Overlooked Population at Risk for AIN.
The purpose of this study is to determine the possibility and compliance of performing anal Pap smear and Human Papilloma Virus (HPV) DNA testing on women with high grade lower genital tract dysplasia or cervical cancer and determining the prevalence of anal dysplasia in this population using a high-resolution anoscopy (HRA). In addition, it is being done to potentially develop screening, diagnostic and treatment protocol for anal dysplasia in women with high-grade lower genital tract dysplasia or cervical cancer.
High Grade Cervical Dysplasia
Procedure: Screening Anal Pap Smear - No High Resolution Anoscopy
Procedure: Screening Anal Pap Smear - With High Resolution Anoscopy
|Study Design:||Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Prevention
|Official Title:||The Overlooked Population at Risk for AIN: Women With High-grade Lower Genital Tract Dysplasia or Cervical Cancer.|
- Prevalence [ Time Frame: Screening and up to 24 weeks. ] [ Designated as safety issue: No ]Prevalence of anal dysplasia in women with high grade cervical dysplasia or cervical cancer. Calculated at screening all women with cervical dysplasia or cancer and performing high-resolution anoscopy on those diagnosed with dysplasia.
|Study Start Date:||October 2013|
|Estimated Study Completion Date:||December 2018|
|Estimated Primary Completion Date:||October 2015 (Final data collection date for primary outcome measure)|
Anal Screening Pap Smear - Negative
Anal Pap Smear with no High Resolution Anoscopy
|Procedure: Screening Anal Pap Smear - No High Resolution Anoscopy|
Anal Pap Smear - Positive Result - High Resolution Anoscopy
Patient who have a positive anal pap smear will go on to have a high resolution anoscopy.
|Procedure: Screening Anal Pap Smear - With High Resolution Anoscopy|
Anal cancer incidence is increasing and although women compose more than half of all cases and those with HPV related lower genital tract dysplasia/malignancy have an even greater risk screening is currently not recommended. We therefore propose performing a prospective cohort study to determine the prevalence of anal dysplasia in women with high-grade lower genital tract dysplasia using high-resolution anoscopy HRA. This will then potentially lead to the development of a screening, diagnosis and treatment schema that can be implemented in all women with high-grade lower genital tract dysplasia. This study can potentially have a high impact on health delivery in women at high risk for anal cancer as this can transform the current treatment of anal cancer to a preventive screening program. This can later be implemented throughout Ontario and in all centers that treat women with cervical dysplasia.
The incidence of anal intraepithelial neoplasm (AIN also known as anal cancer) has increased in Ontario over the last 20 years. Two-thirds of the cases are found in women. The average time between diagnosis of anal cancer and previous cervical dysplasia or cancer is approximately 20 years. This study is giving the opportunity to detect and treat pre-invasive lesions and potentially prevent the development of anal cancer. Currently, no screening, diagnosis or treatment recommendation for anal dysplasia found in women with high-grade lower genital tract dysplasia.
|Contact: Jessica Marer, Clinical Research Associate||416-480-5000 ext firstname.lastname@example.org|
|Odette Cancer Centre||Not yet recruiting|
|Toronto, Ontario, Canada, M4N 3M5|
|Contact: Jessica Marer email@example.com|
|Principal Investigator: Danielle Vicus, MD|
|Principal Investigator:||Daniell Vicus, MD||Odette Cancer Centre|