Effectiveness of Cervical Screening in HPV Vaccinated Women

NCT ID: NCT02149030

Last Updated: 2025-01-20

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

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

6958 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-03-31

Study Completion Date

2025-01-31

Brief Summary

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The main objective of the study is to identify whether or not being informed infrequently results about screening is: 1) At least as safe and accurate as frequently obtaining all information from the present combination of opportunistic/organized cervical screening by comparing regimen results of three screening visits at the ages of 22, 25 and 30 years (Arm A1) vs. results of one screening visit at the age of 30 years (Arm A2) in Human papillomavirus (HPV) vaccinated young women.

Detailed Description

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Altogether 16.500 1992-1995 born women vaccinated with the bi-valent human papillomavirus type 16 and 18 (HPV16/18) vaccine as adolescents either at the age of 12 to 15 or at the age of 18 will be invited to an effectiveness trial at the age of 22 years, and randomized into Arms A1 and A2, and A3, respectively.

Cervical samples and cervico-vaginal self-samples rinsed in first-void urine will be analysed for HPV and C. trachomatis DNA with MGP primer system followed by MALDITOF mass spectrometry on the SEQUENOM platform (HPV) and the Abbott™ PCR (Chlamydia trachomatis), respectively.

With assumed \>50% participation the trial has 80% power to show non-inferiority of the infrequent vs. the frequent screening information.

A one-way (participant) blinded interim analysis among the 1992-born study participants in A1 and A3 arms, who have attended the 2nd study visit at the age of 25 years, will be performed in 2017 for assuring no statistically significant differences in the cervical intraepithelial neoplasia grade 2/3 (CIN2/CIN3) incidences of the two arms.

At the study end testing the null hypotheses of no difference in the incidence of the CIN2/3 end-points between the A1 and A2 intervention arms will be done using the Mantel-Haenszel one degree of freedom chi-square statistics.

Conditions

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Cervical Intraepithelial Neoplasia Grade 2/3

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SCREENING

Blinding Strategy

SINGLE

Participants

Study Groups

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A1

A1) Cytological screening in A1 and A3. Frequent information of screening results for cytology and/or HPV DNA at the ages of 22 (cytology only), 25 and 30.

Group Type ACTIVE_COMPARATOR

Cytological screening in A1 and A3

Intervention Type OTHER

Cytological screening.

A2

A2) infrequent information of screening results, only at the age 30 years.

Group Type NO_INTERVENTION

No interventions assigned to this group

A3

A3) Cytological screening in A1 and A3. With at least 1000 participants is enrolled for interim safety analysis when the 1992 birth cohort is 25 years of age and cytology results are being revealed.

Group Type OTHER

Cytological screening in A1 and A3

Intervention Type OTHER

Cytological screening.

Interventions

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Cytological screening in A1 and A3

Cytological screening.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* HPV 16/18 vaccinated. Born 1992-1995.

Exclusion Criteria

* Immunocompromising disease. HPV 6/11/16/18 vaccination.
Minimum Eligible Age

22 Years

Maximum Eligible Age

22 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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European Union

OTHER

Sponsor Role collaborator

Academy of Finland

OTHER

Sponsor Role collaborator

Cancer Society of Finland

UNKNOWN

Sponsor Role collaborator

Tampere University

OTHER

Sponsor Role lead

Responsible Party

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Matti Lehtinen

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Matti Lehtinen, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Tampere University

Locations

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Nuorisotutkimusasema: Tampereen yliopisto

Äänekoski, , Finland

Site Status

Nuorisotutkimusasema: Tampereen yliopisto

Hämeenlinna, , Finland

Site Status

HUS

Helsinki, , Finland

Site Status

Nuorisotutkimusasema: Tampereen yliopisto

Hyvinkää, , Finland

Site Status

Nuorisotutkimusasema: Tampereen yliopisto

Iisalmi, , Finland

Site Status

Nuorisotutkimusasema: Tampereen yliopisto

Jämsä, , Finland

Site Status

Nuorisotutkimusasema: Tampereen yliopisto

Joensuu, , Finland

Site Status

Nuorisotutkimusasema: Tampereen yliopisto

Jyväskylä, , Finland

Site Status

Nuorisotutkimusasema: Tampereen yliopisto

Kajaani, , Finland

Site Status

Nuorisotutkimusasema: Tampereen yliopisto

Kemi, , Finland

Site Status

Nuorisotutkimusasema: Tampereen yliopisto

Kokkola, , Finland

Site Status

Nuorisotutkimusasema: Tampereen yliopisto

Kotka, , Finland

Site Status

Nuorisotutkimusasema: Tampereen yliopisto

Kouvola, , Finland

Site Status

Nuorisotutkimusasema: Tampereen yliopisto

Kuopio, , Finland

Site Status

Nuorisotutkimusasema: Tampereen yliopisto

Lahti, , Finland

Site Status

Nuorisotutkimusasema: Tampereen yliopisto

Lappeenranta, , Finland

Site Status

Nuorisotutkimusasema: Tampereen yliopisto

Lohja, , Finland

Site Status

Nuorisotutkimusasema: Tampereen yliopisto

Mikkeli, , Finland

Site Status

THL

Oulu, , Finland

Site Status

Nuorisotutkimusasema: Tampereen yliopisto

Pori, , Finland

Site Status

Nuorisotutkimusasema: Tampereen yliopisto

Porvoo, , Finland

Site Status

Nuorisotutkimusasema: Tampereen yliopisto

Rauma, , Finland

Site Status

Nuorisotutkimusasema: Tampereen yliopisto

Rovaniemi, , Finland

Site Status

Nuorisotutkimusasema: Tampereen yliopisto

Salo, , Finland

Site Status

Nuorisotutkimusasema: Tampereen yliopisto

Savonlinna, , Finland

Site Status

Nuorisotutkimusasema: Tampereen yliopisto

Seinäjoki, , Finland

Site Status

Nuorisotutkimusasema: Tampereen yliopisto

Tampere, , Finland

Site Status

Nuorisotutkimusasema: Tampereen yliopisto

Turku, , Finland

Site Status

Nuorisotutkimusasema: Tampereen yliopisto

Vaasa, , Finland

Site Status

Nuorisotutkimusasema: Tampereen yliopisto

Vammala, , Finland

Site Status

Nuorisotutkimusasema: Tampereen yliopisto

Varkaus, , Finland

Site Status

Countries

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Finland

References

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Vanska S, Luostarinen T, Baussano I, Apter D, Eriksson T, Natunen K, Nieminen P, Paavonen J, Pimenoff VN, Pukkala E, Soderlund-Strand A, Dubin G, Garnett G, Dillner J, Lehtinen M. Vaccination With Moderate Coverage Eradicates Oncogenic Human Papillomaviruses If a Gender-Neutral Strategy Is Applied. J Infect Dis. 2020 Aug 17;222(6):948-956. doi: 10.1093/infdis/jiaa099.

Reference Type BACKGROUND
PMID: 32161969 (View on PubMed)

Louvanto K, Eriksson T, Gray P, Apter D, Baussano I, Bly A, Harjula K, Heikkila K, Hokkanen M, Huhtinen L, Ikonen M, Karttunen H, Nummela M, Soderlund-Strand A, Veivo U, Dillner J, Elfstom M, Nieminen P, Lehtinen M. Baseline findings and safety of infrequent vs. frequent screening of human papillomavirus vaccinated women. Int J Cancer. 2020 Jul 15;147(2):440-447. doi: 10.1002/ijc.32802. Epub 2019 Dec 16.

Reference Type BACKGROUND
PMID: 31749143 (View on PubMed)

Gray P, Kann H, Pimenoff VN, Eriksson T, Luostarinen T, Vanska S, Surcel HM, Faust H, Dillner J, Lehtinen M. Human papillomavirus seroprevalence in pregnant women following gender-neutral and girls-only vaccination programs in Finland: A cross-sectional cohort analysis following a cluster randomized trial. PLoS Med. 2021 Jun 7;18(6):e1003588. doi: 10.1371/journal.pmed.1003588. eCollection 2021 Jun.

Reference Type BACKGROUND
PMID: 34097688 (View on PubMed)

Kalliala I, Eriksson T, Aro K, Hokkanen M, Lehtinen M, Gissler M, Nieminen P. Preterm birth rate after bivalent HPV vaccination: Registry-based follow-up of a randomized clinical trial. Prev Med. 2021 May;146:106473. doi: 10.1016/j.ypmed.2021.106473. Epub 2021 Feb 24.

Reference Type BACKGROUND
PMID: 33639181 (View on PubMed)

Lehtinen M, Gray P, Louvanto K, Vanska S. In 30 years, gender-neutral vaccination eradicates oncogenic human papillomavirus (HPV) types while screening eliminates HPV-associated cancers. Expert Rev Vaccines. 2022 Jun;21(6):735-738. doi: 10.1080/14760584.2022.2064279. Epub 2022 Apr 15. No abstract available.

Reference Type BACKGROUND
PMID: 35404177 (View on PubMed)

Lehtinen M, Pimenoff VN, Nedjai B, Louvanto K, Verhoef L, Heideman DAM, El-Zein M, Widschwendter M, Dillner J. Assessing the risk of cervical neoplasia in the post-HPV vaccination era. Int J Cancer. 2023 Mar 15;152(6):1060-1068. doi: 10.1002/ijc.34286. Epub 2022 Oct 10.

Reference Type BACKGROUND
PMID: 36093582 (View on PubMed)

Pimenoff VN, Gray P, Louvanto K, Eriksson T, Lagheden C, Soderlund-Strand A, Dillner J, Lehtinen M. Ecological diversity profiles of non-vaccine-targeted HPVs after gender-based community vaccination efforts. Cell Host Microbe. 2023 Nov 8;31(11):1921-1929.e3. doi: 10.1016/j.chom.2023.10.001.

Reference Type BACKGROUND
PMID: 37944494 (View on PubMed)

Lehtinen M, Bruni L, Elfstrom M, Gray P, Logel M, Mariz FC, Baussano I, Vanska S, Franco EL, Dillner J. Scientific approaches toward improving cervical cancer elimination strategies. Int J Cancer. 2024 May 1;154(9):1537-1548. doi: 10.1002/ijc.34839. Epub 2024 Jan 9.

Reference Type BACKGROUND
PMID: 38196123 (View on PubMed)

Lehtinen M, Elfstrom M, Vanska S, Dillner J. Elimination of cervical cancer by refined vaccination and screening. Int J Cancer. 2025 Feb 15;156(4):886-888. doi: 10.1002/ijc.35228. Epub 2024 Oct 25. No abstract available.

Reference Type BACKGROUND
PMID: 39450703 (View on PubMed)

Louvanto K, Verhoef L, Pimenoff V, Eriksson T, Leppala S, Lagheden C, Gray P, Scibior-Bentkowska D, Sumiec E, Nieminen P, Dillner J, Berkhof J, Meijer CJLM, Lehtinen M, Nedjai B, Heideman DAM. Low methylation marker levels among human papillomavirus-vaccinated women with cervical high-grade squamous intraepithelial lesions. Int J Cancer. 2024 Nov 1;155(9):1549-1557. doi: 10.1002/ijc.35044. Epub 2024 May 27.

Reference Type BACKGROUND
PMID: 38801336 (View on PubMed)

Taavela K, Eriksson T, Huhtala H, Bly A, Harjula K, Heikkila K, Hokkanen M, Nummela M, Kotaniemi-Talonen L, Lehtinen M, Louvanto K. The quality of life of frequently vs. infrequently screened HPV vaccinated women. Qual Life Res. 2024 Apr;33(4):941-949. doi: 10.1007/s11136-023-03575-y. Epub 2024 Jan 18.

Reference Type BACKGROUND
PMID: 38238599 (View on PubMed)

Lehtinen M, Apter D, Baussano I, Eriksson T, Natunen K, Paavonen J, Vanska S, Bi D, David MP, Datta S, Struyf F, Jenkins D, Pukkala E, Garnett G, Dubin G. Characteristics of a cluster-randomized phase IV human papillomavirus vaccination effectiveness trial. Vaccine. 2015 Mar 3;33(10):1284-90. doi: 10.1016/j.vaccine.2014.12.019. Epub 2015 Jan 12.

Reference Type BACKGROUND
PMID: 25593103 (View on PubMed)

Other Identifiers

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HPV-004

Identifier Type: -

Identifier Source: org_study_id

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