A New Approach to Cervical Cancer Prevention in Kenya

Study Overview
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Brief Summary
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The purpose of this study is to determine if the human papillomavirus (HPV) deoxyribonucleic acid (DNA) testing, performed on self-collected vaginal swabs, is acceptable, feasible, and sensitive and specific in detection of high-grade cervical lesions among Kenyan women, compared to the current standard of care.

Detailed Description
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The purpose of this study is to test the hypothesis that effective cervical cancer screening can be performed in a high percentage of women, using HPV DNA of self-collected vaginal samples, provided by women attending either chamas (community groups) or in their own homes. HPV DNA testing will be used to triage women for a secondary screen by visual inspection with acetic acid (VIA) in a local clinic. The investigators will determine if HPV DNA testing, performed on self-collected vaginal swabs, is acceptable, feasible, and sensitive and specific in detection of high-grade cervical lesions among Kenyan women, compared to the current standard of care. In addition, women will bring their children to be vaccinated against HPV in these community meetings, using the standard of care for the approved HPV vaccine available in Kenya. The investigators will test this approach by completing the following Specific Aims: Specific Aim 1. Determine the percentage of women attending community meetings who will provide self-collected vaginal swabs for HPV DNA testing. Specific Aim 2. Following HPV DNA screening using self-collected swabs, determine the percentage of these women who will attend the local clinic. Specific Aim 3. Evaluate the statistical correlation between HPV DNA testing of self-collected vaginal swabs and VIA (as all women in this pilot study will undergo VIA).

Official Title
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A New Approach to Cervical Cancer Prevention in Kenya

Conditions
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Healthy

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Women who live in Kenya who are between the ages of 18 and 60, are willing to provide a self collected vaginal swab and willing to travel to the local clinic for a VIA Exclusion Criteria: current pregnancy, inability to consent due to mental or physical disability, or a medical illness that has rendered the patient unable to understand consent.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Kenyan Women<br>Women living in western Kenya will be asked to complete a self collected vaginal sample for HPV DNA screening and asked to undergo a second screening by VIA. As per Kenyan standard of care, vaccination against HPV will be offered to children/grandchildren (boys and girls) of women, and to the women themselves if age 26 or younger. The second vaccine dose (for children ages 9 through 14) and third doses (for children and adult women ages 15 through 26) will be administered at subsequent visits. There will be no requirement for HPV vaccination (of children or mothers up to 26 years of age) for participation in the study. Results of the screening will be returned to participants and they will be referred to receive standard care as applicable. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage of women attending community meetings who will provide self-collected vaginal swabs for HPV DNA testing. |  | anytime after informed consent up to 2 years | 
| Percentage of women who attend clinic after providing self-collected vaginal swabs |  | any time after completion of self-collected vaginal swab (up to 2 years) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| HPV DNA vaginal swab testing results | analyzed for the human reference gene (specimen adequacy), HPV 16/18, or any of 12 oncogenic HPV types. | any time after after self-collected vaginal swab, up to 2 years | 
| Visual inspection with acetic acid (VIA) testing results | Results reported as abnormal or normal | any time after VIA is performed, up to 2 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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human papillomavirus (HPV), cervical cancer, prevention, Kenya