School of Medicine

Trinity College Dublin, The University of Dublin

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Christine White PhD

Job Title: Researcher
Position: Post-Doctoral Researcher

Dr Christine White is a post-doctoral researcher at the Department of Histopathology Trinity College Dublin/Coombe Women and Infants University Hospital, Dublin. Following an undergraduate degree in Medical Molecular Cytology at the Dublin Institute of Technology, Christine completed a PhD with CERVIVA investigated the utility of biomarkers in cervical screening. Christine went on to work on a 7th framework funded programme, SYSTEMCERV, which identified new biomarkers for cervical pre-cancer and cancer. She is now working on the HPV Primary Screening Study. The Primary Screening study will explore the use human papillomavirus (HPV) testing as a first-line screening method. The study is based on research that indicates that using HPV testing as the initial screen can better indicate which women are at risk of potentially cancerous lesions compared with using PAP tests. Research has shown that HPV testing can detect more cervical cell abnormalities than the traditional PAP test. Furthermore women who do not have HPV have a greater degree of reassurance that they will not develop cancer. The presence of HPV does not always lead to the development of cervical cancer. To ensure HPV testing is effective, we need to find out which HPV positive samples are likely to develop into cancer. To do this, we will look into samples that test positive for HPV in a little more detail. We will do additional tests to look for specific markers that we know are linked to HPV infection. By following women to see what happens over the course of several smear tests we will be able to determine how useful these new approaches to cervical screening are.

Trinity College Dublin
College Green
Dublin 2
Ireland

Projects

What influences cervical screening uptake in older women and how can screening programmes translate this knowledge into behaviour changing strategies? A qualitative and quantitative research project
Each year, about 295 women in Ireland are diagnosed with cervical cancer. Smear tests/cervical screening is an effective way to reduce your risk of getting cervical cancer. CervicalCheck the national cervical cancer screening programme offers free smear tests to women aged 25 – 65 years. However, some women, particularly women over 50, do not attend for these important tests.
In this research study, we aim to identify factors that influence womens decisions on cervical screening (non)‐participation. The ultimate goals are to maximise cervical screening coverage in Ireland and provide information on women’s understanding of cervical screening in order to optimise screening effectiveness and deliver health gains for individual women and the population. The study will be conducted in 3 phases. Phase 1 of this study uses qualitative interviews to explore womens views and understanding of cervical screening in Ireland. This phase has been completed. Phase 2 of this study seeks to determine, by means of a population postal survey, the most important influences on attendance for cervical screening among older women and the inter-relationships between these influences. This phase is currently underway. Phase 3 will use evidence gathered from phases 1 and 2 to conduct behavioural analysis and so form solutions to the problem of low screening coverage in older women.

Project Partners/collaborators: Trinity College Dublin (Lead), CervicalCheck, The National Cervical Screening Programme, The Coombe Women and Infants University Hospital

Funding: Health Research Board, Ireland
Last updated Tue, 04-01-2022
Human papilloma virus DNA and mRNA testing in the Irish screening population
Human papilloma virus is now recognised as the major cause of cervical cancer. Although other factors like smoking can contribute to your risk, the general consensus is, the presence of a high-risk type of human papilloma virus is necessary.
Most sexually active women have been exposed to human papilloma virus, which can infect the cervix. In most women the virus disappears naturally over time. However, some women have difficulty in getting rid of the virus particularly if they smoke. Persistent infection can lead to abnormal changes in the cervix. Women with these abnormal changes do not have symptoms - the only way they can be found is by checking them with a smear test.

Human papilloma virus is very common and most sexually active women will have been exposed to it. In the majority of women, the body's immune system fights off or suppresses the virus before it causes problems. When the infection doesn't go away on its own, certain types of papilloma virus that are called "high-risk", can cause cell changes that may develop into cervical cancer if not detected and treated early.

The purpose of this research program is to investigate the population prevalence of human papilloma virus in the Irish cervical screening population and use of human papilloma virus testing in the diagnosis, treatment and management of women in the Irish population with abnormal smears.

We will focus on the following groups of women:
- Women with persistent low grade abnormal smears who have been referred for colposcopy.
- Human papilloma virus testing in the post-treatment setting.
- Human papilloma virus testing in women over 30 years of age.
- Survey of human papilloma virus prevalence in the Irish population.
Last updated 2015
Systems biology approaches to cervical pre-cancer and cancer "SYSTEMCERV"
The research we propose in SYSTEMCERV adopts a systems biology approach to address the need for specific biomarkers to aid objective CIN lesion grading, to identify true high grade cervical disease, and to increase the specificity and PPV of disease detection. We will build on work performed within a previously funded FP7 collaborative research grant called AUTOCAST, where we have identified and validated a novel panel of RNA based biomarkers for detection of cervical precancerous lesions. This panel of mRNA markers has been developed using systems biology and data mining tools and has demonstrated high specificity [93%] and sensitivity [88%] for detecting CIN 2-3 lesions. This compares to sensitivity and specificity metrics for cytology [specificity: 80-95%, sensitivity: 60-85%] and for HPV screening [specificity: 70-85%, sensitivity: 90-95%]. The combined biomarker panel has a specificity of 92% and sensitivity of 91%, for detecting CIN2+ disease in younger women under 30 years of age, where it outperforms HPV, whose specificity is unacceptably low. This enabling clinical validation work on the biomarker panel provides sufficient evidence that further exploration of existing data sets and biological pathways using a methodical systems biology approach, which combines de novo discovery and used computational, and simulation approaches to extrapolate from existing data sets.
To complement the systems biology discovery component, high throughput biomarker analysis and validation will be performed using the SYSTEMCERV approach. SYSTEMCERV proposes a novel strategy for this which will integrate several technologies to develop cervical pre-cancer and cancer specific protein arrays [IMTEK DNA-to-protein copying technology] for subsequent down-stream generation of antibodies using phage display [CysDisplay] and antibody array technologies [Human Combinatorial Antibody Library (HuCAL)] antibody technology (GenoID). We then intend to use a label free detection approach for the detection of proteins using imaging Reflectometric Interference Spectroscopy [iRIfS] technology (Biametrics). The ultimate goal of the project is to generate a panel of protein and specific detection antibodies [targeted against wild type and mutant protein] for use in cervical pre-cancer screening and for stratification of patients with CIN disease (TCD and GenoID). This novel approach is not limited to cervical cancer biomarker discovery and validation; it can be translated to other diseases and biomarkers, and even has personalised medicine applications.
Last updated 2015