Comparison Of Cytology And Molecular Screening For Detecting Cervical Reactive Cellular Changes In General Population

NCT ID: NCT07211204

Last Updated: 2025-10-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-11-30

Study Completion Date

2026-09-30

Brief Summary

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This study compares the efficacy of cytology (Pap smear) with the molecular screening in their ability to detect reactive cellular changes in the cervix among an open population

Detailed Description

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The primary goal of this study is to compare the efficacy of the cytology (Pap smear) with the molecular screening -of three human biomarkers- in their ability to detect reactive cellular changes in the cervix among an open population. Participants will be asked to attend two study visits. All the clinical procedures will be done on the first visit:

1. Explanation of the study and its procedures. Only participants that give their written Informed Consent will be enrolled in the study.
2. Interview and physical examination to obtain a medical record. The interview will collect information related to known risks factors for cervical lesions.
3. Venipuncture to obtain a blood sample.
4. Colposcopy to obtain a cervical smear and a colposcopic diagnosis. The cervical smear will be used to perform liquid-based cytology and HPV detection.
5. Biopsy, only if the gynecologist detects a cervical lesion or another abnormality during colposcopy.

The gynecologist will make preliminary recommendations based on the colposcopic findings.

During the second visit the study's gynecologist will explain the tests' results and provide clinical recommendations to each participant.

The sensitivity, specificity, and predictive values of cytology, HPV detection, and molecular screening will be calculated using colposcopy (for all participants) and histopathology (for those biopsied). These results will be compared using a DeLong test. Correlation tests will be performed using risk factors data and test results.

Conditions

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Atypical Squamous Cell of Undetermined Significance ASC-US Atypical Glandular Cells of Uncertain Significance AGUS Cervical Intraepithelial Neoplasia (CIN) CIN 1 CIN 2 CIN 3 Cervical Cancer

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Group 1. All participants will receive a colposcopy, Pap smear, and a venipuncture. Diagnosis by colposcopy will set four clinical groups: negative control (CTR), low-grade squamous intraepithelial lesions LSIL (CIN-1), high-grade squamous intraepithelial lesions HSIL (CIN-2/3), and cervical cancer (CC).

Group 2. The participants in groups LSIL, HSIL, and CC will be biopsied. The histopathology analysis of the biopsy is the gold standard for the diagnosis.
Primary Study Purpose

SCREENING

Blinding Strategy

TRIPLE

Participants Caregivers Investigators
Given this is a screening study:

I) Participant. All enrolled participants will be asymptomatic women. Group assignment will be defined after colposcopy or histopathology (when applicable).

II) Care Provider. The gynecologist will not have a priori knowledge of the condition of the participant. During colposcopy only those participants with abnormal results will be biopsied.

III) Investigator. None of the investigators performing the tests (cytology, HPV detection, molecular screening, or histopathology) will know each other's results.

Study Groups

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Screening for reactive cellular changes in the cervix

Participants will be drawn from an open population, so they will be asymptomatic for any cervical disease. Based on colposcopy, there will be four clinical groups: negative control (CTR), low-grade squamous intraepithelial lesion (LSIL, CIN-1), high-grade squamous intraepithelial lesion (HSIL, CIN-2/3), and cervical cancer (CC).

Group Type OTHER

Physical examination

Intervention Type PROCEDURE

Physical examination and interview for obtaining a medical record

Liquid-based cytology

Intervention Type OTHER

Screening test for cervical precursor lesions and/or cancer. LBC is a procedure in which a cervical smear is examined under the microscope.

Molecular screening

Intervention Type OTHER

The molecular screening detects three human biomarkers associated with cervical precursor lesions and/or cervical cancer. Biomarker detection is done by Western blot and ELISA in human sera.

HPV DNA test

Intervention Type OTHER

HPV DNA detection is performed using a cervical swab.

Colposcopy

Intervention Type DIAGNOSTIC_TEST

A diagnostic procedure to visually examine the cervix, vagina, and vulva with a colposcope.

Histopathology of cervical biopsy

Based on colposcopy, participants in the groups LSIL/CIN-1, HSIL/CIN-2/3, and cervical cancer (CC) will be biopsied.

Group Type OTHER

Histopathology

Intervention Type DIAGNOSTIC_TEST

Is the definitive diagnosis of cervical precursor lesions and cervical cancer. It is the microscopic study of diseased cells and tissues stained with hematoxylin and eosin.

Interventions

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Physical examination

Physical examination and interview for obtaining a medical record

Intervention Type PROCEDURE

Liquid-based cytology

Screening test for cervical precursor lesions and/or cancer. LBC is a procedure in which a cervical smear is examined under the microscope.

Intervention Type OTHER

Molecular screening

The molecular screening detects three human biomarkers associated with cervical precursor lesions and/or cervical cancer. Biomarker detection is done by Western blot and ELISA in human sera.

Intervention Type OTHER

HPV DNA test

HPV DNA detection is performed using a cervical swab.

Intervention Type OTHER

Colposcopy

A diagnostic procedure to visually examine the cervix, vagina, and vulva with a colposcope.

Intervention Type DIAGNOSTIC_TEST

Histopathology

Is the definitive diagnosis of cervical precursor lesions and cervical cancer. It is the microscopic study of diseased cells and tissues stained with hematoxylin and eosin.

Intervention Type DIAGNOSTIC_TEST

Other Intervention Names

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Clinical examination LBC Circulating biomarker screening HPV PCR test HPV screening HPV detection Human papillomavirus DNA test Cervical biopsy Biopsy Histopathologic examination Histopathologic analysis Hematoxylin and eosin stain (H&E) in histopathology

Eligibility Criteria

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Inclusion Criteria

* Be in good general health.
* Age 18-85 years.
* A minimum fast of 6 hours and no more than 12 hours.
* Refrain from sexual intercourse 24 hours before the study.
* Give written informed consent.

Exclusion Criteria

* Having a subtotal, total, or radical hysterectomy.
* Being pregnant or suspected of being pregnant. A rapid urine test will be performed. If the result is positive, the patient will be excluded from the protocol and referred for prenatal care.
* Being under oncological treatment (chemotherapy, radiotherapy and/or brachytherapy).
* Being on their period.
* Have a previous confirmatory diagnosis of HIV and/or hepatitis infection.
* Having taken antiplatelet medications, e.g., acetylsalicylic acid, at least 24 hours before the study.

Discontinuation Criteria:

* If the participant refuses any of the study procedures.
* If the study gynecologist detects that the participant has had a hysterectomy.
* If the volume of the biological samples is insufficient (less than 10 mL for the blood sample).
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Timser SAPI de CV

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Leopoldo E Gatica-Galina, MD in OB/GY & Gynecol Oncol

Role: PRINCIPAL_INVESTIGATOR

Clinica Reina Madre Metepec

Locations

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Clinica Reina Madre Metepec

San Mateo Atenco, State of Mexico, Mexico

Site Status

Countries

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Mexico

Central Contacts

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Mercedes Gutiérrez-Smith, Bachelor of Arts in History

Role: CONTACT

+52-55-9057-1000

Alba E Hernández-Sánchez, Bachelor in Computer Science

Role: CONTACT

+52-56-3230-7157

Facility Contacts

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Mariana Ramírez, Bachelor of Social Work

Role: primary

+52-55-3479-4936

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Related Links

Access external resources that provide additional context or updates about the study.

https://gco.iarc.fr/today/home

World Health Organization \& International Agency for Research on Cancer. Global Cancer Observatory

https://www.who.int/publications/i/item/9789240014107

World Health Organization. Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem

https://screening.iarc.fr/colpo.php

Sellors JW \& Sankaranarayanan R. An introduction to Cervical Intraepithelial Neoplasia (CIN). in Colposcopy and treatment of cervical intraepithelial neoplasia: a beginners manual

https://canscreen5.iarc.fr/?page=countryfactsheetcervix&q=MEX&rc=

International Agency for Research on Cancer. CanScreen5. Cervical Cancer Screening Programme. Country Fact Sheet: Mexico

https://www.gob.mx/cms/uploads/attachment/file/10397/NOM-014-SSA2-1994.pdf

Mexico's Ministry of Health. NOM-014-SSA2-1994. For Prevention, Detection, Diagnosis, Treatment, Control and Epidemiological Surveillance of Cervical Cancer

https://www.who.int/publications/i/item/9789240030824

World Health Organization. WHO Guideline for Screening and Treatment of Cervical Pre-Cancer Lesions for Cervical Cancer Prevention.

https://www.imss.gob.mx/sites/all/statics/guiasclinicas/146GER.pdf

Mexican Social Security Institute (IMSS) \& Mexican Government. Clinical Practice Guidelines. Prevention and Timely Detection of Cervical Cancer at the First-Level of Care

https://ieeexplore.ieee.org/document/8764887

William, W., Ware, A., Basaza-Ejiri, A. H. \& Obungoloch, J. Automated diagnosis and classification of cervical cancer from Pap-smear images. in 2019 IST-Africa Week Conference, IST-Africa 2019

https://ccsenet.org/journal/index.php/gjhs/article/view/0/50473

Reyes-Hernández, D. O. et al. Novel Serum Protein Biomarkers for Precancerous Cervical Lesions and Cervical Cancer. Glob J Health Sci 16, 44 (2024).

https://www.imss.gob.mx/sites/all/statics/guiasclinicas/333GER.pdf

Mexican Social Security Institute (IMSS) \& Mexican Government. Clinical Practice Guidelines. Treatment of Cervical Cancer at the Second and Third-Level of Care

Other Identifiers

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2024-EXT-886

Identifier Type: OTHER

Identifier Source: secondary_id

PROT-ATSO-INV-003

Identifier Type: -

Identifier Source: org_study_id

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