Home-Based or Clinic-Based Human Papillomavirus (HPV) Screening

Human Papillomavirus Infection Clinical Trial

Official title: Cytology vs. at Home HPV Screening for Detection of CIN 2,3,CIS

Status Completed

Clinical Trial Summary

This randomized clinical trial studies home-based HPV or clinic-based Pap screening for cervical cancer. It is not yet known whether home-based screening is more effective, cost-effective, and/or acceptable than clinic-based screening for cervical cancer.

Clinical Trial Description

PRIMARY OBJECTIVES:

I. Compare the sensitivity and specificity for cervical intraepithelial neoplasia (CIN) of two screening approaches:

• Novel approach: every 3 years high risk-human papillomavirus (HR-HPV) testing of (at home) self-collected samples with in-clinic cytology of HR-HPV positive women and referral to colposcopy of women with cytology > atypical squamous cells of uncertain significance (ASCUS); repeat HPV testing of HR-HPV positive but cytology negative women at one year;

• Currently recommended approach: for women < 30: every 3 years in-clinic cytology screening, with HPV based triage of women with ASCUS and referral to colposcopy of all women with squamous intraepithelial lesion (SIL) and/or HPV+ ASCUS; for women 30+, screening by Papanicolaou (Pap) and HPV, every 2-3 year (depending on previous history) with referral to colposcopy of those who are HPV 16/18+ or with cytology > ASCUS; retesting of those who are positive for other HR-HPV at one year.

II. Compare these two approaches with respect to overall cost-effectiveness and acceptability.

III. Determine the performance and cost-effectiveness of each approach in vaccinated and unvaccinated women < 30.

OUTLINE: Participants are randomized to 1 of 2 arms.

GROUP I (home-based HPV screening): Participants collect 2 vaginal specimens using polyester swabs. Participants with a positive HPV test result will have a Pap test. Participants with an abnormal Pap test will undergo standard of care as in Group II.

GROUP II (clinic-based standard of care screening): Participants undergo Pap testing. Participants with a positive Pap test undergo standard of care, including colposcopy, HPV testing, cervical biopsy and/or endocervical curettage (ECC). Participants with cervical biopsies showing precancerous changes requiring treatment may undergo loop electrosurgical excision procedure (LEEP) or are referred to appropriate care. ;

Related Conditions & MeSH terms

• Atypical Squamous Cell of Undetermined Significance
• Carcinoma in Situ
• Cervical Carcinoma
• Cervical Intraepithelial Neoplasia
• Cervical Intraepithelial Neoplasia Grade 2/3
• Health Status Unknown
• Human Papillomavirus Infection
• Low Grade Cervical Squamous Intraepithelial Neoplasia
• Neoplasms
• Papillomavirus Infections
• Squamous Intraepithelial Lesions of the Cervix
• Stage 0 Cervical Cancer
• Uterine Cervical Neoplasms

• NCT number: NCT01550783
• Study type: Interventional
• Source: University of Washington
• Status: Completed
• Phase: N/A
• Start date: March 2012
• Completion date: November 16, 2017