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NCI Cervical Cancer 'Last Mile' Initiative 'Self-Collection for HPV Testing to Improve Cervical Cancer Prevention' (SHIP) Trial LMI-001-A-S04

NCT ID: NCT07281430Sponsor: National Cancer Institute (NCI)Last updated: 2026-06-17

Summary

This clinical trial evaluates the use of self-collected vaginal samples for human papillomavirus (HPV) testing in patients referred for a colposcopy and/or cervical excisional procedures to improve cervical cancer prevention. HPV is a common virus which usually causes infections that last only a few months, but sometimes can last longer. HPV is known to cause a variety of cancers including cervical cancer. Even though there are ways to detect cervical cancer, many individuals are not diagnosed. Over half of all new cervical cancer cases are among those who have either never been screened or who are not screened enough. The low screening numbers show more testing needs to be done. Without appropriate screening and care, preventable precancer may turn into cancer. A new way to detect cervical cancer is to have individuals collect their own sample for HPV testing to know their risk for cervical cancer. This may give individuals more flexibility and comfort having the ability to collect samples themselves, compared to a doctor performing a speculum examination and collecting the samples in a clinic. Information gathered from this study compares clinical accuracy of HPV testing on self-collected vaginal samples versus cervical samples collected by clinician. The Self-collection for HPV Testing to Improve Cervical Cancer Prevention (SHIP) Trial is part of the National Cancer Institute (NCI)'s Cervical Cancer 'Last Mile' Initiative, a public private partnership that seeks to increase access to cervical cancer screening. The SHIP Trial focuses on developing clinical evidence to inform the US Food and Drug Administration (FDA)'s regulatory reviews of self-collection approaches as alternative sample collection approaches for cervical cancer screening. Several industry partner-specific self-collection device and assay combinations will be non-competitively and independently evaluated with a similar study design framework to inform pre-approval and/or post-approval regulatory requirements.

Detailed description

PRIMARY OBJECTIVES: I. To evaluate clinical accuracy (including clinical sensitivity, clinical specificity, false positive rate, and false negative rate) for the detection of cervical precancer/cancer and agreement/concordance (including positive percent agreement and negative percent agreement) on self-collected (SC) versus clinician-collected (CC) samples for the following HPV genotype detections and groupings by Abbott Alinity m high risk (HR) HPV assay: Ia. Any HR HPV genotype; Ib. HPV16; Ic. HPV16 and/or HPV18; Id. Non-HPV16 high-risk HPV types (HPV 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68); Ie. Non-HPV16/HPV18 high-risk types (HPV 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68). EXPLORATORY OBJECTIVE: I. To evaluate human factors affecting usability, acceptability, and preferences for self-collection. OUTLINE: Patients undergo self-collection of a vaginal sample and then undergo clinician-collection of a cervical test sample. Patients then undergo standard of care (SOC) colposcopy with or without cervical biopsy/endocervical curettage and/or cervical excisional procedures as clinically indicated. After completion of study intervention (one-time), laboratory results available within 60 days are collected for purposes of study outcomes.

Arms & interventions

  • ProcedureBiospecimen Collection

    Undergo collection of a cervical sample by clinician

  • ProcedureCervical Biopsy

    Undergo cervical biopsy

  • ProcedureColposcopy

    Undergo colposcopy

  • OtherElectronic Health Record Review

    Ancillary studies

  • ProcedureEndocervical Curettage

    Undergo endocervical curettage

  • ProcedureExcision

    Undergo cervical excisional procedure

  • ProcedureHPV Self-Collection

    Undertake self-collection of vaginal sample

  • ProcedureHuman Papillomavirus Test

    Undergo HPV testing of self-collected vaginal samples and cervical samples

  • OtherQuestionnaire Administration

    Ancillary studies

Outcome measures

Primary

  • Clinical sensitivity for self-collected (SC) samples

    Will be defined as the probability of a positive SC sample given cervical intraepithelial neoplasia (CIN)2+. Will report point estimate and 95% confidence intervals (CIs).

    Time frame: One-time, up to 60 days

  • Clinical sensitivity for clinician-collected (CC) samples

    Will be defined as the probability of a positive CC sample given CIN2+. Will report point estimate and 95% CIs.

    Time frame: One-time, up to 60 days

  • Clinical specificity for SC samples

    Will be defined as the probability of a negative SC sample given \< CIN2. Will report point estimate and 95% CIs.

    Time frame: One-time, up to 60 days

  • Clinical specificity for CC samples

    Will be defined as the probability of a negative CC sample given \< CIN2. Will report point estimate and 95% CIs.

    Time frame: One-time, up to 60 days

  • False positive rate (FPR) for SC samples

    Will be defined as the probability of a positive SC sample given \< CIN2. Will report point estimate and 95% CIs.

    Time frame: One-time, up to 60 days

  • FPR for CC samples

    Will be defined as the probability of a positive CC sample given \< CIN2. Will report point estimate and 95% CIs.

    Time frame: One-time, up to 60 days

  • False negative rate (FNR) for SC samples

    Will be defined as the probability of a negative SC sample given CIN2+. Will report point estimate and 95% CIs.

    Time frame: One-time, up to 60 days

  • FNR for CC samples

    Will be defined as the probability of a negative CC sample given CIN2+. Will report point estimate and 95% CIs.

    Time frame: One-time, up to 60 days

  • Sensitivity ratio for SC versus CC samples

    Will be defined as the sensitivity of SC divided by the sensitivity of CC. Will report point estimate and 95% CIs.

    Time frame: One-time, up to 60 days

  • Specificity ratio for SC versus CC samples

    Will be defined as the specificity of SC divided by the specificity of CC. Will report point estimate and 95% CIs.

    Time frame: One-time, up to 60 days

  • False positive (FP) ratio for SC versus CC samples

    Will be defined as the FPR of SC divided by the FPR of CC. Will report point estimate and 95% CIs.

    Time frame: One-time, up to 60 days

  • False negative (FN) ratio for SC versus CC samples

    Will be defined as the FNR of SC divided by the FBR of CC. Will report point estimate and 95% CIs.

    Time frame: One-time, up to 60 days

  • Positive percent agreement

    Will be defined as the probability of positive on SC given positive on CC, expressed as a percent. Will report point estimate and 95% CIs.

    Time frame: One-time, up to 60 days

  • Negative percent agreement

    Will be defined as the probability of negative on SC given negative on CC, expressed as a percent. Will report point estimate and 95% CIs.

    Time frame: One-time, up to 60 days

Eligibility criteria

Sex: FemaleAge: 25 Years and olderHealthy volunteers: Yes
Inclusion Criteria: * Willingness and ability to provide a documented informed consent * Is 25 years or older * Has an intact cervix * Has had a referral for colposcopy in which routine cervical cancer screening has included positive HPV testing (HPV primary screening, co-testing, or atypical squamous cells of undetermined significance \[ASC-US\] cytology triage) or abnormal cytology performed within the past 12 months preceding the referral visit, and/or for cervical excisional procedure * Willing and able to undergo colposcopy, and if clinically indicated for SOC purposes, a biopsy, endocervical curettage, and/or a cervical excisional procedure, as applicable Exclusion Criteria: * Is pregnant when presenting for the referral visit or gave birth within the past 3 months * Has a known history of excisional or ablative therapy to the cervix (e.g., loop electrosurgical excision procedure \[LEEP\], cone biopsy, cervical laser surgery, cryotherapy, thermal ablation) in the last 12 months prior to the referral visit * Has had a complete or partial hysterectomy, either supracervical or involving removal of the cervix, via self-report or confirmation via medical records * Known medical conditions that, in the opinion of the investigator, preclude study participation * Previous participation in the SHIP Trial or another cervical cancer screening study within the past 12 months. Participation is defined as completing the self-collection * Is experiencing unusual bleeding or pelvic pain

Study locations (18)

University of Alabama at Birmingham Cancer Center

Birmingham, Alabama, 35233

Recruiting
Warner K. Huh · Contact
Warner K. Huh · Principal Investigator

Emory University Hospital/Winship Cancer Institute

Atlanta, Georgia, 30322

Recruiting
Lisa C. Flowers · Contact
Lisa C. Flowers · Principal Investigator

Louisiana State University

Lafayette, Louisiana, 70503

Recruiting
Michael E. Hagensee · Contact
Michael E. Hagensee · Principal Investigator

Louisiana State University Health Science Center

New Orleans, Louisiana, 70112

Recruiting
Michael E. Hagensee · Contact
Michael E. Hagensee · Principal Investigator

Minneapolis VA Medical Center

Minneapolis, Minnesota, 55417

Recruiting
Elisheva Danan · Contact
Elisheva Danan · Principal Investigator

University of New Mexico Cancer Center

Albuquerque, New Mexico, 87106

Recruiting
Cosette M. Wheeler · Contact
Cosette M. Wheeler · Principal Investigator

Montefiore Medical Center-Einstein Campus

The Bronx, New York, 10461

Recruiting
Mark H. Einstein · Contact
Mark H. Einstein · Principal Investigator

Montefiore Medical Center-Weiler Hospital

The Bronx, New York, 10461

Recruiting
Mark H. Einstein · Contact
Mark H. Einstein · Principal Investigator

UNC Lineberger Comprehensive Cancer Center

Chapel Hill, North Carolina, 27599

Recruiting
Lisa Rahangdale · Contact
Lisa Rahangdale · Principal Investigator

University of Cincinnati Cancer Center-UC Medical Center

Cincinnati, Ohio, 45219

Recruiting
Leeya F. Pinder · Contact
Leeya F. Pinder · Principal Investigator

University of Oklahoma Health Sciences Center

Oklahoma City, Oklahoma, 73104

Recruiting
Jacqueline A. Bohn · Contact
Jacqueline A. Bohn · Principal Investigator

University of Oklahoma

Oklahoma City, Oklahoma, 73190

Recruiting
Jacqueline A. Bohn · Contact
Jacqueline A. Bohn · Principal Investigator

University of Pennsylvania/Abramson Cancer Center

Philadelphia, Pennsylvania, 19104

Recruiting
Carmen Guerra · Contact
Carmen Guerra · Principal Investigator

UPMC-Magee Womens Hospital

Pittsburgh, Pennsylvania, 15213

Recruiting
Harold C. Wiesenfeld · Contact
Harold C. Wiesenfeld · Principal Investigator

University of Pittsburgh Cancer Institute (UPCI)

Pittsburgh, Pennsylvania, 15232

Recruiting
Harold C. Wiesenfeld · Contact
Harold C. Wiesenfeld · Principal Investigator

UT MD Anderson Cancer Center

Houston, Texas, 77030

Recruiting
Elizabeth Y. Chiao · Contact
Elizabeth Y. Chiao · Principal Investigator

Huntsman Cancer Institute/University of Utah

Salt Lake City, Utah, 84112

Recruiting
Deanna L. Kepka · Contact
Deanna L. Kepka · Principal Investigator

West Virginia University Healthcare

Morgantown, West Virginia, 26506

Recruiting
Krista S. Pfaendler · Contact
Krista S. Pfaendler · Principal Investigator