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(MCRC Clinical) Urinary HPV testing for cervical cancer screening


Project Description

Background
Cervical cancer is caused by chronic infection with human papillomavirus (HPV). Cervical screening tests for HPV in cells collected from the cervix using a soft brush. If the test is HPV positive, the cells are examined under the microscope by cytology. If cytology shows abnormal cells, the woman is referred to colposcopy, where pre-cancer cells are identified and treated. In this way, cervical screening saves lives from cervical cancer. Yet only 7 in 10 women in the UK attend cervical screening, the lowest rate in 20 years. Reasons include embarrassment, fear of examination and inconvenience, factors that may be overcome by ‘self- sampling’. Vaginal self-sampling is an effective way of identifying cervical pre-cancer, but only 1 in 10 women return a sample. We hypothesise that a urine test will pick up cervical pre-cancer and encourage more women to be screened.

Aims
1. To perform a systematic review of urinary HPV testing for cervical pre-cancer
2. To optimise and test urinary HPV testing for cervical pre-cancer detection
3. To see whether methylation testing can triage HPV+ urine samples into those that are/ are not associated with cervical pre-cancer

Methods
In Study 1, the fellow, who may be a gynaecology, oncology or primary care trainee, will carry out a systematic review of the diagnostic test accuracy of urinary HPV testing for cervical pre-cancer detection. In Study 2, s/he will optimise urine sampling, processing and HPV testing against matched cervical samples in women attending colposcopy clinic. In Study 3, s/he will determine whether HPV positive urine samples can be triaged by a methylation test, which measures the impact of HPV on the genetic makeup, or DNA, of cervical cells. Together, these studies will determine whether urine testing could provide a viable alternative to routine cervical screening, with a view to reversing current trends of declining participation in the programme.

Entry Requirements:
Candidates must be post-registration clinicians and ideally have a specialist post in a related subject, for example, obstetrics and gynaecology, oncology, or primary care. Applicants must have been resident and worked within the EEA (European Economic Area) for at least three years prior to application.

Funding Notes

The clinical fellowships are usually tenable for three years, although in certain circumstances they may be four years duration. We will provide running expenses, an appropriate salary in line with the applicant’s current salary and grade, and full coverage of University PhD fees. Where international student fees are payable, please provide evidence with your application of how the shortfall will be covered (approximately £19,000 per annum).

The length of this project will be THREE YEARS.

Related Subjects

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