PRIORITY Study in Cervical Cancer (PRIORITY)
The PRIORITY Study in Cervical Cancer: A Prospective Multicenter Observational Evaluation of an Integrated Molecular and Digital Model for Diagnostic Prioritization
The PRIORITY study is a prospective, multicenter observational study designed to evaluate an integrated diagnostic model combining extended molecular self-sampling and digital colposcopy supported by telemedicine for the prioritization of women at risk of cervical cancer.
The study aims to assess the diagnostic performance, concordance, and clinical utility of this integrated approach in real-world settings, as well as its impact on diagnostic timeliness and patient navigation across different levels of care.
Participants will undergo standard-of-care evaluation, and data will be collected on molecular test results, colposcopic findings, diagnostic outcomes, and time intervals within the care pathway. No interventions are assigned as part of the study protocol.
The findings are expected to inform scalable strategies to improve early detection and optimize diagnostic pathways for cervical cancer, particularly in settings with structural and geographic barriers to timely care.
Studieoversikt
Status
Detaljert beskrivelse
The PRIORITY study is a prospective, multicenter observational study designed to evaluate an integrated diagnostic model for cervical cancer that combines extended high-risk human papillomavirus (HPV) self-sampling, digital colposcopy, and telemedicine-based prioritization.
The study will be conducted across multiple healthcare centers in Chile, including primary care and referral centers, reflecting real-world clinical pathways. Participants will be women undergoing evaluation for cervical cancer screening or diagnostic follow-up according to standard clinical practice. No interventions are assigned as part of the study protocol.
Data will be collected prospectively and will include results from molecular HPV testing, digital colposcopic assessments, and histopathological findings when available. Additional variables will include time intervals across the diagnostic pathway, including time from screening to diagnostic confirmation, as well as healthcare system navigation indicators.
The primary objective is to assess the diagnostic performance and concordance between molecular testing and colposcopic findings. Secondary objectives include evaluation of diagnostic timeliness, feasibility of implementing the integrated model, and patient-reported experience measures.
This study is designed to generate real-world evidence on the potential of integrated diagnostic strategies to improve prioritization and reduce delays in cervical cancer detection, particularly in settings with structural and geographic barriers to timely care.
Studietype
Registrering (Antatt)
Kontakter og plasseringer
Studiekontakt
- Navn: Mauricio A Cuello, MD
- Telefonnummer: +56223543034
- E-post: mcuello@uc.cl
Studer Kontakt Backup
- Navn: Nicolás Saez, MD
- Telefonnummer: +56223543034
- E-post: nsaez@ucchristus.cl
Studiesteder
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Aysén
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Coyhaique, Aysén, Chile, 5951801
- Hospital regional de Coyhaique
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Ta kontakt med:
- Mauricio A Cuello, MD
- Telefonnummer: +56223543034
- E-post: mcuello@uc.cl
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Ta kontakt med:
- Pablo Mardones, MD
- Telefonnummer: +56998881617
- E-post: jefeobstetriciahrc@saludaysen.cl
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Hovedetterforsker:
- Pablo Mardones, MD
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Coquimbo Region
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Coquimbo, Coquimbo Region, Chile, 1781881
- Hospital San Pablo
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Ta kontakt med:
- Mauricio A Cuello, MD
- Telefonnummer: +56223543034
- E-post: mcuello@uc.cl
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Ta kontakt med:
- Pablo Avalos, MD
- Telefonnummer: +56974785169
- E-post: pabloavalosc@gmail.com
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Hovedetterforsker:
- Pablo Avalos, MD
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Maule Region
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Talca, Maule Region, Chile, 3460001
- Hospital de Talca
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Ta kontakt med:
- Mauricio A Cuello, MD
- Telefonnummer: +56223543034
- E-post: mcuello@uc.cl
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Ta kontakt med:
- Yesica Sagredo, MD
- Telefonnummer: +56983354093
- E-post: sagredo.yesica@gmail.com
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Hovedetterforsker:
- Yesica Sagredo, MD
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Metropolitan Region
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Santiago, Metropolitan Region, Chile, 7580153
- San Jorge Medical Center UC-Christus Health Network
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Ta kontakt med:
- Nicolas A Saez, MD
- Telefonnummer: +56963940423
- E-post: nsaez@ucchristus.cl
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Ta kontakt med:
- Mauricio A Cuello, MD
- Telefonnummer: +56982391249
- E-post: mcuello@uc.cl
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Hovedetterforsker:
- Nicolas Saez, MD
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Underetterforsker:
- Mauricio A Cuello, MD
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Santiago, Metropolitan Region, Chile, 7820436
- San Joaquín Medical Center, UCChristus Health Network
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Ta kontakt med:
- Mauricio A Cuello, MD
- Telefonnummer: +56982391249
- E-post: mcuello@uc.cl
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Hovedetterforsker:
- Nicolas Saez, MD
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Ta kontakt med:
- Nicolas Saez, MD
- Telefonnummer: +56963940423
- E-post: nsaez@ucchristus.cl
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Santiago, Metropolitan Region, Chile, 8150031
- Ancora San Francisco Medical Center UC Christus Health Network
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Ta kontakt med:
- Mauricio A Cuello, MD
- Telefonnummer: +56982391249
- E-post: mcuello@uc.cl
-
Hovedetterforsker:
- Nicolas Saez, MD
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Ta kontakt med:
- Nicolas Saez, MD
- Telefonnummer: +56963940423
- E-post: nsaez@ucchristus.cl
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Santiago, Metropolitan Region, Chile, 8330032
- Cancer Centre UC-Christus Nuestra Sra de la Esperanza
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Ta kontakt med:
- Mauricio A Cuello, MD
- Telefonnummer: +56982391249
- E-post: mcuello@uc.cl
-
Ta kontakt med:
- Nicolas Saez, MD
- Telefonnummer: +56963940423
- E-post: nsaez@ucchristus.cl
-
Hovedetterforsker:
- Mauricio A Cuello, MD
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Underetterforsker:
- Nicolas Saez, MD
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Santiago, Metropolitan Region, Chile, 8331010
- Santa Lucia Medical Center UC-Christus Health Network
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Ta kontakt med:
- Mauricio A Cuello, MD
- Telefonnummer: +56982391249
- E-post: mcuello@uc.cl
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Hovedetterforsker:
- Nicolas Saez, MD
-
Underetterforsker:
- Mauricio A Cuello, MD
-
Ta kontakt med:
- Nicolas Saez, MD
- Telefonnummer: +56963940423
- E-post: nsaez@ucchristus.cl
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Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
- Voksen
- Eldre voksen
Tar imot friske frivillige
Prøvetakingsmetode
Studiepopulasjon
Beskrivelse
Inclusion Criteria:
- Women aged 30 to 65 years
- Eligible for cervical cancer screening according to national guidelines
- Able and willing to provide informed consent
- Able to perform self-sampling or attend clinical evaluation if required
Exclusion Criteria:
- Previous diagnosis of cervical cancer
- History of total hysterectomy (removal of the cervix)
- Current pregnancy if it precludes study procedures according to clinical judgment
- Any medical or social condition that, in the opinion of the investigators, would interfere with participation or follow-up
Studieplan
Hvordan er studiet utformet?
Designdetaljer
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Diagnostic accuracy of the integrated molecular and digital model for detection of CIN2+
Tidsramme: Up to 6 months
|
Sensitivity, specificity, positive predictive value, and negative predictive value of the combined strategy including extended molecular self-sampling, clinician-collected sampling, and digital colposcopy for detecting histologically confirmed cervical intraepithelial neoplasia grade 2 or worse (CIN2+). Measure reported: sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). |
Up to 6 months
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Concordance between self-collected and clinician-collected samples for high-risk HPV and extended molecular panel detection
Tidsramme: Baseline
|
Agreement between vaginal self-sampling and clinician-collected cervical samples for detection of high-risk HPV genotypes and extended molecular findings, assessed using Cohen's kappa and percent agreement. Measure reported: Cohen's kappa coefficient and percent agreement. |
Baseline
|
|
Prevalence of sexually transmitted infections and vaginal dysbiosis markers detected by extended molecular screening
Tidsramme: Baseline
|
Prevalence of sexually transmitted infections and vaginal dysbiosis markers detected through the extended molecular panel, including Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis, bacterial vaginosis-associated markers, Candida species, and genital ulcer pathogens. Measure reported: Prevalence (%) of sexually transmitted infections and vaginal dysbiosis markers detected through extended molecular screening. |
Baseline
|
|
Prevalence ratio of high-risk HPV positivity in participants with sexually transmitted infections detected by extended molecular screening
Tidsramme: Up to 6 months
|
Prevalence ratio of high-risk HPV positivity among participants with sexually transmitted infections detected using the extended molecular screening panel. High-risk HPV positivity will be defined as the proportion (%) of participants with a positive validated molecular HPV test. Measure reported: Prevalence ratio (PR) with 95% confidence intervals. |
Up to 6 months
|
|
Odds ratio for histologically confirmed CIN2+ in participants with sexually transmitted infections detected by extended molecular screening
Tidsramme: Up to 6 months
|
Odds ratio for histologically confirmed cervical intraepithelial neoplasia grade 2 or worse (CIN2+) among participants with sexually transmitted infections detected using the extended molecular screening panel. CIN2+ will be defined as the proportion (%) of participants with histologically confirmed cervical intraepithelial neoplasia grade 2 or worse. Measure reported: Odds ratio (OR) with 95% confidence intervals. |
Up to 6 months
|
|
Time to diagnostic resolution
Tidsramme: Up to 6 months
|
Time from initial molecular self-sampling to diagnostic resolution, defined as histological confirmation when clinically indicated or completion of diagnostic evaluation according to standard care. Measure reported: days from initial molecular self-sampling to diagnostic resolution. |
Up to 6 months
|
Andre resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Participant-Reported Acceptability Score Using the Self-Sampling and Telemedicine Diagnostic Pathway Acceptability Questionnaire
Tidsramme: Up to 6 months
|
Participant-reported acceptability will be assessed using the investigator-developed Self-Sampling and Telemedicine Diagnostic Pathway Acceptability Questionnaire, a structured 5-item questionnaire evaluating ease of self-sampling, confidence in performing the procedure, understanding of instructions, comfort with digital colposcopy, and satisfaction with telemedicine-supported follow-up. Each item is scored on a 5-point Likert scale from 1 to 5. A composite score will be calculated by summing all item responses. Scores range from 5 to 25 points, with higher scores indicating greater acceptability. Measure reported: Composite acceptability score (range 5-25 points; higher scores indicate greater acceptability). |
Up to 6 months
|
|
Direct transportation costs associated with the diagnostic pathway
Tidsramme: Up to 6 months
|
Participant-reported transportation expenses associated with screening, diagnostic evaluation, referral visits, and follow-up care will be assessed using an investigator-developed healthcare utilization and cost questionnaire. Total transportation costs will be calculated as the cumulative sum of all transportation-related expenses incurred throughout the diagnostic pathway. Measure reported: Total transportation cost in Chilean pesos (CLP). |
Up to 6 months
|
|
Productive Activity Days Lost Associated With the Diagnostic Pathway
Tidsramme: Up to 6 months
|
Number of participant-reported productive activity days lost throughout the diagnostic pathway, assessed as a single cumulative count variable. Measure reported: Total number of productive activity days lost. |
Up to 6 months
|
|
Indirect non-medical expenses associated with the diagnostic pathway
Tidsramme: Up to 6 months
|
Participant-reported indirect non-medical expenses incurred during the diagnostic process will be assessed using an investigator-developed healthcare utilization and cost questionnaire. Total indirect non-medical expenses will be calculated as the cumulative sum of eligible participant-reported expenses. Measure reported: Total indirect non-medical expenses in Chilean pesos (CLP). |
Up to 6 months
|
Samarbeidspartnere og etterforskere
Etterforskere
- Hovedetterforsker: Mauricio A Cuello, MD, Pontificia Universidad Católica de Chile
Publikasjoner og nyttige lenker
Studierekorddatoer
Studer hoveddatoer
Studiestart (Antatt)
Primær fullføring (Antatt)
Studiet fullført (Antatt)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
Ytterligere relevante MeSH-vilkår
- Urogenitale sykdommer
- Kjønnssykdommer
- Patologiske prosesser
- Urogenitale neoplasmer
- Neoplasmer etter nettsted
- Neoplasmer
- Kvinnelige urogenitale sykdommer
- Kvinnelige urogenitale sykdommer og graviditetskomplikasjoner
- Sykdomsattributter
- Infeksjoner
- Virussykdommer
- Livmorsykdommer
- Kjønnssykdommer, kvinner
- Smittsomme sykdommer
- Seksuelt overførbare sykdommer, virale
- Seksuelt overførbare sykdommer
- DNA-virusinfeksjoner
- Genitale neoplasmer, kvinnelige
- Forstadier til kreft
- Livmor livmorhalssykdommer
- Uterine neoplasmer
- Tumorvirusinfeksjoner
- Patologiske tilstander, tegn og symptomer
- Uterine cervikale neoplasmer
- Papillomavirusinfeksjoner
- Livmor livmorhalsdysplasi
Andre studie-ID-numre
- UC-CCU-PRIORITY-2026
- FNC-2025-1440 (Annet stipend/finansieringsnummer: Ministry of Health of Chile (National Cancer Fund))
Plan for individuelle deltakerdata (IPD)
Planlegger du å dele individuelle deltakerdata (IPD)?
IPD-planbeskrivelse
De-identified individual participant data (IPD) including clinical, molecular, imaging (colposcopy), and patient-reported outcomes collected during the study will be available.
Data will be shared after publication of the primary results, upon reasonable request, and subject to approval by the study investigators and the corresponding ethics committee.
All shared data will be fully anonymized and will not include any direct or indirect identifiers.
Data access will be granted for scientifically sound proposals, with a signed data access agreement, and in compliance with Chilean data protection laws (Law 19.628) and institutional policies.
No identifiable data will be shared under any circumstances.
IPD-delingstidsramme
De-identified individual participant data and supporting documents will be available beginning 6 months after publication of the primary results and will remain available for at least 5 years.
Access will be provided upon reasonable request to the study investigators and subject to approval by the corresponding ethics committee.
Tilgangskriterier for IPD-deling
Access to de-identified data will be granted to researchers who provide a methodologically sound proposal.
Requests will be reviewed by the study investigators and must receive approval from the corresponding ethics committee.
A data use agreement will be required, ensuring compliance with institutional policies and Chilean data protection regulations (Law 19.628).
No identifiable data will be shared under any circumstances.
IPD-deling Støtteinformasjonstype
- STUDY_PROTOCOL
- SEVJE
- ICF
Legemiddel- og utstyrsinformasjon, studiedokumenter
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