NCT03061435

Screening for Anal Cancer in Women With High-grade Vulvar Dysplasia or Vulvar Cancer.

• Status: Recruiting
• Phase: N/A
• Study type: Interventional
• Enrollment: 110 (estimated)
• Sponsor: Dr. Danielle Vicus · Academic / Other
• Sex: Female
• Age: 40 Years
• Healthy volunteers: Accepted

Summary

Almost half of all women will develop an HPV infection in their lifetime. While most infections are naturally asymptomatic or cleared by the immune system, some persist and can lead to the development of cervical, vulvar, or anal lesions and eventually cancer. Screening regimens for these lesions are currently only in place for the cervix through regular Pap tests. These Pap tests usually involve an examination of the vulva -however, no screening procedures exist for anal cancer for women. Several studies have suggested that women with existing gynecological lesions are more likely to develop anal lesions and anal cancer. Here the investigators propose a multi-center study which seeks to screen for and treat anal cancer in women over the age of 40 with vulvar lesions and a stable immune system. The investigators will achieve this through performing anal Pap smears on eligible women and conducting High Resolution Anoscopy (HRA) and appropriate treatment procedures on those with abnormal anal cells. With enough evidence, there may be an indication to establish regular anal cancer screening measures in this potentially underserved population. Hypothesis: The investigators hypothesize that at least 40% of women with vulvar cancer or VIN2/3 will have abnormal anal cytology. 35% of the population will be hrHPV DNA positive and 11% will additionally have AIN2/3. This prospective study may lay the groundwork for routine anal screening regimens in Ontario and help shift health policy to treat this population.

Conditions

• Vulvar Cancer
• Cervical Cancer
• Vulvar Dysplasia
• Cervical Dysplasia
• Anal Cancer
• Anal Dysplasia
• HPV-Related Anal Squamous Cell Carcinoma

Interventions

Type	Name	Description
PROCEDURE	Screening anal Pap smear - No high-resolution anoscopy	75% of patients with negative cytology on their anal Pap smear will not receive high-resolution anoscopy
PROCEDURE	Screening anal Pap smear - High-resolution anoscopy	25% of patients with negative cytology on their anal Pap smear will receive high-resolution anoscopy. All patients with positive (abnormal) cytology on their anal Pap smear will receive high-resolution anoscopy.

Timeline

• Start date: 2021-02-01
• Primary completion: 2025-08-01
• Completion: 2026-01-01
• First posted: 2017-02-23
• Last updated: 2025-05-16

Locations

1 site across 1 country: Canada