Swabs in Screening for HPV (SWISH) (SWISH)
Randomised Controlled Trial of Self-collected vs Clinician-collected Anal Swabs for Anal Cancer Screening in People Living With HIV (PLHIV) in Australia
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Descrizione dettagliata
This multi-centred, order-randomised, controlled, cross-over clinical trial of self-versus clinician- collected swabs (SCS) and clinician-collected swabs (CCS), enrolling 700 participants across participating clinical trial recruitment sites in Australia. Participants will undertake SCS immediately followed by CCS, or vice versa, in an order-randomised manner with all participants completing both methods of collection. Both anal swabs will be tested for HRHPV, cytology, and methylation.
In the cervix, evidence suggests that a second swab taken on the same day may produce an inferior sample for cytology compared with the first swab. For this reason, studies comparing two swabs must control for the order of collection. In this trial, the order of the self-collected and clinician-collected anal swabs will be randomised. Randomisation will be stratified by clinical trial site.
Clinicians and participants will be unblinded to allow for swab collection; diagnostic and research laboratory staff, and research investigators who analyse the study outcomes will be blinded to both the order and method of collection for each swab.
Enrolment will continue until 700 participants have been randomised at a mixture of metropolitan and regional clinical trial sites. The study duration is 5 years.
Participants will be recruited via their regular HIV medical care at participating clinical trial sites.
Participants will be either gay or bisexual man (GBM) or trans women living with HIV aged 35 years or older, or all other people living with HIV aged 45 years or older. It is expected that most participants will be GBM, reflecting the Australian HIV epidemic but to ensure diversity, a minimum aggregate of 50 non- GBM living with HIV will be recruited per the inclusion criteria.
Participants who are HRHPV negative will exit the trial, unless they have been diagnosed with possible HSIL (pHSIL) or HSIL on cytology. Participants who are tested positive for HRHPV will be referred for high-resolution anoscopy (HRA). Participants who are tested negative for HRHPV but have pHSIL or HSIL diagnosed on cytology will be referred for high-resolution anoscopy (HRA).
During the HRA, the anoscopist will take small biopsies of any tissue suspected to have abnormal cells. The biopsy samples will undergo diagnostic histology.
Participants who are not diagnosed with high-grade squamous intraepithelial lesion (HSIL), will exit the trial. Participants who are diagnosed with HSIL but undergo treatment will exit the trial. Participants who are diagnosed with HSIL and do not receive treatment will have a 12-month Follow-up HRA then exit the trial.
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Fase
Fase
- Non applicabile
Contatti e Sedi
Contatto studio
Contatto studio
- Nome: Dr Isobel Mary Poynten, MBBS, MPH, DCH PhD
- Numero di telefono: +61293850900
- Email: Mpoynten@kirby.unsw.edu.au
Backup dei contatti dello studio
- Nome: Ms Barbara Yeung, BHSc, MPH
- Numero di telefono: +61293850879
- Email: byeung@kirby.unsw.edu.au
Luoghi di studio
-
-
New South Wales
-
Cudgen, New South Wales, Australia, 2487
- North Coast Sexual Health and HIV Services, Tweed Valley Sexual Health Clinic
-
Contatto:
- A/Professor Vincent Cornellise, MBBS, PhD
- Numero di telefono: +612 66772850
- Email: Vincent.Cornelisse@health.nsw.gov.au
-
Investigatore principale:
- A/Professor Vincent Cornellise, MBBS, PhD
-
Darlinghurst, New South Wales, Australia, 2010
- Taylor Square Private Clinic
-
Contatto:
- Dr Mark O'Reilly, MBBS
- Numero di telefono: +612 93316151
- Email: moreilly@tspc.com.au
-
Investigatore principale:
- Dr Mark O'Reilly, MBBS
-
Sydney, New South Wales, Australia, 2010
- Holdsworth House Medical Practice
-
Contatto:
- Dr Mark Bloch, MBBS
- Numero di telefono: +612 93317228
- Email: Mark.Bloch@holdsworthhouse.com.au
-
Investigatore principale:
- Dr Mark Bloch, MBBS
-
Sydney, New South Wales, Australia, 2010
- St Vincent's Hospital, Sydney
-
Contatto:
- Prof Richard Hillman, MBChB, PhD, FRCP
- Numero di telefono: +61283823707
- Email: Richard.Hillman@svha.org.au
-
Investigatore principale:
- Prof Richard Hillman, MBChB, PhD, FRCP
-
Sydney, New South Wales, Australia, 2000
- Sydney Sexual Health Centre
-
Contatto:
- Dr Rick Varma, MB ChB, MRCP
- Numero di telefono: +612 93827440
- Email: rick.varma@health.nsw.gov.au
-
Investigatore principale:
- Dr Rick Varma, MB ChB, MRCP
-
Sydney, New South Wales, Australia, 2050
- RPA Sexual Health
-
Contatto:
- Dr Rachel Burdon, MBBS, MPH
- Numero di telefono: +612 95151200
- Email: Rachel.Burdon@health.nsw.gov.au
-
Investigatore principale:
- Dr Rachel Burdon, MBBS, MPH
-
Sydney, New South Wales, Australia, 2010
- Easy Sydney Doctors
-
Contatto:
- Dr David Baker, MBBS
- Numero di telefono: +612 93322531
- Email: dbaker@eastsydneydoctors.com.au
-
Investigatore principale:
- Dr David Baker, MBBS
-
Sydney, New South Wales, Australia, 2150
- Western Sydney Sexual Health Centre
-
Contatto:
- Prof David Lewis, MBBS, PhD
- Numero di telefono: +612 97625388
- Email: david.lewis2@health.nsw.gov.au
-
Investigatore principale:
- Prof David Lewis, MBBS, PhD
-
-
South Australia
-
Adelaide, South Australia, Australia, 5000
- Royal Adelaide Hospital
-
Contatto:
- Dr Michelle Thomas, MBBS, PhD
- Numero di telefono: +618 70742790
- Email: michelle@adelaideprivate.com
-
Investigatore principale:
- Dr Michelle Thomas, MBBS, PhD
-
-
Victoria
-
Melbourne, Victoria, Australia, 3053
- Melbourne Sexual Health Centre
-
Contatto:
- Professor Jason Ong, MBBS, PhD
- Numero di telefono: +613 93416200
- Email: JOng@mshc.org.au
-
Investigatore principale:
- Professor Jason Ong, MBBS, PhD
-
-
Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Descrizione
Inclusion Criteria:
- Living with HIV.
- Gay, bisexual or other man who has sex with men or trans woman aged at least 35 years, or all other people aged at least 45 years.
- Able to commit to and undertake all study procedures.
- Willing and able to provide informed consent, in any of the following languages:
i. English. ii. Alternatively, use of the accredited translation service usually utilised in the participant's healthcare appointments.
Exclusion Criteria:
- Aged over 75 years of age at time of enrolment.
- Previously undergone an HRA.
- History of anal cancer and/or anal HSIL.
- Medically directed treatment (including topical treatments) to the anal canal in the preceding two weeks, which in the opinion of the consenting investigator could impact swab viability.
- Concurrent malignancy requiring systemic therapy, or medical conditions otherwise considered contraindicated to HRA by the delegated investigators.
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Selezione
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione incrociata
- Mascheramento: Doppio
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
|
Sperimentale: Arm A: Self-collected anal swab followed by clinician-collected anal swab
Cross over
|
Each participant will be order-randomised to undergo a self-collected or clinician-collected anal swab first, with the alternate swab collected immediately afterwards.
Both swab will be collected on the same day at the Baseline Visit.
|
|
Sperimentale: Arm B: Clinician-collected anal swab followed by self-collected anal swab
Cross over
|
Each participant will be order-randomised to undergo a self-collected or clinician-collected anal swab first, with the alternate swab collected immediately afterwards.
Both swab will be collected on the same day at the Baseline Visit.
|
Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Compare the sample validity of self-collected anal swabs with clinician-collected anal swabs, for HRHPV, in the eligible cohort.
Lasso di tempo: At Baseline.
|
To measure the percentage of self-collected anal swabs that are valid for HRHPV testing compared with clinician-collected anal swabs, as defined by internal control positivity.
|
At Baseline.
|
Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
To evaluate sample quality for cytology of self-collected ana swabs compared with clinician-collected anal swabs, in the eligible cohort.
Lasso di tempo: At Baseline.
|
To measure the proportion of self-collected anal swabs that have satisfactory sample quality for cytology, compared with the proportion of clinician-collected anal swabs that have satisfactory sample quality.
|
At Baseline.
|
|
To compare the HRHPV findings of self-collected anal swabs compared with clinician-collected anal swabs, in the eligible cohort.
Lasso di tempo: At Baseline.
|
To measure between self-collected and clinician-collected swabs, the level of agreement between HRHPV testing results.
|
At Baseline.
|
|
To compare the HRHPV findings of self-collected anal swabs compared with clinician-collected anal swabs, in the eligible cohort.
Lasso di tempo: At Baseline.
|
To measure between self-collected and clinician-collected swabs, prevalence of any HRHPV.
|
At Baseline.
|
|
To compare the HRHPV findings of self-collected anal swabs compared with clinician-collected anal swabs, in the eligible cohort.
Lasso di tempo: At Baseline.
|
To measure between self-collected and clinician-collected swabs, prevalence of HPV16.
|
At Baseline.
|
|
To compare the cytology findings of self-collected anal swabs compared with clinician-collected anal swabs, according to the modified Bethesda criteria in the eligible cohort.
Lasso di tempo: At Baseline.
|
To measure between self-collected and clinician-collected swabs according to modified Bethesda criteria, the level of agreement between cytology testing results.
|
At Baseline.
|
|
To compare the cytology findings of self-collected anal swabs compared with clinician-collected anal swabs, according to the modified Bethesda criteria in the eligible cohort.
Lasso di tempo: At Baseline.
|
To measure between self-collected and clinician-collected swabs according to modified Bethesda criteria, prevalence of any cytological abnormality.
|
At Baseline.
|
|
To compare the cytology findings of self-collected anal swabs compared with clinician-collected anal swabs, according to the modified Bethesda criteria in the eligible cohort.
Lasso di tempo: At Baseline.
|
To measure between self-collected and clinician-collected swabs according to modified Bethesda criteria, prevalence of cytological HSIL.
|
At Baseline.
|
Altre misure di risultato
Altre misure di risultato
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
To evaluate participant perception of self-collected anal swabs as an alternative to clinician-collected anal swabs.
Lasso di tempo: At Baseline.
|
To measure distribution of participant responses on the acceptability and feasibility of self-collected anal swabs in future screening, measured via the Participant Reported Experience Measures instrument.
|
At Baseline.
|
|
To evaluate participant self-reported awareness of anal cancer, acceptability and willingness to complete self-collected swab for screening.
Lasso di tempo: At Baseline.
|
Interview data will be evaluated using standard qualitative analysis, including thematic analysis.
|
At Baseline.
|
|
To evaluate use of methylation testing, compared with anal cytology as a triage test for anal HSIL.
Lasso di tempo: At Baseline.
|
To compare sensitivity and specificity of methylation testing compared with anal cytology, for predicting histologically confirmed HSIL.
|
At Baseline.
|
|
To evaluate anal HSIL persistence at 12-month follow-up HRA, compared with Diagnostic HRA by Baseline anal swab methylation status.
Lasso di tempo: From Baseline through to Month 15.
|
To measure the proportion of participants diagnosed with HSIL at Diagnostic HRA who have persistent HSIL at 12-month follow-up HRA, stratified by Baseline anal swab methylation status.
|
From Baseline through to Month 15.
|
|
To evaluate long-term anal cancer outcomes, for participants that consent to data linkage.
Lasso di tempo: From Baseline until 5 years after the completion of the initial trial.
|
Evaluation of anal cancer diagnoses against HRHPV status, histological findings and methylation testing results.
|
From Baseline until 5 years after the completion of the initial trial.
|
Collaboratori e investigatori
Sponsor
Sponsor
Investigatori
Investigatori
- Cattedra di studio: Dr Isobel Mary Poynten, MBBS, MPH, DCH PhD, The Kirby Institute, University of New South Wales Sydney, Australia
- Investigatore principale: Scientia Prof Andrew Grulich, MBBS, PhD, FAFPHM, FAAHMS, The Kirby Institute, University of New South Wales Sydney, Australia
Studiare le date dei record
Studia le date principali
Inizio studio (Stimato)
Inizio studio
Completamento primario (Stimato)
Completamento primario
Completamento dello studio (Stimato)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- HEPP 202601
- APP2047111 (Altro numero di sovvenzione/finanziamento: National Health and Medical Research Council, Australia)
Informazioni su farmaci e dispositivi, documenti di studio
Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti
Studia un dispositivo regolamentato dalla FDA degli Stati Uniti
Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .