The goal of the COMBISCREEN project is to develop a fully molecular cervical screening and triage approach that is applicable on self-samples, which are an easily accessible and non-invasive source of biomarkers. The project allows a one-step screening and triage modality and thereby identifies women with clinically relevant disease that are in need of treatment.
Currently, there is still 37% of the Flemish population eligible for cervical cancer screening that remains un(der)screened. Self-collected urine and vaginal samples that can be collected from home and are non-invasive provide an attractive alternative for this group. The aim of this study is to collect different samples from patients with a cervical cancer or a scheduled conization in order to identify potential biomarkers for cervical cancer and cervical intraepithelial neoplasia (CIN). These samples include a home-collected first-void urine (Colli-Pee 20mL prefilled with urine conservation medium (UCM)) and vaginal self-sample (Evalyn Brush), as well as a clinician collected cervical smear, blood sample and when appropriate also a tissue sample. A tissue sample will only be collected when the patient is undergoing surgical procedures for their standard therapy. As such, they do not undergo additional invasive procedures as part of the study. The samples are collected prior to starting therapeutic processes (e.g. conization, chemotherapy, radiotherapy, surgery…). The presence of biomarkers (e.g. human papillomavirus (HPV) and DNA methylation) for cervical cancer and cervical intraepithelial neoplasia (CIN) will be determined and compared in each of the sample types. The results of the biomarker assays will also be compared to clinical results from cytology and histology in order to determine the accuracy.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
100
Women will collect a first-void urine (the initial part of the urine stream) sample at home the day before a hospital appointment using the 20mL Colli-Pee device prefilled with urine conservation medium (UCM, Novosanis, Belgium).
Women will collect a vaginal self-sample using the Evalyn Brush (Rovers Medical Devices, The Netherlands) at home the day before a hospital appointment.
Universitair Ziekenhuis Antwerpen (UZA)
Edegem, Antwerpen, Belgium
RECRUITINGDetection of (epi)genetic biomarkers for cervical cancer and precancer
A novel assay will be developed for the detection of the human papillomavirus (HPV) and epigenetic biomarkers to determine the presence of cervical (pre)cancer. Using histology outcomes as a reference test.
Time frame: 48 months
Comparison of the biomarkers detected in the different sample types.
The biomarkers detected in each of the sample types and their performance will be compared.
Time frame: 48 months
Demonstrate non-inferiority of the biomarker assay in self-samples compared to conventional cytology on pap smears.
Demonstrate non-inferiority of the developed biomarker assay in self-samples (index tests) compared to conventional cytology on pap smears (comparator test) for the detection of cervical (pre)cancer, using histology outcomes from tissue samples as reference test.
Time frame: 48 months
Determine the predictive value of the biomarker assay and the long-term risk of cervical (pre)cancer
Determine the developed biomarker assay's predictive value and long-term risk of cervical (pre)cancer after an initial test-outcome. Measuring the cumulative incidence of cervical (pre)cancer over time. Using histology outcomes from tissue samples ten years pre- and post-study enrolment as reference test outcomes.
Time frame: Within 1 year after study completion
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