NCI Cervical Cancer 'Last Mile' Initiative 'Self-Collection for HPV Testing to Improve Cervical Cancer Prevention' (SHIP) Trial LMI-001-A-S04
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
Study locations (18)
University of Alabama at Birmingham Cancer Center
Birmingham, Alabama, 35233
Emory University Hospital/Winship Cancer Institute
Atlanta, Georgia, 30322
Louisiana State University
Lafayette, Louisiana, 70503
Louisiana State University Health Science Center
New Orleans, Louisiana, 70112
Minneapolis VA Medical Center
Minneapolis, Minnesota, 55417
University of New Mexico Cancer Center
Albuquerque, New Mexico, 87106
Montefiore Medical Center-Einstein Campus
The Bronx, New York, 10461
Montefiore Medical Center-Weiler Hospital
The Bronx, New York, 10461
UNC Lineberger Comprehensive Cancer Center
Chapel Hill, North Carolina, 27599
University of Cincinnati Cancer Center-UC Medical Center
Cincinnati, Ohio, 45219
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma, 73104
University of Oklahoma
Oklahoma City, Oklahoma, 73190
University of Pennsylvania/Abramson Cancer Center
Philadelphia, Pennsylvania, 19104
UPMC-Magee Womens Hospital
Pittsburgh, Pennsylvania, 15213
University of Pittsburgh Cancer Institute (UPCI)
Pittsburgh, Pennsylvania, 15232
UT MD Anderson Cancer Center
Houston, Texas, 77030
Huntsman Cancer Institute/University of Utah
Salt Lake City, Utah, 84112
West Virginia University Healthcare
Morgantown, West Virginia, 26506