Promoting Comprehensive Cervical Cancer Prevention and Better Women Health in Cameroon (PCCCP)
In sub-Saharan Africa, cervical cancer is the leading cause of cancer death among women because of the difficulty in implementing screening programs. The main obstacles in these countries are poverty, lack of healthcare infrastructures and trained practitioners. With the availability of new technologies, researchers are looking for new strategies adapted to low- and middle-income countries to identify cervical precancerous lesions.
Current evidence shows that Human Papilloma Virus (HPV) testing is more effective than cytology (Pap smear) for cervical cancer screening in resource-limited settings. Indeed, the GeneXpert® HPV test offers the opportunity to prevent cervical cancer (CC) in a single visit: rapid detection of high-risk HPV (HPV) infection followed by same day treatment of HPV-positive women during the same visit (screen-and-treat approach).
However only a small proportion of HPV-positive women will develop cervical (pre)cancer, making it important to select those to treat. This triage can be achieved by colposcopy, cytology and visual inspection after application of acetic acid (VIA). Though VIA is the triage test recommended by WHO for resource-limited countries, it has not yet been widely assessed in sub-Saharan Africa (SSA).
The main objective of the investigators is to assess the performance of HPV-test followed by Visual Inspection after application of Acetic acid and Lugol's iodine VIA/VILI to detect cervical precancerous lesions in a screen-and-treat strategy in Cameroon (sub-Saharan Africa) where there is no cervical cancer-screening program.
The investigators organized a successful free screening campaign in Cameroon in 2015 that allowed to identify the expectations of women and their eagerness to benefit from prevention of gynecological cancers and sexually transmitted diseases.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Geneva, Switzerland, 1205
- University of Geneva
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Women aged 30-49 years, able to comply with the study protocol
Exclusion Criteria:
- Pregnancy
- Previous total hysterectomy
- Conditions impairing examination of the cervix
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: Self HPV
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Vaginal specimens for HPV test will be collected by participants themselves using flocked swabs after explanations by co-investigators.
Two transport mediums will be used for those self-collected vaginal samples: NaCl 0.9%.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Sensitivity and specificity of HPV test followed by VIA/VILI to detect cervical precancerous lesions in sub-Saharan Africa using histology as gold standard
Time Frame: 3 - 5 years
|
VIA/VILI is assessed by pelvic examination and Sensitivity and specificity are measured by using histology as gold stantard
|
3 - 5 years
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Prevalence of HPV infection
Time Frame: 3 - 5 years
|
HPV self-test analysed by GeneXpert machine
|
3 - 5 years
|
|
Prevalence of cervical pre-cancer and cancer among Cameroonian women
Time Frame: 3 - 5 years
|
Histological analyses of cervical biopsies and endocervical brushing
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3 - 5 years
|
|
HPV clearance
Time Frame: 3 - 5 years
|
Measured by self HPV performed at 6 and 12 months follow up
|
3 - 5 years
|
|
Persistance of CIN2+ disease at the 12-month follow-up
Time Frame: 3 - 5 years
|
Histological analyses of cervical biopsies and endocervical brushing
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3 - 5 years
|
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Provide teaching material for professional training on cervical cancer prevention through VIA/VILI (cervical images database)
Time Frame: 3 - 5 years
|
images database
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3 - 5 years
|
|
Acceptability rate of self-HPV test and cervical cancer screening procedures
Time Frame: 3 years
|
To assess the acceptability of self-HPV, patients complete a questionnaire comprising different questions about the collection device (embarassment, comfort, anxiety and confidence about the test). Likert Scale 4 points : 1 (not at all) to 4 (very). |
3 years
|
|
Proportion of side effects and complications after thermoablation or LEEP
Time Frame: 3 - 5 years
|
questionnaire
|
3 - 5 years
|
|
VIA test-positive rate (HPV-positive women);
Time Frame: 3 - 5 years
|
VIA/VILI is assessed by pelvic examination
|
3 - 5 years
|
|
VIA test-positive rate after 1- year follow-up of VIA-negative tests
Time Frame: 3 - 5 years
|
VIA/VILI is assessed by pelvic examination
|
3 - 5 years
|
|
Thermal ablation efficacy rate
Time Frame: 3 - 5 years
|
Thermal ablation efficacy rate will be assessed according to the biopsy proven CIN2+ rate after thermoablation treatment at the 6 and 12-month follow-up. The absence of CIN2+ will determine the success of the treatment in a patient who previously had a CIN2+ lesion. Adverses event : bleeding, complications, hospitalization |
3 - 5 years
|
|
Acceptability rate of thermoablation
Time Frame: 3 years
|
To assess the acceptability of thermoablation, patients completed a questionnaire comprising different questions about treatment tolerance, pain and following side effects.
Respondent were invited to rate answers on a likert scale of 1 (no accpetability) to 4 (high acceptability)
|
3 years
|
|
Sexual dysfunction score, score of anxiety and method of contraception after screening procedures,
Time Frame: 2 years
|
SF12, Asex, STAI 6 Y-form
|
2 years
|
|
Number of women screened with and without community health care workers.
Time Frame: 2 years
|
community health workers registre
|
2 years
|
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Increase awareness on gynecological pathologies, including cervical cancer, sexually transmitted diseases and HIV, vaginal fistula in the community of the study area,
Time Frame: 3-5 years
|
questionnaire
|
3-5 years
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- Petignat P, Kenfack B, Wisniak A, Saiji E, Tille JC, Tsuala Fouogue J, Catarino R, Tincho E, Vassilakos P. ABCD criteria to improve visual inspection with acetic acid (VIA) triage in HPV-positive women: a prospective study of diagnostic accuracy. BMJ Open. 2022 Apr 4;12(4):e052504. doi: 10.1136/bmjopen-2021-052504.
- Metaxas T, Kenfack B, Sormani J, Tincho E, Lemoupa Makajio S, Wisniak A, Vassilakos P, Petignat P. Acceptability and safety of thermal ablation to prevent cervical cancer in sub-Saharan Africa. BMC Cancer. 2022 Feb 2;22(1):132. doi: 10.1186/s12885-022-09202-2.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Urogenital Diseases
- Genital Diseases
- Urogenital Neoplasms
- Neoplasms by Site
- Neoplasms
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Uterine Diseases
- Genital Diseases, Female
- Genital Neoplasms, Female
- Uterine Cervical Diseases
- Uterine Neoplasms
- Uterine Cervical Neoplasms
Other Study ID Numbers
Other Study ID Numbers
- 2017-01110
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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