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Cervix

DCEG researchers conduct studies on cancers of the cervix, more commonly referred to as cervical cancer. The primary cause of cervical cancer is persistent infection with the human papillomavirus (HPV). Selected studies include:

  • Cancer Moonshot: HPV Vaccine Trial and Accelerated Cervical Cancer Control

    Researchers in the Infections and Immunoepidemiology Branch (IIB) and the Clinical Epidemiology Unit (CEU), Clinical Genetics Branch, are leading priorities of the Cancer Moonshot. IIB is running the one-dose HPV vaccine trial in Costa Rica. CEU is creating new cervical cancer screening approaches that are effective and efficient. For high-resource settings, they are designing a quick and cost-effective HPV genotyping assay to improve the detection and management of cervical cancer.

  • ASC-US/LSIL Triage Study (ALTS)

    ALTS is a study of the clinical management of low-grade cervical cytologic abnormalities conducted by the Clinical Genetics Branch and the NCI Division of Cancer Prevention.

  • Biopsy Study to Improve Detection of Cervical Precancer

    A collaborative study on colposcopic biopsy with aims to study cervical disease on the lesion level, optimize criteria for biopsy placement, and analyze the incremental benefit of taking multiple biopsies

  • Cervical Cancer Screening Among HIV-Infected Women in India

    A study to evaluate a cohort of HIV-infected women using two novel and potentially sustainable, lower-cost tests for accurate screening for cervical cancer

  • Enduring Consensus Cervical Cancer Screening and Management Guidelines

    The Enduring Guidelines Effort is a process to provide regular updates to the 2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors. A consensus committee reviews new evidence from population-based and other studies to continually improve clinical management.

  • Guanacaste HPV Natural History Study

    A population-based natural history study of HPV and cervical neoplasia launched with Costa Rican colleagues in 1993.

  • Human Papillomavirus (HPV) Cervical Cancer Risk Prediction

    This study, a Cancer Moonshot priority, is designed to develop a cervical cancer risk prediction model incorporating clinical and laboratory covariates. The goal is to classify women’s risks of cervical intraepithelial neoplasia 2 (CIN 2), CIN 3, and cancer into strata upon which clinical management decisions can be based. Eight articles comprising a supplemental issue in the Journal of Lower Genital Tract Disease formed the early core of this effort.

  • Human Papillomavirus (HPV) Cervical Visualization Study

    Human Papillomavirus (HPV) Cervical Visualization Study

  • HPV Vaccine Trial in Costa Rica (CVT)

    The HPV Vaccine Trial in Costa Rica (CVT) was a randomized, controlled phase III trial of the bivalent human papillomavirus-16/18 virus-like particle (VLP) vaccine. In addition to strong evidence for vaccine safety and efficacy, data from the trial demonstrated that three doses of the HPV vaccine may not be necessary, as similar vaccine efficacy against cervical HPV 16/18 infection was observed among women who received two, and even a single dose, after over 10 years of follow-up.

  • Human Papillomavirus (HPV) Genomics Project

    There is huge variability in risk of precancer and cancer conferred by different HPV types that is poorly explained. HPV type 16 is known to cause half of all cervical cancer cases worldwide, however, the specific reason for its carcinogenicity has been elusive. The HPV Genomics Project is designed to interrogate the relationship between sequence changes in the HPV genome and carcinogenicity.

  • Human Papillomavirus (HPV) Methylation

    A Cancer Moonshot priority to study methylation of the HPV viral genome and risk of cervical intraepithelial neoplasia 3+ to prevent cervical cancer

  • Human Papillomavirus (HPV) Natural History, Genomics and Risk Assessment

    Studies of human papillomavirus (HPV) natural history, genomics and risk assessment that led to advances in screening and clinical management

  • Human Papillomavirus (HPV) Persistence and Progression Cohort (PaP Cohort)

    The Persistence and Progression Cohort (PaP Cohort) is a collaborative study with Kaiser Permanente Northern California to create a repository of specimens for natural history studies, HPV typing, methylation, and HPV variant genomics.

  • Improvement of Risk-Informed Screening (IRIS)

    IRIS is a comprehensive evaluation of candidate biomarkers for use in cervical cancer screening and triage in a large cohort study in partnership with Kaiser Permanente Northern California. This is a Cancer Moonshot priority.

  • PRIMAVERA Trial to Compare One Dose of Bivalent HPV Vaccine to Three Doses of Quadrivalent Vaccine

    An immunobridging trial comparing the antibody levels elicited by one dose of bivalent HPV vaccine in girls to three doses of quadrivalent vaccine in women, the population where HPV vaccine efficacy was originally demonstrated. Immunobridging trials enable the inference of efficacy in populations where it is currently not possible to evaluate, such as young girls.

  • Scientific Evaluation of One or Two Doses of the Bivalent or Nonavalent Prophylactic HPV Vaccines—The ESCUDDO* Study

    ESCUDDO is a scientific evaluation of one or two doses of the bivalent or nonavalent vaccine against HPV. Findings from the trial will provide the definitive evidence of the non-inferiority of one dose compared to two doses, the global gold standard in young girls. Positive results from the trial will provide actionable evidence needed to update the current HPV vaccine policy both domestically and globally.

  • The Selfie Study to Detect Cervical Precancers

    The NCI is partnering with the George Washington University to evaluate novel biomarkers measured from self-collected samples in women undergoing cervical cancer screening. The Selfie Study is a Cancer Moonshot priority.

  • Single-Dose HPV Vaccination among Young Adult Women in Costa Rica: The PRISMA* Trial

    Researchers are conducting the PRISMA trial to determine if one dose of HPV vaccine is sufficient to reduce the risk of HPV infection in women, compared to a non-HPV vaccine—the standard in the majority of the world. If one dose is sufficient, vaccinating women could help to accelerate the timeline for cervical cancer control, averting potentially millions of projected HPV-related cervical cancers expected over the coming decades as the population of the globe ages.

  • STRIDES: Studying Risk and Improving Disparities of Cervical Cancer in Mississippi

    The NCI is partnering with the University of Mississippi Medical Center to evaluate risk of cervical precancer and to study novel biomarkers in women undergoing cervical cancer screening. STRIDES is a Cancer Moonshot priority.

  • Study to Understand Cervical Cancer Early Endpoints and Determinants (SUCCEED)

    A study to comprehensively assess biomarkers of risk for progressive cervical neoplasia, and thus develop a new set of biomarkers that can distinguish those at highest risk of cervical cancer from those with benign infection

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