological exams also help reduce the risk of the disease. Even vaccinated women must maintain periodic follow-up with a gynecologist, as screening is essential to identify changes early and ensure adequate treatment.
