Cervical cancer is often caused by human papillomavirus (HPV) infection. While early detection is crucial, there are significant barriers worldwide. 'In countries like Panama, where I come from, screening programmes are not as well organised as in The Netherlands,' Molina says. 'In Panama they usually start with a Pap test and only then an HPV test. This is less effective because they first look for cell abnormalities and only with the HPV test they could see if the HPV virus is present. Cervical cancer is also prevalent there because HPV is a sexually transmitted infection.' 

Moreover, invasive tests such as smears are not always practical or accessible, especially in low- and middle-income countries. Molina's project offers a solution: 'With a new test on urine, women can easily collect it from home without having to visit a clinic. This significantly lowers the barrier to participation.' 

The research focuses on so-called transfer RNAs (tRNAs) as a biomarker for cervical cancer. ‘Our first step is to find specific tRNAs that change in expression during cancer development,’ Molina explains. ‘Then we'll see if we can find those molecules in urine as well. If successful, we can develop a non-invasive screening test.’ 

How do the molecules behave at different stages of the disease? 

Molina's methodology is innovative and multidisciplinary. 'We combine techniques such as sequencing (a laboratory technique used to determine the order of nucleotides, the building blocks of DNA or RNA in genetic material). with cell lines and clinical samples from women with and without HPV or cervical disease. The idea is to see how these molecules behave at different stages of the disease. We know they might increase or decrease, but we don't yet know what they do throughout cervical cancer development,’ he says. 

The project is a collaboration between different research groups at the Department of Pathology and the Cancer Center Amsterdam of the Amsterdam UMC. 'We are collaborating with experts in sequencing, biomarker discovery, and clinicians using new techniques developed specifically to accurately detect tRNAs. These molecules are very small and have unique modifications, so we need to be very precise.' 

'We want to understand which molecules change during cervical cancer development. This can not only improve early detection, but can also provide insights into the biological mechanisms behind cancer.' The potential impact of Molina's work extends beyond The Netherlands. 'With a urine test, we can make screening accessible to women worldwide, especially in countries where traditional tests are less accessible or stigmatizing,' he stresses.   

Simple and affordable PCR tests 

Molina hopes to achieve significant results within two years. 'If we can validate these biomarkers in urine, we can work on a PCR test that is simple and affordable. PCR machines are available worldwide, so a test could be implemented quickly,’ he says. 

The impact of the research could be significant: 

• Early detection of cervical cancer in urine: This could reduce the burden on women and save lives. 
• Affordable screening: Especially important for low- and middle-income countries. 
• Wider use of non-invasive diagnostics: A model for other diseases. 

The AUF Startstipendium plays a crucial role in the implementation of the project. 'The stipendium allows for laboratory materials and sequencing costs,' Molina explains. 'It feels like recognition of the importance of my research.' 

For Molina personally, the grant is a springboard. 'It gives me a chance to develop a risky but promising idea. This kind of funding helps young researchers start innovative projects and make their way in science.' 

Steppingstone to broader applications in cancer diagnostics 

Molina sees his research as a steppingstone to broader applications in cancer diagnostics: 'My dream is to develop a test that combines different signals - tRNAs, the microbiome, and other biomarkers - to get a more complete picture of the disease,' he says. 'With this research, I hope to make a difference, not only for women in The Netherlands, but worldwide.'