Screening for Anal Cancer in Men Who Have Sex With Men Using Pre-Exposure Prophylaxis

NCT ID: NCT07029152

Last Updated: 2025-11-18

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

RECRUITING

Clinical Phase

NA

Total Enrollment

296 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-09-23

Study Completion Date

2026-12-31

Brief Summary

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This study aims to learn more about anal cancer risk in men who have sex with men (MSM) who are using Pre-Exposure Prophylaxis (PrEP) to prevent HIV. Specifically, we want to check how common High-Grade Squamous Intraepithelial Lesions (HSIL) are in this group, how well anal swabs can screen for these lesions, and how having HSIL affects their quality of life. We'll also test if DNA methylation testing can give us extra information about the lesions.

The main questions the study aims to answer are:

* How common are HSIL in MSM using PrEP?
* How accurate are anal swabs for detecting HSIL in this group?
* How does having HSIL affect the quality of life of MSM using PrEP?
* Can DNA methylation testing help improve our understanding of HSIL in these individuals?

Participants will:

* Answer questions about their health and quality of life.
* Have an anal smear collected for testing.
* Undergo High-Resolution Anoscopy (HRA) to check for HSIL and get a biopsy if deemed necessary.

Detailed Description

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This study aims to evaluate High-Grade Squamous Intraepithelial Lesions (HSIL) in men who have sex with men (MSM) using Pre-Exposure Prophylaxis (PrEP) for HIV prevention. MSM are at increased risk for developing anal cancer, and HSIL is a known precursor to this type of cancer. The study seeks to assess the prevalence of HSIL, the screening accuracy of anal swabs, and the impact of HSIL on quality of life for MSM using PrEP. Furthermore, the study will explore the use of DNA methylation testing as a potential tool for improving the detection and understanding of HSIL in this high-risk group.

This multicenter clinical trial will involve MSM using PrEP at several study sites to ensure a diverse and representative sample.

The study will focus on prevalence, screening accuracy, and quality of life impacts, and will incorporate DNA methylation testing to explore potential molecular markers for early detection and progression of HSIL.

The primary goal of the study is to improve the early detection of HSIL in MSM using PrEP. By evaluating screening methods and quality of life, this study aims to provide valuable data that could lead to more effective screening strategies and interventions for preventing anal cancer in this population. The use of DNA methylation testing will provide additional insights into the molecular biology of HSIL, potentially informing future screening protocols.

This study addresses a significant gap in current research regarding the prevention and early detection of anal cancer in MSM using PrEP and aims to contribute critical data to improve healthcare outcomes for this high-risk population.

Conditions

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Anal Cancer Squamous Intraepithelial Lesions HSIL, High Grade Squamous Intraepithelial Lesions LSIL, Low-Grade Squamous Intraepithelial Lesions HPV Squamous Cell Carcinoma

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

SCREENING

Blinding Strategy

NONE

Study Groups

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MSM group

The MSM group consists of men who have sex with men (MSM) who are using Pre-Exposure Prophylaxis (PrEP) for HIV prevention.

Participants in this group will undergo the following interventions:

* Health and Quality of Life Questionnaires
* Anal Smear Collection
* High-Resolution Anoscopy (HRA)

Group Type EXPERIMENTAL

High Resolution Anoscopy (HRA)

Intervention Type DIAGNOSTIC_TEST

HRA will be conducted using advanced tools, such as the Zeiss Extaro at UZ Brussel.

HRA will be conducted at participating centers with expertise in the technique, including UZ Brussel, UZ Gent, UZ Leuven, UZ Antwerpen, CHU St Pierre, AZ Sint-Jan Brugge, and Citadelle Liège. However, all biopsy specimens will be sent to AML Lab for analysis and stored in the biobank (BB190002).

In certain centers, HRA is performed using high-resolution scopes.

Anal smear

Intervention Type DIAGNOSTIC_TEST

The intervention in this study involves the anal smear collection using the FLOQSwab® (COPAN, pouch type 502CS01). The swab is inserted 3-5 cm into the anal canal, reaching the transitional zone, the pressed against the canal wall and withdrawn in a spiral motion over approximately 20 seconds. After collection, the swab is immediately placed into a ThinPrep vial containing 20 ml of PreservCyt® and rinsed vigorously.

The procedure is performed by a physician or trained study team member and is designed to be quick, minimally invasive, and comfortable for participants. The FLOQSwab®'s patient-friendly design reduces irritation and false-positive results in comparison to earlier methods.

Samples collected in the ThinPrep PreservCyt® solution should be stored at room temperature and transferred to AML within a maximum of six weeks

Self-administered questionnaire

Intervention Type BEHAVIORAL

It includes questions related to:

Socio-demographic characteristics Health-related issues Past HPV vaccination (indication? age at vaccination?) History of condylomata and/or other STIs Drug use, tobacco use, alcohol use Anal symptoms: discomfort, itch, pain, nodules, blood loss/discharge, constipation Sexual behavior Insertive/receptive intercourse, chemsex, number of sex partners (stable, occasional, anonymous), condom use.

EQ-5D-5L questionnaire

Intervention Type BEHAVIORAL

This questionnaire will be used after a negative HRA or during the communication of the results (per telephone) and during the treatment if indicated. This questionnaire assesses the impact of health conditions and treatments on person's quality of life. We will use an adapted version of the EQ-5D-5L. This modified version includes additional questions tailored to assess specific domains highlighted in the A-HRSI.

The additional items cover:

* Physical Symptoms: Question on anal symptoms such as pain, discharge, and burning sensations.
* Impact on Physical Functioning: Question on how these symptoms affect daily activities, including work, sitting, and social interactions.
* Impact on Psychological Functioning: Question on psychological and sexual well-being, including enjoyment and desire for sex, as well as challenges with intimacy.

Interventions

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High Resolution Anoscopy (HRA)

HRA will be conducted using advanced tools, such as the Zeiss Extaro at UZ Brussel.

HRA will be conducted at participating centers with expertise in the technique, including UZ Brussel, UZ Gent, UZ Leuven, UZ Antwerpen, CHU St Pierre, AZ Sint-Jan Brugge, and Citadelle Liège. However, all biopsy specimens will be sent to AML Lab for analysis and stored in the biobank (BB190002).

In certain centers, HRA is performed using high-resolution scopes.

Intervention Type DIAGNOSTIC_TEST

Anal smear

The intervention in this study involves the anal smear collection using the FLOQSwab® (COPAN, pouch type 502CS01). The swab is inserted 3-5 cm into the anal canal, reaching the transitional zone, the pressed against the canal wall and withdrawn in a spiral motion over approximately 20 seconds. After collection, the swab is immediately placed into a ThinPrep vial containing 20 ml of PreservCyt® and rinsed vigorously.

The procedure is performed by a physician or trained study team member and is designed to be quick, minimally invasive, and comfortable for participants. The FLOQSwab®'s patient-friendly design reduces irritation and false-positive results in comparison to earlier methods.

Samples collected in the ThinPrep PreservCyt® solution should be stored at room temperature and transferred to AML within a maximum of six weeks

Intervention Type DIAGNOSTIC_TEST

Self-administered questionnaire

It includes questions related to:

Socio-demographic characteristics Health-related issues Past HPV vaccination (indication? age at vaccination?) History of condylomata and/or other STIs Drug use, tobacco use, alcohol use Anal symptoms: discomfort, itch, pain, nodules, blood loss/discharge, constipation Sexual behavior Insertive/receptive intercourse, chemsex, number of sex partners (stable, occasional, anonymous), condom use.

Intervention Type BEHAVIORAL

EQ-5D-5L questionnaire

This questionnaire will be used after a negative HRA or during the communication of the results (per telephone) and during the treatment if indicated. This questionnaire assesses the impact of health conditions and treatments on person's quality of life. We will use an adapted version of the EQ-5D-5L. This modified version includes additional questions tailored to assess specific domains highlighted in the A-HRSI.

The additional items cover:

* Physical Symptoms: Question on anal symptoms such as pain, discharge, and burning sensations.
* Impact on Physical Functioning: Question on how these symptoms affect daily activities, including work, sitting, and social interactions.
* Impact on Psychological Functioning: Question on psychological and sexual well-being, including enjoyment and desire for sex, as well as challenges with intimacy.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* HIV-uninfected MSM (men who have sex with men) aged 35 years or older.
* participants must have been using PrEP for at least 3 months.
* Dutch, English or French speaking and writing

Exclusion Criteria

* Any intervention in the (peri-)anal region within the past 3 months
* Enema usage within 2 h before sampling
* Currently undergoing peri-anal topical HPV-treatment
* HRA in the last year (anal swab or HRA prior to the last year is no exclusion)
Minimum Eligible Age

35 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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A.M.L.

UNKNOWN

Sponsor Role collaborator

Universitair Ziekenhuis Brussel

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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AZ Sint Jan

Bruges, , Belgium

Site Status RECRUITING

CHU Saint-Pierre

Brussels, , Belgium

Site Status RECRUITING

Cliniques universitaires Saint-Luc - UCLouvain

Brussels, , Belgium

Site Status RECRUITING

UZ Brussel

Brussels, , Belgium

Site Status NOT_YET_RECRUITING

UZ Gent

Ghent, , Belgium

Site Status NOT_YET_RECRUITING

UZ Leuven

Leuven, , Belgium

Site Status RECRUITING

CHU Charleroi - Chimay

Lodelinsart, , Belgium

Site Status RECRUITING

Countries

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Belgium

Central Contacts

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Magali Surmont

Role: CONTACT

024776001

Facility Contacts

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Jens Van Praet, dr.

Role: primary

+32 (0)50 45 23 10

Agnes Libois, dr.

Role: primary

+32(0)2/5354130

Leila Belkhir, prof. dr.

Role: primary

+ 32 2 764 70 87

UZ Brussel

Role: primary

024776001

Marie-Angélique De Scheerder, Prof. dr.

Role: primary

+32 (0)9 3322350

Inge Derdelinckx, prof. dr.

Role: primary

+32 16 340911

Remy Demeester, dr.

Role: primary

+32 (0)71 922258

Other Identifiers

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SCOPE

Identifier Type: -

Identifier Source: org_study_id

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