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Cervical Intraepithelial Neoplasia Grade 2/3HPV-004NCT02149030

Effectiveness of Cervical Screening in HPV Vaccinated Women

A study testing Cytological screening in A1 and A3 in people with Cervical Intraepithelial Neoplasia Grade 2/3, run by Tampere University at 31 sites in Finland.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

The main objective of the study is to identify whether or not being informed infrequently results about screening is: 1) At least as safe and accurate as frequently obtaining all information from the present combination of opportunistic/organized cervical screening by comparing regimen results of three screening… Read more about this study

Who is it for?
Ages 22 to 22 years, women onlyHealthy volunteers can take part
What is being tested?
Cytological screening in A1 and A3
Could I receive a placebo?
No, everyone receives an active treatment
How many people
6,958 participants
Where
31 sitesFinland
Study dates
Mar 2014to Jan 2025
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 22 to 22 years
  • Women only
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • HPV 16/18 vaccinated. Born 1992-1995.

Who cannot join

  • Immunocompromising disease. HPV 6/11/16/18 vaccination.

Trial locations and contacts

31 sites in 1 country.

31 sites in 1 country

Finland31 sites
  • Nuorisotutkimusasema: Tampereen yliopisto

    Äänekoski

  • Nuorisotutkimusasema: Tampereen yliopisto

    Hämeenlinna

  • HUS

    Helsinki

  • Nuorisotutkimusasema: Tampereen yliopisto

    Hyvinkää

  • Nuorisotutkimusasema: Tampereen yliopisto

    Iisalmi

  • Nuorisotutkimusasema: Tampereen yliopisto

    Jämsä

  • Nuorisotutkimusasema: Tampereen yliopisto

    Joensuu

  • Nuorisotutkimusasema: Tampereen yliopisto

    Jyväskylä

  • Nuorisotutkimusasema: Tampereen yliopisto

    Kajaani

  • Nuorisotutkimusasema: Tampereen yliopisto

    Kemi

  • Nuorisotutkimusasema: Tampereen yliopisto

    Kokkola

  • Nuorisotutkimusasema: Tampereen yliopisto

    Kotka

  • Nuorisotutkimusasema: Tampereen yliopisto

    Kouvola

  • Nuorisotutkimusasema: Tampereen yliopisto

    Kuopio

  • Nuorisotutkimusasema: Tampereen yliopisto

    Lahti

  • Nuorisotutkimusasema: Tampereen yliopisto

    Lappeenranta

  • Nuorisotutkimusasema: Tampereen yliopisto

    Lohja

  • Nuorisotutkimusasema: Tampereen yliopisto

    Mikkeli

  • THL

    Oulu

  • Nuorisotutkimusasema: Tampereen yliopisto

    Pori

  • Nuorisotutkimusasema: Tampereen yliopisto

    Porvoo

  • Nuorisotutkimusasema: Tampereen yliopisto

    Rauma

  • Nuorisotutkimusasema: Tampereen yliopisto

    Rovaniemi

  • Nuorisotutkimusasema: Tampereen yliopisto

    Salo

  • Nuorisotutkimusasema: Tampereen yliopisto

    Savonlinna

  • Nuorisotutkimusasema: Tampereen yliopisto

    Seinäjoki

  • Nuorisotutkimusasema: Tampereen yliopisto

    Tampere

  • Nuorisotutkimusasema: Tampereen yliopisto

    Turku

  • Nuorisotutkimusasema: Tampereen yliopisto

    Vaasa

  • Nuorisotutkimusasema: Tampereen yliopisto

    Vammala

  • Nuorisotutkimusasema: Tampereen yliopisto

    Varkaus

Other trials in Finland

About this study

Official title: Effectiveness of Cervical Screening in HPV Vaccinated Women - a Randomized Trial

The main objective of the study is to identify whether or not being informed infrequently results about screening is: 1) At least as safe and accurate as frequently obtaining all information from the present combination of opportunistic/organized cervical screening by comparing regimen results of three screening visits at the ages of 22, 25 and 30 years (Arm A1) vs. results of one screening visit at the age of 30 years (Arm A2) in Human papillomavirus (HPV) vaccinated young women.

Read the detailed description

Altogether 16.500 1992-1995 born women vaccinated with the bi-valent human papillomavirus type 16 and 18 (HPV16/18) vaccine as adolescents either at the age of 12 to 15 or at the age of 18 will be invited to an effectiveness trial at the age of 22 years, and randomized into Arms A1 and A2, and A3, respectively.

Cervical samples and cervico-vaginal self-samples rinsed in first-void urine will be analysed for HPV and C. trachomatis DNA with MGP primer system followed by MALDITOF mass spectrometry on the SEQUENOM platform (HPV) and the Abbott™ PCR (Chlamydia trachomatis), respectively.

With assumed >50% participation the trial has 80% power to show non-inferiority of the infrequent vs. the frequent screening information.

A one-way (participant) blinded interim analysis among the 1992-born study participants in A1 and A3 arms, who have attended the 2nd study visit at the age of 25 years, will be performed in 2017 for assuring no statistically significant differences in the cervical intraepithelial neoplasia grade 2/3 (CIN2/CIN3) incidences of the two arms.

At the study end testing the null hypotheses of no difference in the incidence of the CIN2/3 end-points between the A1 and A2 intervention arms will be done using the Mantel-Haenszel one degree of freedom chi-square statistics.

Being tested
Cytological screening in A1 and A3

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Cytological screening in A1 and A3Other

    Cytological screening.

Study groups in NCT02149030
Study groupRoleWhat they receive
A1Active comparatorA1) Cytological screening in A1 and A3. Frequent information of screening results for cytology and/or HPV DNA at the ages of 22 (cytology only), 25 and 30.
Receives: Other: Cytological screening in A1 and A3
A2No interventionA2) infrequent information of screening results, only at the age 30 years.
A3OtherA3) Cytological screening in A1 and A3. With at least 1000 participants is enrolled for interim safety analysis when the 1992 birth cohort is 25 years of age and cytology results are being revealed.
Receives: Other: Cytological screening in A1 and A3

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Occurrence of intraepithelial neoplasia grade 2/3 (CIN2/3).

    1a) No marked difference in the incidence of CIN2/3 between arms A1 (participants frequently informed of the cytological results) and A3 (participants not informed of the cytological findings at the age of 22) (interim analysis). 1b) No difference in the incidence of CIN2/3 between arms A1 (participants frequently informed of the cytological results) and A2 (participants infrequently informed of the cytological results).

    The participants will be followed for 9 years starting from the year they turn 22. For 1992 born the follow-up will start in 2014 and end in 2023. For 1995 born the follow-up will start in 2017 and end in 2026.

    The interim analysis will include only 1992 cohort. The final analysis will include all cohorts (1992, 1993, 1994, 1995).

    Measured: 2017-2020, i.e. four years (interim), 2021-2025, i.e. five years (final analysis). Participants will be followed for the duration of the study until 2026, an expected average of 9 years.

Secondary outcomes (1)
  1. Type-replacement

    Whether the post-vaccination distributions of vaccine-covered and/or non-vaccine covered HPV types develop differentially in the different vaccination arms by vaccination arm over time up to 15 years post vaccination.

    Measured: 2021-2025, i.e. four years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted29 May 2014 (estimated)
  2. Study startMar 2014
  3. Primary completionJan 2025 (estimated)
  4. Study completionJan 2025 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Screening
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Participant
Enrolment
6,958 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02149030
Sponsor's protocol ID
HPV-004
Acronym
HPV-004
Status last verified
Jan 2025
First submitted
19 May 2014
Last updated
20 Jan 2025
Results posted
No
Data monitoring committee
No

Publications

  • Vanska S, Luostarinen T, Baussano I, Apter D, Eriksson T, Natunen K, Nieminen P, Paavonen J, Pimenoff VN, Pukkala E, Soderlund-Strand A, Dubin G, Garnett G, Dillner J, Lehtinen M. Vaccination With Moderate Coverage Eradicates Oncogenic Human Papillomaviruses If a Gender-Neutral Strategy Is Applied. J Infect Dis. 2020 Aug 17;222(6):948-956. doi: 10.1093/infdis/jiaa099.

    PubMed 32161969
  • Louvanto K, Eriksson T, Gray P, Apter D, Baussano I, Bly A, Harjula K, Heikkila K, Hokkanen M, Huhtinen L, Ikonen M, Karttunen H, Nummela M, Soderlund-Strand A, Veivo U, Dillner J, Elfstom M, Nieminen P, Lehtinen M. Baseline findings and safety of infrequent vs. frequent screening of human papillomavirus vaccinated women. Int J Cancer. 2020 Jul 15;147(2):440-447. doi: 10.1002/ijc.32802. Epub 2019 Dec 16.

    PubMed 31749143
  • Gray P, Kann H, Pimenoff VN, Eriksson T, Luostarinen T, Vanska S, Surcel HM, Faust H, Dillner J, Lehtinen M. Human papillomavirus seroprevalence in pregnant women following gender-neutral and girls-only vaccination programs in Finland: A cross-sectional cohort analysis following a cluster randomized trial. PLoS Med. 2021 Jun 7;18(6):e1003588. doi: 10.1371/journal.pmed.1003588. eCollection 2021 Jun.

    PubMed 34097688
  • Kalliala I, Eriksson T, Aro K, Hokkanen M, Lehtinen M, Gissler M, Nieminen P. Preterm birth rate after bivalent HPV vaccination: Registry-based follow-up of a randomized clinical trial. Prev Med. 2021 May;146:106473. doi: 10.1016/j.ypmed.2021.106473. Epub 2021 Feb 24.

    PubMed 33639181
  • Lehtinen M, Gray P, Louvanto K, Vanska S. In 30 years, gender-neutral vaccination eradicates oncogenic human papillomavirus (HPV) types while screening eliminates HPV-associated cancers. Expert Rev Vaccines. 2022 Jun;21(6):735-738. doi: 10.1080/14760584.2022.2064279. Epub 2022 Apr 15. No abstract available.

    PubMed 35404177
  • Lehtinen M, Pimenoff VN, Nedjai B, Louvanto K, Verhoef L, Heideman DAM, El-Zein M, Widschwendter M, Dillner J. Assessing the risk of cervical neoplasia in the post-HPV vaccination era. Int J Cancer. 2023 Mar 15;152(6):1060-1068. doi: 10.1002/ijc.34286. Epub 2022 Oct 10.

    PubMed 36093582
  • Pimenoff VN, Gray P, Louvanto K, Eriksson T, Lagheden C, Soderlund-Strand A, Dillner J, Lehtinen M. Ecological diversity profiles of non-vaccine-targeted HPVs after gender-based community vaccination efforts. Cell Host Microbe. 2023 Nov 8;31(11):1921-1929.e3. doi: 10.1016/j.chom.2023.10.001.

    PubMed 37944494
  • Lehtinen M, Bruni L, Elfstrom M, Gray P, Logel M, Mariz FC, Baussano I, Vanska S, Franco EL, Dillner J. Scientific approaches toward improving cervical cancer elimination strategies. Int J Cancer. 2024 May 1;154(9):1537-1548. doi: 10.1002/ijc.34839. Epub 2024 Jan 9.

    PubMed 38196123
  • Lehtinen M, Elfstrom M, Vanska S, Dillner J. Elimination of cervical cancer by refined vaccination and screening. Int J Cancer. 2025 Feb 15;156(4):886-888. doi: 10.1002/ijc.35228. Epub 2024 Oct 25. No abstract available.

    PubMed 39450703
  • Louvanto K, Verhoef L, Pimenoff V, Eriksson T, Leppala S, Lagheden C, Gray P, Scibior-Bentkowska D, Sumiec E, Nieminen P, Dillner J, Berkhof J, Meijer CJLM, Lehtinen M, Nedjai B, Heideman DAM. Low methylation marker levels among human papillomavirus-vaccinated women with cervical high-grade squamous intraepithelial lesions. Int J Cancer. 2024 Nov 1;155(9):1549-1557. doi: 10.1002/ijc.35044. Epub 2024 May 27.

    PubMed 38801336
  • Taavela K, Eriksson T, Huhtala H, Bly A, Harjula K, Heikkila K, Hokkanen M, Nummela M, Kotaniemi-Talonen L, Lehtinen M, Louvanto K. The quality of life of frequently vs. infrequently screened HPV vaccinated women. Qual Life Res. 2024 Apr;33(4):941-949. doi: 10.1007/s11136-023-03575-y. Epub 2024 Jan 18.

    PubMed 38238599
  • Lehtinen M, Apter D, Baussano I, Eriksson T, Natunen K, Paavonen J, Vanska S, Bi D, David MP, Datta S, Struyf F, Jenkins D, Pukkala E, Garnett G, Dubin G. Characteristics of a cluster-randomized phase IV human papillomavirus vaccination effectiveness trial. Vaccine. 2015 Mar 3;33(10):1284-90. doi: 10.1016/j.vaccine.2014.12.019. Epub 2015 Jan 12.

    PubMed 25593103

Questions about this trial

What is this clinical trial studying?

A study testing Cytological screening in A1 and A3 in people with Cervical Intraepithelial Neoplasia Grade 2/3, run by Tampere University at 31 sites in Finland.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 20 Jan 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 31 sites in Finland. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Occurrence of intraepithelial neoplasia grade 2/3 (CIN2/3). (time frame: 2017-2020, i.e. four years (interim), 2021-2025, i.e. five years (final analysis). Participants will be followed for the duration of the study until 2026, an expected average of 9 years.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02149030, which also lists 12 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Jan 2025.

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