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Trial registered on ANZCTR
Registration number
ACTRN12616001401448
Ethics application status
Approved
Date submitted
3/10/2016
Date registered
10/10/2016
Date last updated
19/02/2021
Date data sharing statement initially provided
19/02/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
Feasibility of a human papilloma virus (HPV) self-sampling for cervical screening in Maori women in West Auckland
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Scientific title
Feasibility of Waitemata and Auckland District Health Board (DHB ) Human Papilloma Virus (HPV) self-sampling for cervical screening in Maori Women in West Auckland
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Secondary ID [1]
290259
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Nil known
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Universal Trial Number (UTN)
U1111-1188-3226
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Trial acronym
HPV-SS
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Linked study record
Nil
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Health condition
Health condition(s) or problem(s) studied:
Cervical screening
300477
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Human papilloma virus
300478
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Self-sampling
300479
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Condition category
Condition code
Public Health
300335
300335
0
0
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Health service research
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Infection
300344
300344
0
0
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Sexually transmitted infections
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Using a novel HPV detection method (low vaginal self-sampling with cotton swab and HPV molecular testing with the Roche Cobas 4800 platform), as a primary screening test for cervical screening. Invitation through the primary care clinic (monthly matched lists between primary care enrolled patient and cervical screening register is routine practice, these lists will be used for recruitment). Invitation to attend the clinic, discuss the study and consent. Women able to complete the self-sampling at the clinic (in the bathroom) during this visit or take it home and return the kit to the clinic. Women are asked their preference for receipt of results. All results are provided to women, even it is usual practice for the clinic not to return negative results. Negative results will be phoned or text per patient preference. Positive results women will be phoned and asked to attend a clinic to discuss with the GP, practice nurse or research nurse. The completed kits are stable for 6 months for analysis and will be processed if received before this date.
Feasibility study of the impact of this intervention on cervical screening programme participation. The study is therefore assessing: a novel device, a potential process-of-care change, impact on behavioural change and preventive care.
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Intervention code [1]
296052
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Early detection / Screening
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Comparator / control treatment
No control group - feasibility and acceptability study
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Participation rate (uptake) of HPV self-sampling. Sample population are eligible women identified on primary care data-matched lists as never-screened or underscreened (5 years since last recorded screen) and Maori. The proportion of these women able to be contacted, who perform the self test and for whom a laboratory test result is received.
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Assessment method [1]
299799
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Timepoint [1]
299799
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12 months post offer of self-test kit from datamatched list.
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Primary outcome [2]
299800
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Prevalence of high risk HPV genotypes from self test low vaginal swab, as detected by the Roche Cobas 4800 platform (negative, positive HPV16, HPV18, or 'other' high risk HPV type).
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Assessment method [2]
299800
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Timepoint [2]
299800
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12 months post offer of self-test kit from datamatched list.
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Primary outcome [3]
299801
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Follow up rate of HPV positive women for cytology with primary care provider or colposcopy at hospital clinic as assessed by National Cervical Screening Programme Register (records all cytology and histology events), general practice electronic records, and colposcopy clinical electronic records.
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Assessment method [3]
299801
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Timepoint [3]
299801
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6 months post HPV positive test recorded in the National Cervical Screening Programme Register.
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Secondary outcome [1]
328168
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Provider knowledge questionnaire - composite outcome based on validated questionnaire tool developed in the UK Sue Sherman (Keele University) with primary care providers (Ref below) localised with permission. This questionnaire has ethical approval from Massey University Institutional Committee, and is already in use with providers in the Auckland and Wellington regions). This questionnaire will be completed with different health disciplines within primary care as part of the provider education training package.
Reference: Patel H, Austin-Smith K, Sherman SM, Tincello D, Moss EL. Knowledge, attitudes and awareness of the human papillomavirus amongst primary care practice nurses: an evaluation of current training in England. Journal of Public Health. 2016.
Knowledge questionnaire for women - composite outcome based on a qualitative tool developed in the UK by Sue Sherman (Keele University) HPV public knowledge questionnaire (Ref below) has been localised with permission for this purpose. This questionnaire will be optional for women, and will be completed prior to the HPV self-sample test in order to more accurately reflect baseline level of HPV knowledge before detailed discussion related to self-sampling consent.
Reference: Sherman SM, Nailer E, Minshall C, Coombes R, Cooper J, Redman CWE. Awareness and knowledge of HPV and cervical cancer in female students: A survey (with a cautionary note). Journal of Obstetrics and Gynaecology. 2016;36(1):76-80
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Assessment method [1]
328168
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Timepoint [1]
328168
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12 months post offer of self-test kit from datamatched list.
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Secondary outcome [2]
328169
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Resource requirements for follow-up >90%.
Assessed by the research nurse and Independent Service Provider of support to services (support to cytology and to colposcopy). Variables are support for specific activities (none, childcare, transport, financial, visit attendance, further information/education) for those women who are referred for support.
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Assessment method [2]
328169
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Timepoint [2]
328169
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6 months post HPV positive test recorded in the National Cervical Screening Programme Register.
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Eligibility
Key inclusion criteria
Age 30-69
Never-screened or under-screened (5 years from previous test)
Maori ethnicity
Resident Waitemata DHB or Auckland DHB
Enrolled in a West Auckland general practice
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Minimum age
30
Years
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Maximum age
69
Years
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Sex
Females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Previous High Grade history with incomplete clinical follow up
Symptomatic
Pregnant
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
N/A
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
N/A
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
Feasibility and acceptability study
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Descriptive statistics and thematic analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
7/11/2016
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Actual
14/12/2016
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Date of last participant enrolment
Anticipated
6/11/2017
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Actual
1/08/2018
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Date of last data collection
Anticipated
31/07/2018
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Actual
31/01/2019
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Sample size
Target
200
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Accrual to date
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Final
84
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Recruitment outside Australia
Country [1]
8292
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New Zealand
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State/province [1]
8292
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Auckland
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Funding & Sponsors
Funding source category [1]
294627
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Government body
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Name [1]
294627
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Waitemata District Health Board
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Address [1]
294627
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15 Shea Tce, Takapuna 0740
Private Bag 93-503
Auckland
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Country [1]
294627
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New Zealand
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Funding source category [2]
294628
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Charities/Societies/Foundations
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Name [2]
294628
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Awhina Charitable Trust
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Address [2]
294628
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North Shore Hospital
Private Bag 93-503
Takapuna 0740
Auckland
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Country [2]
294628
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New Zealand
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Primary sponsor type
Individual
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Name
Dr Karen Bartholomew
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Address
Waitemata District Health Board
15 Shea Tce, Takapuna 0740
Private Bag 93-503
Auckland
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Country
New Zealand
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Secondary sponsor category [1]
293492
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None
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Name [1]
293492
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None
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Address [1]
293492
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Country [1]
293492
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
296068
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HDEC Central Committee
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Ethics committee address [1]
296068
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Ethics Committees Protection Regulation and Assurance Ministry of Health PO Box 5013 Wellington 6140
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Ethics committee country [1]
296068
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New Zealand
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Date submitted for ethics approval [1]
296068
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13/10/2016
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Approval date [1]
296068
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25/11/2016
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Ethics approval number [1]
296068
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16STH176
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Summary
Brief summary
While overall cervical cancer rates have reduced, Maori women are still twice as likely as non-Maori women to be diagnosed or die from cervical cancer. Auckland and Waitemata DHBs have low Maori cervical screening coverage rates (56.4% and 59.2%, respectively), which remain longstanding despite local and national initiatives to reduce screening barriers. Improving access to cervical screening for Maori women remains a priority for the Ministry of Health and in the Auckland and Waitemata DHBs Maori Health Plans (indicator 5). Innovative ways to address access barriers are required. In the context of announced changes by the Ministry of Health from the traditional ‘pap smear’ (cytology) to human papilloma virus (HPV) testing to screen women for cervical cancer, there is a window of opportunity to consider the novel technology of self-sampling to improve screening coverage in a New Zealand context relevant for our population. Self-sampling means that women can perform a low vaginal swab themselves (cervical sampling is not required) rather than requiring a speculum examination from a health professional. The sample could be taken at home or in a health care setting, or potentially another appropriate community setting. HPV detection using vaginal self-sampling is as accurate as clinician-sampling, provided that high performing assays are used to test the samples for the presence of HPV. The objective of this small initial study is to examine the feasibility and acceptability of self-sampling in Maori women as the key audience for this novel technology, and to determine pathway requirements to follow up HPV-positive women. The investigators are committed to Maori health gain and working in partnership with Maori providers, primary care and hospital services. This work purposefully commences with Maori women, to ensure that this novel technology is appropriate and optimised to address inequalities before assessing the technology with other groups of women in our population.
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Trial website
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Trial related presentations / publications
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Public notes
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Attachments [1]
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/AnzctrAttachments/371591-5_Protocol_ADHB WDHB HPVSS_28092016_Final v1_11.docx
(Protocol)
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Attachments [2]
1146
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/AnzctrAttachments/371591-8_HPVSS_Consent form_Final draft.doc
(Participant information/consent)
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Attachments [3]
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/AnzctrAttachments/371591-9_HPVSS_Information Sheet_Focus Groups_29 09 2016_Final draft.docx
(Participant information/consent)
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Attachments [4]
1148
1148
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/AnzctrAttachments/371591-10_Acceptability Questionnaire_Revised_28 09 2016.doc
(Supplementary information)
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Attachments [5]
1149
1149
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/AnzctrAttachments/371591-11_HPV Knowledge Questionnaire_Localised Keele Sherman_Oct 2016.doc
(Supplementary information)
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Attachments [6]
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1150
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/AnzctrAttachments/371591-12_Participant Information sheet_Practitioners_Massey.pdf
(Supplementary information)
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Attachments [7]
1151
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/AnzctrAttachments/371591-13_Provider Knowledge Questionnaire_Massey.pdf
(Supplementary information)
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Attachments [8]
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2095
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/AnzctrAttachments/371591-HPV A5 Brochure_Englishv4.pdf
(Participant information/consent)
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Attachments [9]
2096
2096
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/AnzctrAttachments/371591-HPV Instruction Sheetv5.pdf
(Other)
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Contacts
Principal investigator
Name
69422
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Dr Karen Bartholomew
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Address
69422
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Waitemata District Health Board
Level 1, 15 Shea Tce, Takapuna 0740
Private Bag 93-503
Auckland
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Country
69422
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New Zealand
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Phone
69422
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+64 09 486 8920 ext 5434
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Fax
69422
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Nil
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Email
69422
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[email protected]
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Contact person for public queries
Name
69423
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Karen Bartholomew
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Address
69423
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Waitemata District Health Board
Level 1, 15 Shea Tce, Takapuna 0740
Private Bag 93-503
Auckland
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Country
69423
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New Zealand
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Phone
69423
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+64 09 486 8920 ext 5434
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Fax
69423
0
Nil
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Email
69423
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[email protected]
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Contact person for scientific queries
Name
69424
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Karen Bartholomew
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Address
69424
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Waitemata District Health Board
Level 1, 15 Shea Tce, Takapuna 0740
Private Bag 93-503
Auckland
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Country
69424
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New Zealand
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Phone
69424
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+64 09 486 8920 ext 5434
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Fax
69424
0
Nil
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Email
69424
0
[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
10761
Clinical study report
Report being finalised for publication shortly
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF