Self-sampling and Human Papillomavirus (HPV)-Testing for Unscreened Women in Cervical Cancer Prevention (APACHE-2)
Attitudes to Different Strategies Among Women Not Attending Cervical Cancer Screening: Further Invitation by Mail or Kit for Self-collected Vaginal Sample
Scientific Context:
High-risk types of human papillomavirus (HPV) are the causative agents for cervical cancer. Cervical cancer screening strategies rely on periodic Papanicolaou (Pap) testing. It's well-known that this test has significantly contributed to the reduction of mortality and morbidity due to cervical cancer. In France, it now seems that the screening strategy could be optimized. The two main ways are to reach the 7 million underscreened women (organized screening, self-sampling for HPV DNA testing) and to improve the screening test (HPV DNA testing, computer-assisted cytology). Self-collected vaginal samples (SCVS) for HPV DNA testing could be a relevant screening option: this technique appears reliable and it could allow to reach women who are never or seldom screened. The performance of the SCVS to detect cervical HPV infection has been assessed by the first part of the whole study: APACHE-1.
The goal of this study is to compare the attitudes of women not attending organized cervical cancer screening face to different strategies: further invitation to make a cervical smear or kit for self-collected vaginal sample sent at home.
Description of the project :
Nine months after a primary invitation to make a cervical smear, a random sample of 6000 women not attending organized cervical cancer screening will be randomly assigned to one of the following arms:
- Intervention arm 1:
Women will receive a further invitation to make a cervical smear
- Intervention arm 2:
Women will be directly sent the kit for self-collected vaginal sample at home. The women who will send the self-sample to the laboratory for analyse will receive their results at home as well as their general practitioner if the HPV DNA test is positive (infection by a high-risk HPV).
For them who will have a HPV DNA test positive, it will be necessary to complete the screening action with a cervical smear. That's why those women will receive an invitation to make a cervical smear if they won't do it during the 9 months following the first mail.
- Control arm: Those women will receive complete information about the study, the main results and the screening recommendations at the end of the study.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Type d'étude
Inscription (Réel)
Phase
- Première phase 1
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria :
- Women from 30 to 65 years
- Living in Indre-et-Loire (french territorial division 37)
Exclusion Criteria :
- Women who attend organized cervical cancer screening or who answer to the invitation
- Cervical smear made in the three last years
- HPV linked cervical condition undergoing treatment
- Hysterectomy (including cervix)
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Dépistage
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Seul
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Expérimental: Group 1 : Further invitation by mail
Further invitation to attend for cervical cytology
|
A further invitation to attend for cervical cytology are going to be sent by mail to women
|
|
Expérimental: Group 2 : Kit for Self-collected vaginal sample
Kit for Self-collected vaginal sample sent at home and then test for Human Papillomavirus (HPV)
|
Kit for self-collected vaginal sample are going to be directly sent at women's home
|
|
Aucune intervention: Group 3: Control
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Comparison of women's attitude according to the arm: participation or not to a whole screening action
Délai: 9 months after the beginning of the study (sending of mails)
|
Comparison of attitudes among women not attending organized cervical cancer according to the type of intervention or the lack of intervention: participation or not to a whole screening action. Are considered as whole screening action:
|
9 months after the beginning of the study (sending of mails)
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Analysis in sub-groups
Délai: 9 months after the beginning of the study (sending of mails)
|
Analysis in sub-groups in order to compare the efficacy of interventions according to :
|
9 months after the beginning of the study (sending of mails)
|
|
Identification of the psychological determinants and mechanisms (checks and motivational factors)
Délai: 9 months after the beginning of the study (sending of mails)
|
Identify the psychological determinants and mechanisms (checks and motivational factors) that can affect enrollment to the screening procedure for self-collection vaginal sample or cervical smear. Nine months after the beginning of the study, a questionnaire will be send to the 6000 women. |
9 months after the beginning of the study (sending of mails)
|
Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Directeur d'études: Ken HAGUENOER, François Rabelais University, Public Health Laboratory, Tours, France
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Estimation)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- INCA08-KH / APACHE-2
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