Cervical Cancer Clinical Trial
Official title:
CINtec PLUS Triage of HPV Positive Women in HPV Primary Screening
Prospective study which will recruit participants when they attend for a routine cervical screening. The study will evaluate the use of CINtec PLUS for triage of human papillomavirus (HPV) positive participants in HPV primary screening.
The study will recruit participants (9800) prospectively by verbal invitation from the sample
taker when they attend for their cervical screening test. Recruitment will take up to one
year to complete. Participants in the study will undergo primary HPV testing. This will be
followed by cervical cytology testing as per the normal National Health Service Cervical
Screening Programme (NHSCSP) screening invitation pathway. Participants testing HPV negative
will have reached their end point and will exit the study. Participants who test HPV positive
will be triaged by cytology (the cytology screening result, available through the NHSCSP
screen will be used). Participants with moderate or severe dyskaryosis (high-grade disease)
will be immediately referred to colposcopy (as per NHSCSP guidelines) without further
testing. Participants with borderline or mild dyskaryosis (low-grade findings) will undergo
CINtec PLUS Cytology triage simulation; however, regardless of the CINtec PLUS result, all
participants will also be referred to colposcopy as per NHSCSP guidelines. Participants with
negative cytology will undergo CINtec PLUS Cytology triage and those testing positive (an
indication of increased risk of CIN2+ [high-grade disease]) will be referred to colposcopy.
Participants with negative cytology who also test CINtec PLUS negative will only be referred
to colposcopy if they have tested positive for HPV16 or HPV18 as these 2 genotypes have been
shown to confer an elevated risk for CIN2+ compared with the other HPV types. Participants
with negative cytology who also test CINtec PLUS negative and have tested positive for non
HPV16 and HPV18 types will undergo repeat HPV testing at 12 months as the low risk of CIN2+
associated with these participants does not justify immediate colposcopy referral and is
unlikely to be granted ethical approval.
Clinical outcomes based on colposcopy and/or histology and/or cervical cytology will be
recorded. All biopsies will have one slide stained with CINtec Histology (p16). The risk of
CIN2+ will be evaluated for all participants in the study. Subsequently, clinical performance
of CINtec PLUS Cytology will be evaluated.
This work will also include a cost analysis.
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