Effect of Human Papillomavirus Self-Collection on Cervical Cancer Screening in High Risk Women: My Body, My Test 3 (MBMT-3)

UNC Lineberger Comprehensive Cancer Center

Status: Completed

Conditions: Uterine Cervical Neoplasms; Human Papillomavirus; Cervical Cancer

Treatments: Behavioral: Self-collection for HPV testing; Behavioral: Screening invitation (with education)

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT02651883

1R01CA183891-01A1 (U.S. NIH Grant/Contract)

14-3042

Details and patient eligibility

About

This study will investigate whether cervical cancer screening completion among under-screened women could be improved by offering HPV (human papillomavirus) testing by at-home self-collection followed by screening invitation compared to screening invitation alone.

Full description

Invasive cervical cancer (ICC) is preventable through regular screening and treatment, but one fifth of US women report not receiving Pap testing at recommended intervals. More than half of ICC cases occur in these under-screened women. For women 30 years and older, the US Preventive Services Task Force recommends Pap smears alone every 3 years or physician-collected HPV testing with Pap smear (co-testing) every 5 years. The FDA approved primary HPV physician screening for US women 25 years and older. Self-collection for HPV testing is a valid and well-accepted method for detecting HPV infection with comparable sensitivity and specificity to physician-collection for detecting high-grade cervical lesions.

This 2-arm randomized control trial of 510 women will investigate whether offering HPV testing by mailed at-home self-collection to under-screened women increases their likelihood of completing cervical cancer screening. All participants will received a screening invitation by phone: a phone call providing (i) education on cervical cancer, and (ii) assistance scheduling an appointment for free screening at a study-affiliated clinic, if needed. Those randomized to the intervention arm will first be mailed a kit to self-collect a cervico-vaginal sample, return the sample for oncogenic HPV testing, and receive their results by phone. HPV negative women will be considered screening complete. HPV positive women will be invited to schedule an appointment for free follow-up in-clinic screening in the same call in which their results are delivered. The study endpoint of screening completion will be defined as completing in-clinic screening (control arm participants and HPV positive intervention arm participants) or receiving a negative HPV self-collection result (intervention arm).

Aim 1. Determine whether at-home HPV self-collection increases completion of cervical cancer screening among under-screened women offered enhanced reminders.

Aim 2. Examine possible mechanisms explaining the intervention's effect, or lack of an effect.

Aim 3. Estimate the incremental cost per additional woman completing screening of adding at-home HPV self-collection to enhanced reminders.

Enrollment: 665 patients

Sex: Female

Ages: 25 to 64 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Female
• Aged 25 to 64 years old
• Living at ≤250% of the federal poverty line
• Eligible to receive cervical cancer screening from a study-associated clinic
• Resides within the same or bordering county of a study-associated clinic

Exclusion criteria

• Completion of cervical Pap screening in preceding 4 years
• Completion of HPV testing in preceding 6 years
• Pregnant
• History of hysterectomy
• Private insurance
• Unable to provide informed consent

Trial design

Primary purpose: Screening

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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665 participants in 2 patient groups

Screening invitation (with education)

Active Comparator group

Description:

Participants will receive a phone call providing (i) education on cervical cancer, and (ii) assistance scheduling an appointment for free cervical cancer screening at a study-affiliated clinic.

Treatment:

Behavioral: Screening invitation (with education)

Self-collection for HPV testing

Experimental group

Description:

Participants in the intervention arm will receive a kit to self-collect a sample and return it for HPV testing. Participants will then receive a phone call providing their HPV results plus (i) education on cervical cancer, and (ii) assistance scheduling an appointment for free cervical cancer screening at a study-affiliated clinic, if desired.

Treatment:

Behavioral: Screening invitation (with education)

Behavioral: Self-collection for HPV testing