Cervical Disease Clinical Trial
Official title:
Initial Study With the CNDS Advanced Cervical Scan to Recalibrate Spectral Data for Use in Future Screening Studies
The purpose of this study is to evaluate whether fluorescence and reflectance spectroscopy can improve the ability to detect the presence of premalignant lesions on the cervix.
Subjects (approximately 500) will be initially enrolled from a general screening population
in the first phase, and during the second phase from the colposcopy clinic population
(approximately 300) based on their referral abnormal Pap cytology conducted within 120-days
in order to achieve a statistically viable number of normal women, women with Cervical
Intra-epithelial Neoplasia (CIN1/2) and women with CIN3+, as described in Section 6.1,
"Cervical Cytology Enrollment Targets". After the Cervical Neoplasia Detection System (CNDS)
test, a sample for Hybrid Capture 2 Human papillomavirus (HPV) testing and liquid cytology
will be collected in addition to colposcopy and biopsy, if indicated.
A key component of effective screening studies designed to evaluate new detection modalities
is verification of the gold standard comparison by which estimates of sensitivity and
specificity are generated. In the case of screening studies in general and studies of
cervical disease detection in particular, the avoidance of verification bias is a priority.
For the purposes of the proposed study, CIN3 or cancer (CIN3+) must be verified or
adjudicated by multiple histopathologists. Results for women with CIN1 or CIN2 will be
confirmed histopathologically and analyzed as a separate subgroup because these lesions
often regress to normal in certain populations and tend to cause disagreement among
histopathologists. In order to verify absence of disease (i.e., CIN1 or less severe), the
investigators will not rely on histopathology, as it would not be ethical to perform
multiple biopsies or excisional procedures to obtain a tissue sample for histopathology.
Instead, women will be considered normal if they have negative referral cytology, are free
of high risk HPV and are colposcopically normal.
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Observational Model: Cohort, Time Perspective: Retrospective
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