Condition category
Date applied
Date assigned
Last edited
Retrospectively registered
Overall trial status
Recruitment status
No longer recruiting
Publication status

Plain English Summary

Not provided at time of registration

Trial website

Contact information



Primary contact

Dr NWJ Bulkmans


Contact details

VU University Medical Center
Department of Pathology
De Boelelaan 1117
1081 VH
+31 (0)20 4440102

Additional identifiers

EudraCT number number

Protocol/serial number

1998/04WBO; NTR218

Study information

Scientific title

High-risk human papillomavirus (HrHPV) in the population research on cervical cancer: a randomised clinical trial



Study hypothesis

The main aims of the POBASCAM trial are to find out whether the efficacy and cost-effectiveness of the cervical screening programme can be improved by increasing the screening interval for women with normal cytology and a negative high-risk human papillomavirus (hrHPV) test, and by referring women with mild cytological abnormalities and a negative hrHPV test back to the next screening round, without increasing the risk of missing cervical intraepithelial neoplasia 3 (CIN3) lesions or cervical cancer.

Ethics approval

Ethics approval received from the local medical ethics committee

Study design

Multicentre, randomised, triple blinded, active controlled, parallel group trial.

Primary study design


Secondary study design

Randomised controlled trial

Trial setting

Not specified

Trial type


Patient information sheet

Not available in web format, please use the contact details below to request a patient information sheet


Cervical intraepithelial neoplasia


In the POBASCAM trial, the addition of a high-risk human papillomavirus (hrHPV) test to the regular cervical screening programme to improve detection of precursor lesions of cervical cancer is evaluated in a randomised trial design.

During the trial, participants will receive either the regular test results and regular repeat and referral recommendations (control group, hrHPV test results blinded to participants, treating clinicians and study personnel) or participants will receive modified repeat and referral recommendations based on the presence or absence of hrHPV in the cervical smear (intervention group, hrHPV test results disclosed).

Intervention type



Not Specified

Drug names

Primary outcome measure

The primary outcome measure of POBASCAM trial is the occurrence of histologically confirmed CIN3 lesions or (micro-) invasive carcinoma of the cervix found during the time span from intake up to and including the next screening round, i.e., in five years. Since women with normal cytology at the next screening round will not be referred for colposcopically-directed biopsies and therefore will not have a histological endpoint, it will be assumed that no precursor lesions of cervical cancer are present. This policy complies with regular cervical screening in The Netherlands.

Secondary outcome measures

As a secondary outcome measure, histologically confirmed cervical intraepithelial neoplasia grade 2 will also be investigated, since current guidelines recommend ablative treatment for these lesions as well. Other secondary parameters obtained include progression and regression of cytology diagnoses, clearance and acquisition of hrHPV infections and the number of referrals for colposcopically-directed biopsies.

Overall trial start date


Overall trial end date


Reason abandoned (if study stopped)


Participant inclusion criteria

1. Women invited for the cervical cancer screening program (ages 30 - 60 years)
2. Residing in either the region covered by district health authority Amstelland-de Meerlanden and Zuid-Kennemerland

Participant type


Age group




Target number of participants


Participant exclusion criteria

1. Not called for screening, ie ages under 30 years, or over 60 years
2. Follow-up of previous non-normal cytology within the current screening round of the program, i.e., abnormal cytology or CIN lesions less than two years before inclusion
3. Status after extirpation of the uterus or amputation of the portio

Recruitment start date


Recruitment end date



Countries of recruitment


Trial participating centre

VU University Medical Center,
1081 VH

Sponsor information


Vrije University Medical Centre (VUMC) (The Netherlands)

Sponsor details

Department of Pathology
PO Box 7057
1007 MB

Sponsor type




Funder type

Research organisation

Funder name

The Netherlands Organization for Health Research and Development (ZonMw) (The Netherlands)

Alternative name(s)

Funding Body Type

Funding Body Subtype


Results and Publications

Publication and dissemination plan

Not provided at time of registration

Intention to publish date

Participant level data

Not provided at time of registration

Basic results (scientific)

Publication list

1. Design, methods and baseline data:
2. 2005 results in
3. 2007 five-year follow up in
4.. 2012 final results in
5. 2018 fourteen-year follow up in

Publication citations

  1. Results

    Bulkmans NW, Bleeker MC, Berkhof J, Voorhorst FJ, Snijders PJ, Meijer CJ, Prevalence of types 16 and 33 is increased in high-risk human papillomavirus positive women with cervical intraepithelial neoplasia grade 2 or worse., Int. J. Cancer, 2005, 117, 2, 177-181, doi: 10.1002/ijc.21210.

  2. Bulkmans NW, Rozendaal L, Snijders PJ, Voorhorst FJ, Boeke AJ, Zandwijken GR, van Kemenade FJ, Verheijen RH, v Groningen K, Boon ME, Keuning HJ, van Ballegooijen M, van den Brule AJ, Meijer CJ, POBASCAM, a population-based randomized controlled trial for implementation of high-risk HPV testing in cervical screening: design, methods and baseline data of 44,102 women., Int. J. Cancer, 2004, 110, 1, 94-101, doi: 10.1002/ijc.20076.

  3. Bulkmans NW, Berkhof J, Rozendaal L, van Kemenade FJ, Boeke AJ, Bulk S, Voorhorst FJ, Verheijen RH, van Groningen K, Boon ME, Ruitinga W, van Ballegooijen M, Snijders PJ, Meijer CJ, Human papillomavirus DNA testing for the detection of cervical intraepithelial neoplasia grade 3 and cancer: 5-year follow-up of a randomised controlled implementation trial., Lancet, 2007, 370, 9601, 1764-1772, doi: 10.1016/S0140-6736(07)61450-0.

  4. Rijkaart DC, Berkhof J, Rozendaal L, van Kemenade FJ, Bulkmans NW, Heideman DA, Kenter GG, Cuzick J, Snijders PJ, Meijer CJ, Human papillomavirus testing for the detection of high-grade cervical intraepithelial neoplasia and cancer: final results of the POBASCAM randomised controlled trial., Lancet Oncol., 2012, 13, 1, 78-88, doi: 10.1016/S1470-2045(11)70296-0.

Additional files

Editorial Notes

05/02/2019: Publication reference added. 20/09/2017: internal review.