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Screening Women With Prior HPV for Anal Neoplasia

Not Applicable
Recruiting
Conditions
Early Stage Lower Genital Tract Cancers
HPV-related Anal Neoplasias
HPV-related Lower Genital Tract Neoplasias
Interventions
Diagnostic Test: Diagnostic tests for anal cancer screening
Registration Number
NCT05217940
Lead Sponsor
Icahn School of Medicine at Mount Sinai
Brief Summary

The goal of this single arm trial is to prospectively evaluate screening methods for anal cancer precursors in HIV uninfected women with a history of lower genital tract neoplasias and cancers.

Detailed Description

This single arm trial will enroll 300 HIV uninfected women with a history of genital neoplasia (ie., cervical intraepithelial neoplasia grade 2-3, vaginal intraepithelial neoplasia grade 2-3 or vulvar intraepithelial neoplasia grade 2-3) or early stage cervical or vulvar cancer to evaluate the test characteristics of anal cancer screening tests (cytology, HPV testing and high resolution anoscopy) and determine the prevalence and incidence of anal high-grade squamous intraepithelial lesions in this population. Participants will undergo evaluation at baseline and then at 12 and 24 months. The investigators will also measure the acceptability of anal cancer screening in this previously unstudied group. The trial is expected to run from 2021-2027.

Recruitment & Eligibility

Status
RECRUITING
Sex
Female
Target Recruitment
300
Inclusion Criteria
  • Women with a history of pathologically proven high-grade genital HPV-associated neoplastic disease (cervical intraepithelial neoplasia 2+, vulvar intraepithelial neoplasia 2+, or vaginal intraepithelial neoplasia 2+, or history of non-metastatic cervical, vaginal or vulvar cancer)
  • Documented HIV seronegativity
  • Aged 35 years and older
  • Seen in the Mount Sinai Health System (MSHS) or the Harris Health System (HHS) in Houston
  • English or Spanish speaking
Exclusion Criteria

• prior history or high resolution anoscopy

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Women With Prior HPV for Anal NeoplasiaDiagnostic tests for anal cancer screeningStandard of care anal cancer screening with anal cytology, HPV testing and high resolution anoscopy.
Primary Outcome Measures
NameTimeMethod
Sensitivity and specificity of anal cytologyBaseline

Test sensitivity and specificity

Secondary Outcome Measures
NameTimeMethod
Concordance of self- and clinician-collected PCR testingbaseline

Proportionate concordance of high-risk HPV testing

Prevalence of hrHPV types at baselineBaseline

Proportion of subjects with high-risk HPV and subtype proportions

hrHPV with Cobas PCR testing (self-collected)24 months

Presence of high-risk HPV subtype

Incidence of aHSIL at follow-up24 months

Proportion of subjects with new aHSIL during follow-up period

Proportion of subjects with new hrHPV infection24 months

Proportion of subjects with prevalent hrHPV without measurable hrHPV at follow-up

hrHPV with Cobas PCR testing (clinician-collected)24 months

Presence of high-risk HPV subtype

Screening Experience SurveyBaseline

Survey measures anal cancer screening test acceptability. Each item is scored 0-3, with higher score indicting more acceptability. 0-3. There is no total scale. Each question is scored separately and the overall results are used qualitatively.

Incidence of hrHPV, by type24 months

Proportion of subjects with new hrHPV infection

Prevalence of aHSIL at baselineBaseline

Proportion of subjects with aHSIL

Trial Locations

Locations (3)

University of Texas M D Anderson Cancer Center

🇺🇸

Houston, Texas, United States

Medical University of South Carolina

🇺🇸

Charleston, South Carolina, United States

Icahn School of Medicine at Mount Sinai

🇺🇸

New York, New York, United States

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