Randomized Implementation of Primary Human Papillomavirus (HPV) Testing in the Organized Screening for Cervical Cancer in Stockholm

The recruitment status of this study is unknown because the information has not been verified recently.
Verified January 2012 by Karolinska Institutet.
Recruitment status was  Not yet recruiting
Stockholm County Council, Sweden
Cancer Screening Unit, Oncology Center, Stockholm, Sweden
Information provided by (Responsible Party):
Joakim Dillner, Karolinska Institutet
ClinicalTrials.gov Identifier:
First received: December 20, 2011
Last updated: January 12, 2012
Last verified: January 2012

The purpose is to evaluate whether implementation of primary human papillomavirus (HPV) screening in the screening programme for cervical cancer improves the programme in terms of better cancer protection and better cost efficiency.

Condition Intervention
High-grade Cervical Intraepithelial Neoplasia
Other: HPV testing

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Screening

Resource links provided by NLM:

Further study details as provided by Karolinska Institutet:

Primary Outcome Measures:
  • number of CIN 2+ cases for the two different diagnostic procedures [ Time Frame: first evaluation, the 1 of january 2013 ] [ Designated as safety issue: No ]
    The number of women with CIN2+ detected by primary HPV testing will be compared with the number of women with CIN2+ detected by primary cytology

Secondary Outcome Measures:
  • calculation of cost for the two different diagnostic procedures [ Time Frame: first evaluation, 1 of January 2013 ] [ Designated as safety issue: No ]
    The cost for the new procedure with HPV test in primary screening will be compared to the routine procedure with primary cytology

Study Start Date: January 2012
Arms Assigned Interventions
Experimental: HPV testing
Women randomised to this arm get primary HPV testing
Other: HPV testing
Testing for Human Papilloma Virus
No Intervention: cytology
women included follow the standard procedure with primary cytology

Detailed Description:

Primary HPV screening is a method with higher sensitivity than cytology for detection of high-grade cervical intraepithelial neoplasia, which is the precursor of cervical cancer. In particular, HPV test is a better test for revealing adenocarcinomas, since these cancers often show a normal cytology.

Cervical cancer screening at age 60:

Cytology is less effective in older women, and screening with cytology in women over 60 has no documented effect. Today a large part of cervical cancer develop in women older than 60, to whom no screening is offered. The prevalence of HPV is around 4% in this age group. Since we know that testing negative for HPV gives a better long-term protection against cervical cancer compared to cytology, primary screening for HPV in 60-year old women would give a longer lasting protection in this high-risk group compared with today.

Cervical cancer screening at age 30-40:

HPV screening is most cost effective above 35 years of age. The reason for this is that HPV is less prevalent at age 35 than in younger women and also because cervical cancer seldom develops before this age. Since the HPV test has a negative predictive value (NPV) of almost 100% this could lead to longer screening intervals, which would be improve cost-effectiveness.


Ages Eligible for Study:   56 Years to 65 Years
Genders Eligible for Study:   Female
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • women between the age 56 and 65 years
  Contacts and Locations
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Please refer to this study by its ClinicalTrials.gov identifier: NCT01511328

Contact: Sven Törnberg, MD, PhD 46-8-51773194 Sven.tornberg@karolinska.se

Karolinska University Hospital Not yet recruiting
Stockholm, Sweden, 141 86
Contact: Mikael Björnstedt, MD, PhD    +46-8-58583809    Mikael.Bjornstedt@karolinska.se   
Principal Investigator: Joakim Dillner, MD, PhD         
Sponsors and Collaborators
Karolinska Institutet
Stockholm County Council, Sweden
Cancer Screening Unit, Oncology Center, Stockholm, Sweden
Principal Investigator: Joakim Dillner, MD, PhD Karolinska Institutet
  More Information

Responsible Party: Joakim Dillner, Professor of infectious disease epidemiology, Karolinska Institutet
ClinicalTrials.gov Identifier: NCT01511328     History of Changes
Other Study ID Numbers: SLL-KI-HPV
Study First Received: December 20, 2011
Last Updated: January 12, 2012
Health Authority: Sweden: Regional Ethical Review Board
Sweden: Swedish Research Council

Keywords provided by Karolinska Institutet:
HPV testing
Primary screening
Cervical Cancer

Additional relevant MeSH terms:
Cervical Intraepithelial Neoplasia
Carcinoma in Situ
Neoplasms by Histologic Type
Neoplasms, Glandular and Epithelial

ClinicalTrials.gov processed this record on March 26, 2015