Triage Strategies in Cervical Cancer Prevention (FRIDA)
July 27, 2015 updated by: Eduardo Cesar Lazcano Ponce, Instituto Nacional de Salud Publica, Mexico
Molecular Triage in Cervical Cancer Prevention: The Tlaxcala Study
While there is broad consensus that HR-HPV detection is the best available primary screening test, there is no agreement about the most efficient and reliable triage procedure for HR-HPV positive women.
Transient HR-HPV infections are very common, and the vast majority of these infections spontaneously regress after a year or two.
Only a small fraction of cases will lead to persistent infection responsible for cervical neoplasia.
The FRIDA Study is a large, population-based study that was designed to evaluate the performance and cost-effectiveness of different triage strategies for hrHPV-positive women in Mexico.
Study Overview
Status
Unknown
Conditions
Intervention / Treatment
Detailed Description
The target population is over <100,000 women aged 30 to 64 years who attend the Cervical Cancer Screening Program in 100 health centers in the state of Tlaxcala, Mexico.
All women will be evaluated to determine hrHPV infection using the Cobas® 4800 HPV test.
Triage strategies will be performed as reflex tests in all hrHPV-positive participants: HPV-16/18/45 genotyping, detection of the E6 oncoprotein of HPV-16/18, cytology, and immunocytochemistry using p16INK4a/Ki67.
Women with at least one positive triage test will be referred for colposcopy evaluation, where a minimum of four biopsies and an endocervical sample are systematically collected.
Histological confirmation will be performed by a standardized panel of pathologists.
Study Type
Observational
Enrollment (Anticipated)
100000
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
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Tlaxcala, Mexico
- Recruiting
- Primary health care centers from Sanitary Jurisdiction No. 1 of Tlaxcala Health Services
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Contact:
- Jorge Salmerón, DSc
- Phone Number: +52-246-4645879
- Email: jorge.salmec@gmail.com
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
30 years to 64 years (Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
Female
Sampling Method
Non-Probability Sample
Study Population
This is a population-based study that includes all women aged 30 to 64 years living in the 32 municipalities in Tlaxcala covered by Sanitary Jurisdiction No. 1 of Tlaxcala Health Services
Description
Inclusion Criteria:
- Women aged 30 to 64
- Residents of the municipalities included in Sanitary Jurisdiction No. 1 of Tlaxcala.
Exclusion Criteria:
- Pregnant or hysterectomized women
- Legally disabled women unable to give verbal informed consent required by the study protocol
- Women who do not wish to participate in the present study
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
|---|---|
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Women aged 30-64 years old
Women aged 30 to 64 years who attend the Cervical Cancer Screening Program in 100 health centers in the state of Tlaxcala, Mexico
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All cervical and/or vaginal specimens are tested for hrHPV using the Cobas® 4800 HPV test.
Triage testing will be performed on all participants with a positive HR-HPV test declared consent at recruitment visit: HPV16/18 genotyping, Cobas® 4800 HPV test, HPV16/18/45 genotyping, BD OnclarityTM HPV Assay, OncoE6 Cervical Test, Liquid based cytology with Papanicolaou stain and p16INK4a/ Ki-67 immunostain.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Histologically confirmed cervical intraepithelial neoplasia grade 2 or worse (CIN2+)
Time Frame: 36 months
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All women will be colposcopically evaluated in order to rule out any clinically evident invasive cancer.
In cases of invasive cancer, patients will be referred to onco-gynecology services immediately.
Before biopsy collection, endocervical sampling is performed using an Endocervex Brush®.
A minimum of four biopsies are collected, at least one per quadrant, from the more suspicious area on cervical transformation zone.
Histological evaluation of all samples (biopsies and/or endocervical curettage samples) will be evaluated for final diagnosis and confirmation of CIN2+ cases by two pathologists according to Mexico's Cervical Cancer Screening Programme's guidelines.
An external expert-pathologist, will resolve discrepancies and render a final decision.
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36 months
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Collaborators
Investigators
- Principal Investigator: Eduardo C Lazcano-Ponce, MD DSc, Instituto Nacional de Salud Pública, Mexico
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
- Torres-Ibarra L, Lorincz AT, Wheeler CM, Cuzick J, Hernandez-Lopez R, Spiegelman D, Leon-Maldonado L, Rivera-Paredez B, Mendez-Hernandez P, Lazcano-Ponce E, Salmeron J. Adjunctive testing by cytology, p16/Ki-67 dual-stained cytology or HPV16/18 E6 oncoprotein for the management of HPV16/18 screen-positive women. Int J Cancer. 2021 May 1;148(9):2264-2273. doi: 10.1002/ijc.33414. Epub 2020 Dec 22.
- Hernandez-Lopez R, Lorincz AT, Torres-Ibarra L, Reuter C, Scibior-Bentkowska D, Warman R, Nedjai B, Mendiola-Pastrana I, Leon-Maldonado L, Rivera-Paredez B, Ramirez-Palacios P, Lazcano-Ponce E, Cuzick J, Salmeron J; FRIDA Study Group. Methylation estimates the risk of precancer in HPV-infected women with discrepant results between cytology and HPV16/18 genotyping. Clin Epigenetics. 2019 Oct 12;11(1):140. doi: 10.1186/s13148-019-0743-9.
- Rudolph SE, Lorincz A, Wheeler CM, Gravitt P, Lazcano-Ponce E, Torres-Ibarra L, Leon-Maldonado L, Ramirez P, Rivera B, Hernandez R, Franco EL, Cuzick J, Mendez-Hernandez P, Salmeron J; FRIDA Study Group. Population-based prevalence of cervical infection with human papillomavirus genotypes 16 and 18 and other high risk types in Tlaxcala, Mexico. BMC Infect Dis. 2016 Sep 1;16(1):461. doi: 10.1186/s12879-016-1782-x.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
August 1, 2013
Primary Completion (Anticipated)
December 1, 2017
Study Registration Dates
First Submitted
July 24, 2015
First Submitted That Met QC Criteria
July 27, 2015
First Posted (Estimate)
July 28, 2015
Study Record Updates
Last Update Posted (Estimate)
July 28, 2015
Last Update Submitted That Met QC Criteria
July 27, 2015
Last Verified
July 1, 2015
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 1094
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