# Composing CODAs to cervical cancer screening through an integrated CRISPR and fluorescent nucleic acid approach

> **NIH NIH U01** · MASSACHUSETTS GENERAL HOSPITAL · 2024 · $527,535

## Abstract

ABSTRACT
Challenges. Despite being curable when caught early, cervical cancer remains the second leading cause of
death in women living in sub-Saharan Africa. Even with available screening technologies (cytology, visual
inspection with acetic acid (VIA), and sometimes high-risk Human Papillomavirus [hrHPV] testing), only
10-20% of eligible women in low-and-middle-income countries (LMIC) are currently screened. Barriers cited
include technical expertise, laboratory capacity, cost, and access. Most developed countries have adopted
PCR-based HPV screening, furthering the resource divide with LMICs, where 80% of cancer deaths occur.
Innovation. In dire response to the diagnostic gaps unveiled by the pandemic, team members within our group
developed and validated in human specimens a robust and frugal technology to detect nucleic acid targets.
The approach, CRISPR Optical Detection of Anisotropy or CODA, combines CRISPR/Cas (a Nobel Prize-
winning technology for highly precise gene editing) with ﬂuorescence anisotropy (differential rotational motion
of ﬂuorescent molecules). Automated nucleic acid readouts are generated in < 30 minutes. We have adopted
this technology for: a) the detection of DNA and RNA markers of CIN2+; and b) reliable use by clinicians and
clinical lab personnel in point-of-care settings. Our plan for this proposal is to operationalize this technology for
low resource settings, notably our partner sites in Uganda and Ghana, with close LMIC input. We will then
leverage CODA and other parameters to create a panel of tests to optimally detect CIN2+ in a single
encounter. Aim 1: Construct a robust CODA platform for comprehensive HPV screening. Aim 2: Further
examine CODA performance on human specimens and reﬁne for LMIC operations. Aim 3: Develop a novel
and rapid multi-modal algorithm for screen and treat in LMICs. Impact. Given CODA's core strengths in nucleic
acid analyses (e.g., DNA or RNA), we envision an approach that yields fully quantitive readouts of high-risk
HPV DNA and E6, E7, and p16 mRNA. Since the CODA assay underlies all readouts driving this proposal, a
high potential exists for end-user-friendly, practical, and rapid triage of high-risk cervical disease or invasive
cancer. These beneﬁts could help decentralize and harmonize screening efforts with those guidelines currently
endorsed by resource-rich countries.

## Key facts

- **NIH application ID:** 10870008
- **Project number:** 5U01CA279858-02
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Cesar M Castro
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $527,535
- **Award type:** 5
- **Project period:** 2023-07-01 → 2028-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10870008

## Citation

> US National Institutes of Health, RePORTER application 10870008, Composing CODAs to cervical cancer screening through an integrated CRISPR and fluorescent nucleic acid approach (5U01CA279858-02). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10870008. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*
