Primary and Secondary Prevention of Human Papillomavirus (HPV) Disease in China

NCT ID: NCT01021904

Last Updated: 2009-11-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

6200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-06-30

Study Completion Date

2014-12-31

Brief Summary

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In a hospital-based multi-center study in China, HPV 16 was found to be the predominant type (72.9%) in cervical cancer, followed by HPV 18(8.0%) which indicated that if the HPV prophylactic vaccine are wisely applied in China, about 80% of cervical cancer can be prevented.The reported prevalence of HPV in the female population in China was about 13.2%, with women in the study between ages 15-55. HPV prevalence peaks in young adults (ages 20-24:15.5%) and pre-menopausal women (ages 45-49:15%) and this suggests an underestimation of cervical cancer burden in China.

So far, there is no nation wide organized screening program in China, nor is the vaccine available for girls innocent to HPV infection. This study aims to vaccinate the daughters (aged between 13-15 yrs) living in the selected study areas thus to evaluate how cervical cancer and other HPV related diseases can be curbed through primary and secondary prevention(in company to screening the mothers aged 35-54 yrs) and to develop a China specific model for cervical cancer prevention through HPV vaccination and HPV DNA test (careHPV).

Detailed Description

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Selection of Vaccination age group

-It is well acknowledged that preadolescent or adolescent girls before their sexual debut will benefit the most from HPV vaccination. According to our previous study conducted in year 2007, the median age of sexual debut in Xinjiang was 17 years old (95% CI: 14-21). Data on the age of sexual debut in the other two identified regions is not available and we made an approximate estimation according to our data previously collected from other parts of China.From these data, we don't see an obvious time trend of sexual debut age from other parts of China and the majority of girls became sexually active after 15 years old. We thus suggest coverage of 13-15 years old girls for HPV vaccination in our identified regions.

Goal of this Program

-The purpose of this program is to implement and evaluate what it takes to establish and operate a public health program on cervical cancer prevention by vaccination and early detection treatment program in resource restricted selected autonomous regions of China. The learnings on how to implement such projects and the costing of the interventions and program will be useful for national policy planners and regional authorities when they consider future health priorities and allocation of resources.

Objectives

The objectives of the pilot program are to:

1. Develop a communication and education program on cervical cancer for families in the target area and try to deliver the message of 'Vaccinate the daughters and screen the mothers' to curb cervical cancer.
2. Develop a China specific model for cervical cancer prevention through HPV vaccination and HPV DNA test ( careHPV).
3. Capacitate the health facilities in the selected counties in each region to conduct HPV vaccination, screen for cervical cancer and treat precancerous lesions and cervical cancer.
4. Develop a referral system for advanced cases of cervical cancer that cannot be treated at lower level facilities
5. Develop training guidelines and supportive management systems for all levels of the health care system and cost all interventions for policy purposes.

Conditions

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HPV Infections Precancerous Disease of the Cervix Cervical Cancer HPV Related Diseases

Keywords

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Primary prevention HPV Vaccination HPV Infection Cervical Cancer HPV Related Diseases

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Interventions

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Gardasil (VLP, HPV Quadrivalent prophylactic vaccine)

0.5cc I/M Site deltoid Lt Rt 3-dose regimen: 0, 2, 6 months

Intervention Type BIOLOGICAL

Eligibility Criteria

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Inclusion Criteria

* Long term residence in the selected study areas (at least more than 5 years from the beginning of the study)
* aged between 13-15 yrs
* With complete cervix
* Not sexually active
* Physically competent to undergo vaccination
* With ability to provide informed consent

Exclusion Criteria

* Short term residence (less than 5 years from the beginning of the study)
* Dose not have a cervix
* Physically incompetent to undergo vaccination
* With no ability to provide informed consent
Minimum Eligible Age

13 Years

Maximum Eligible Age

15 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Chinese Academy of Medical Sciences

OTHER

Sponsor Role lead

Responsible Party

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Cancer Hospital/Institute, Chinese Academy of Medical Sciences

Principal Investigators

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You-lin Qiao, M.D. Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Cancer Hospital/Institute, Chinese Academy of Medical Sciences

Central Contacts

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You-Lin Qiao, Ph.D

Role: CONTACT

Phone: +86-10-8778-8489

Email: [email protected]

Jing Li, M.D. M.Sc

Role: CONTACT

Phone: 86-10-8778-8942

Email: [email protected]

References

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Munoz N. Human papillomavirus and cancer: the epidemiological evidence. J Clin Virol. 2000 Oct;19(1-2):1-5. doi: 10.1016/s1386-6532(00)00125-6.

Reference Type BACKGROUND
PMID: 11091143 (View on PubMed)

Bosch FX, Lorincz A, Munoz N, Meijer CJ, Shah KV. The causal relation between human papillomavirus and cervical cancer. J Clin Pathol. 2002 Apr;55(4):244-65. doi: 10.1136/jcp.55.4.244.

Reference Type BACKGROUND
PMID: 11919208 (View on PubMed)

Trottier H, Franco EL. The epidemiology of genital human papillomavirus infection. Vaccine. 2006 Mar 30;24 Suppl 1:S1-15. doi: 10.1016/j.vaccine.2005.09.054.

Reference Type BACKGROUND
PMID: 16406226 (View on PubMed)

Schiffman M, Castle PE. Human papillomavirus: epidemiology and public health. Arch Pathol Lab Med. 2003 Aug;127(8):930-4. doi: 10.5858/2003-127-930-HPEAPH.

Reference Type BACKGROUND
PMID: 12873163 (View on PubMed)

Franco EL, Harper DM. Vaccination against human papillomavirus infection: a new paradigm in cervical cancer control. Vaccine. 2005 Mar 18;23(17-18):2388-94. doi: 10.1016/j.vaccine.2005.01.016.

Reference Type BACKGROUND
PMID: 15755633 (View on PubMed)

Munoz N, Bosch FX, de Sanjose S, Herrero R, Castellsague X, Shah KV, Snijders PJ, Meijer CJ; International Agency for Research on Cancer Multicenter Cervical Cancer Study Group. Epidemiologic classification of human papillomavirus types associated with cervical cancer. N Engl J Med. 2003 Feb 6;348(6):518-27. doi: 10.1056/NEJMoa021641.

Reference Type BACKGROUND
PMID: 12571259 (View on PubMed)

Cox JT. Epidemiology and natural history of HPV. J Fam Pract. 2006 Nov;Suppl:3-9.

Reference Type BACKGROUND
PMID: 17366752 (View on PubMed)

Padel AF, Venning VA, Evans MF, Quantrill AM, Fleming KA. Human papillomaviruses in anogenital warts in children: typing by in situ hybridisation. BMJ. 1990 Jun 9;300(6738):1491-4. doi: 10.1136/bmj.300.6738.1491.

Reference Type BACKGROUND
PMID: 2164854 (View on PubMed)

Sugase M, Moriyama S, Matsukura T. Human papillomavirus in exophytic condylomatous lesions on different female genital regions. J Med Virol. 1991 May;34(1):1-6. doi: 10.1002/jmv.1890340102.

Reference Type BACKGROUND
PMID: 1653304 (View on PubMed)

Qiao YL, Sellors JW, Eder PS, Bao YP, Lim JM, Zhao FH, Weigl B, Zhang WH, Peck RB, Li L, Chen F, Pan QJ, Lorincz AT. A new HPV-DNA test for cervical-cancer screening in developing regions: a cross-sectional study of clinical accuracy in rural China. Lancet Oncol. 2008 Oct;9(10):929-36. doi: 10.1016/S1470-2045(08)70210-9. Epub 2008 Sep 19.

Reference Type BACKGROUND
PMID: 18805733 (View on PubMed)

Other Identifiers

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37207

Identifier Type: -

Identifier Source: org_study_id