- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04298957
See and Treat in an Outpatient Setting in Women Above 45 Years With Cervical Dysplasia
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
In Denmark, 370 women are diagnosed with cervical cancer every year and approximately 100 women die from the disease. Young women can be protected with the HPV vaccine, but it will take decades before the vaccine has an effect on older women. Women who are HPV positive have a risk of developing severe dysplasia of 25-55% within 10 years. Compared to younger women, older women are also more likely to be diagnosed with advanced-stage disease and their mortality is high. Due to retraction of the transformation zone into the cervical canal and atrophy of the mucosa the performance of colposcopy is low. Furthermore, the sensitivity of cytology decreases with age. This makes it very difficult to obtain sufficient biopsies and therefore postmenopausal women are often required to undergo colposcopy two to three times. Waiting for a final diagnosis and treatment not only has a large mental and practical impact on the women themselves, but it is also an economic burden for the health care system.
"See and treat" is a procedure that involves cervical cytology and HPV test, a colposcopy, cervical biopsies, and finally a loop electrosurgical excisional procedure by which the transformation zone is removed. This approach allows women to be diagnosed and treated in one visit.
In this project, the aim is to investigate if the implementation of "see and treat" in a gynecological outpatient clinic can optimize the diagnostics, clinical follow-up, and treatment of older women with abnormal cervical cytology or HPV-infection.
Participants Women aged ≥ 45 years with cervical dysplasia and/or a positive HPV test are referred from the general practitioner to the gynecological department.
Procedure At each inclusion site, the local project manager evaluates all the referred women for possible inclusion. Project information is sent either by e-mail or letter to eligible women. At the outpatient clinic, the eligible women will be informed about the project and asked to sign an informed consent form regarding their participation in the project.
If the eligible women agree to participate a physician in the outpatient clinic will obtain a cervical smear (i.e. cytology and Human Papillomavirus (HPV) test) and perform colposcopy and take four random biopsies. If the transformation zone (TZ) is partly visible or not visible a cone biopsy will be performed in local anesthesia (Citanest).
If the participant meet the exclusion criteria or declines to participate standard treatment will be offered (colposcopy and biopsies).
The included patients will be followed up with an HPV test after 6 months.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Jutland
-
Horsens, Jutland, Denmark, 8700
- Horsens Regional Hospital
-
Randers, Jutland, Denmark, 8930
- Randers Regional Hospital
-
Viborg, Jutland, Denmark, 8800
- Viborg Regional Hospital
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Women ≥ 45 years with a positive screening test (abnormal cytology and/or persistence HPV positive) who are referred to the Department of Obstetrics and Gynecology.
- Type 2 or 3 transformation zone (a partly or invisible transformation zone).
Exclusion Criteria:
- Type 1 transformation zone (fully visible)
- Current or previous diagnosis of cervical cancer.
- Pregnancy or pregnancy wish.
- Previously cone biopsy
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Other: See and treat
Cone biopsi is offered to women age ≥ 45 years referred to Department of Obstetrics and Gynecology due to a positive cervical screening test and partly or invisible transformation zone.
|
Cone biopsy if transformation Zone (TZ) 2 or TZ 3
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Cervical intraepithelial neoplasia ≥ grade 2 (CIN2+) lesion after referral with a positive cervical screening test
Time Frame: The histological diagnose from the Pathological Department will be available 8 weeks after inclusion.
|
The prevalence of CIN2+ lesions in women ≥45 years included in the study
|
The histological diagnose from the Pathological Department will be available 8 weeks after inclusion.
|
Concordance between cytology and histology
Time Frame: The histological diagnose from the Pathological Department will be available 8 weeks after inclusion.
|
Concordance between cytology, biopsies and cone biopsy in the ability to detect CIN2+ changes
|
The histological diagnose from the Pathological Department will be available 8 weeks after inclusion.
|
Clearance of HPV
Time Frame: This will be available 7 months after inclusion.
|
Clearance rate of HPV after 6 months
|
This will be available 7 months after inclusion.
|
Complication rate
Time Frame: Complication rate will be evaluated 6 months after inclusion.
|
Complication rate of bleeding, infection and/or stenosis
|
Complication rate will be evaluated 6 months after inclusion.
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Line W Gustafson, MD, Randers Regional Hospital and Aarhus University
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 172230
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
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.
Clinical Trials on Cervical Dysplasia
-
University of Mississippi Medical CenterNot yet recruitingCervical Dysplasia, Uterine | Vaginal Dysplasia | Vulvar Dysplasia
-
National Institute of Allergy and Infectious Diseases...Hoffmann-La RocheCompletedHIV Infections | Cervix, DysplasiaUnited States, Puerto Rico
-
M.D. Anderson Cancer CenterNational Cancer Institute (NCI)Terminated
-
Sunnybrook Health Sciences CentreCompleted
-
Ruhr University of BochumCompletedUterine Cervical DysplasiaGermany
-
Indiana UniversityRecruitingHIV Infections | HIV/AIDS | Cervical DysplasiaKenya, United States, Uganda
-
University of AarhusNot yet recruitingCervical Cancer
-
NHS Greater Glasgow and ClydeUnknownCervical Carcinoma | Cervical Dysplasia
-
Ruhr University of BochumRecruiting
-
University of CopenhagenDanish Cancer SocietyUnknown
Clinical Trials on Cone biopsy
-
Zydolab - Institute of Cytology and Immune CytochemistryRuhr University of BochumCompletedUterine Cervical DysplasiaGermany
-
Gynecologic Oncology GroupNational Cancer Institute (NCI)CompletedPrecancerous Condition | Stage 0 Cervical CancerUnited States
-
Northwell HealthRecruiting
-
GOG FoundationNational Cancer Institute (NCI)Active, not recruitingLymphedema | Cervical Adenocarcinoma | Cervical Adenosquamous Carcinoma | Cervical Squamous Cell Carcinoma | Stage IA2 Cervical Cancer AJCC v6 and v7 | Stage IB1 Cervical Cancer AJCC v6 and v7 | Stage IA1 Cervical Cancer AJCC v6 and v7United States, Korea, Republic of, Canada
-
Semmelweis UniversityCompletedAlveolar Bone Loss | Edentulous; Alveolar Process, Atrophy | Sinus PneumatizationHungary
-
Centre Hospitalier Universitaire, AmiensActive, not recruiting
-
University Health Network, TorontoPrincess Margaret Hospital, CanadaCompleted
-
Fondation Ophtalmologique Adolphe de RothschildCompleted
-
University of Alabama at BirminghamActive, not recruitingRAD 1601: EDGE Radiosurgery for Intractable Essential Tremor and Tremor-Dominant Parkinson's DiseaseParkinson Disease | Essential TremorUnited States
-
University Hospital, BordeauxTerminated