Study aims to support development of evidence based health care in Norway through evaluating recently proposed technological improvements in cervical cancer control before their routine use. SESAM II study evaluates the accuracy of vaginal self-sampling for high risk human papillomavirus (hrHPV) testing compared with a physician-taken sample.
Concept of collecting cervical cancer screening smear in home through self-sampling is new both for target population and medical professionals. Self-sampling increases screening attendance and could be an alternative to recruit more women to cervical cancer screening in Norway. As there are is an implementation ongoing to switch from cytology based screening to HPV based screening in Norway, a reliable self-sampling method for HPV testing should be available. Furthermore, detection of HPV from self-sampled specimen requires laboratory capacity and expertise to comply with quality assurance demands such as internal quality control, external quality assessment and quality improvement. National studies are crucial to obtain knowledge and build expertize among health care providers. This study aims to show non-inferior sensitivity of hrHPV testing on self-sampled vs. clinician-sampled specimens to detect high-grade cervical lesions and cancer (CIN2+). Additionally we will; * Evaluate overall and hrHPV type specific concordance between self-taken and physician-taken samples. * Evaluate participants views on feasibility and acceptability of self-sampling (questionnaire) * Compare participants screening history with the questionnaire to evaluate the reason for not participating in the national screening program (if that is the case). * Biobank biological material collected from self-sample, physician taken samples, blood and urine, for future analysis on HPV-related diseases and cancer. Study participants will be recruited from the colposcopy referrals and cancer care units from three different hospitals. Patients with CIN 2 or CIN 3 lesions (n=200) will be recruited from Oslo University Hospital, Ullevål and Østfold Hospital Trust, while cancer patients (n=50) will be recruited from Radiumhospital.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
310
Each woman use the self-sampling devices in an advised order the day before they go to the hospital. There will be change of sampling order with every patient so that 50% of women will use Evalyn®Brush (Rovers Medical Devices, Oss, The Netherlands) first and 50% a FloqSwab (Coban Flock Technologies, Italy) first. In addition women are asked to provide a first void urine sample using a Colli-PeeTM (Novosanis, Belgium) on the same morning as the hospital visit. At the hospital clinician will take an additional specimen for which the performance of different self-sampling devices will be compared to.
Ostfold Hospital Trust
Fredrikstad, Norway
Oslo University Hospital, Molecular Pathology
Oslo, Norway
Oslo University Hospital, Ullevål
Oslo, Norway
Radiumhospital
Oslo, Norway
High-risk HPV (hrHPV) testing on self-sampled specimens has non-inferior sensitivity for CIN 2+ compared to clinician-sampled specimens.
Relative sensitivity will be measured through histologically confirmed detection rates using clinician-sampled specimen as a reference.
Time frame: Sensitivity will be assessed through study completion, up to 36 months
Overall and hrHPV specific concordance between self- and clinician-sampled specimens
Agreement of hrHPV positivity rates between self-collected samples and physician-collected reference samples will be assessed by the kappa statistic.
Time frame: Through study completion, an average of 6 months
Acceptability of feasibility of self-sampling
We will evaluate the acceptability of different self-sampling devices based on the participants' views from a questionnaire.
Time frame: Through study completion, an average of 6 months
Participants screening history and reasons for possible non-participation
We will evaluate reasons for possible non-participation based on the participants' responses from a questionnaire and individual screening records at the Cancer Registry of Norway.
Time frame: Through study completion, an average of 6 months
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