Interventions to increase participation in the cervical cancer screening program for non- attendees in Sweden

ISRCTN ISRCTN78719765
DOI https://doi.org/10.1186/ISRCTN78719765
Submission date
17/01/2020
Registration date
23/01/2020
Last edited
05/07/2020
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Cancer
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Cervical cancer is a highly preventable disease. To not attend an organized cervical cancer screening program increases the risk for cervical dysplasia and cervical cancer. The aim is to investigate the participation rate in three different intervention groups for non- attendees in the Swedish national program for cervical screening.

Who can participate?
Women who have not participated in the cervical cancer screening programme during the last six years if aged 30-49 and the last eight years if aged 50-64.

What does the study involve?
Women participating in the study are offered different methods for cervical cancer screening; a visit to a midwife for a Pap smear or an HPV self-test.

What are the possible benefits and risks of participating?
If women participate and dysplasia is detected it can be treated before it develops into cervical cancer.
We can not identify any risk of great importance.

Where is the study run from?
Faculty of Medicine and Health Sciences, Linköping University, Sweden.

When is the study starting and how long is it expected to run for?
April 2016 to December 2017.

Who is funding the study?
ALF Grants Region Östergötland, Sweden.

Who is the main contact?
Dr Caroline Lilliecreutz
caroline.lilliecreutz@regionostergtoland.se

Contact information

Dr Caroline Lilliecreutz
Scientific

Department of Obstetric and Gynaecology
Womens clinic
Plan 14
Universitets sjukhuset Linköping
Linköping
58185
Sweden

ORCiD logoORCID ID 0000-0001-9491-9728
Phone +46 708731124
Email caroline.lilliecreutz@regionostergtoland.se

Study information

Study designSingle centre Interventional randomized controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typePrevention
Participant information sheet Not available in web format, please use contact detalis to request participant information sheet
Scientific titleParticipation in interventions and recommended follow-up for non-attendees in cervical cancer screening- taking the women's own preferred test method into account - a Swedish randomised controlled trial
Study objectivesThe participation rate will increase if the non-attendees can choose between different test methods presented by a midwife in a telephone call (an HPV self-test or Pap Smear in the clinic) or if they receive an HPV self-test directly by post for sampling rather than yearly invitations (routine procedure)
Ethics approval(s)Approved 12/04/2016, Regional Ethical Review Board in Linköping, Sweden (Etikprövningsmyndigheten, Box 2110, 750 02, Uppsala, Sweden; +46 10-475 08 00; registrator@etikprovning.se), ref: Dnr 2015/480-31
Health condition(s) or problem(s) studiedCervical cancer and cervix dysplasia
InterventionNon-attendees are defined as women who had not participated in the cervical cancer screening programme during the last six years if aged 30 - 49, and the last eight years if aged 50 - 64. This strategy was in accordance with the Swedish age-differentiated screening intervals at that time. The population was defined as non-attendees living in the region of Östergötland, Sweden on March 8th 2016. Data are extracted from the Swedish national cervical cancer screening registry (NKCx) which has almost 100% coverage of invitations. The results of Pap smears and biopsies and variables can be extracted from the unique national social security number for each individual. The results from the HPV self-tests are extracted from a local registry in the clinic. Data concerning follow-up results are obtained until the 31st of December 2017 when the study period will end. The non-attendees’ addresses are obtained from the Swedish Population Register (SPR). The trial was not registered before the enrolment of participants started because it was not recommended by the Ethical board.

The non-attendees are randomly, 1:1:1, assigned to one of three different groups: telephone, HPV self-test, or control with no intervention except for the yearly invitations (routine procedure). The study groups are computer randomised and adjusted for area code and age by a statistician uninvolved in the study. All three groups received the yearly invitations. The first analysed sample, Pap smear or HPV test, in all groups is referred to as the index sample. We will consider that the different interventions had an effect if an HPV self-test is ever returned during the study period or a Pap smear is analysed within six months from the date a study invitation letter is sent. Non-attendees randomised to the telephone group are offered a choice of different sampling options. Invitation letters are posted between April 1st 2016 and 31st May 2017 (telephone) and September 30th 2017 (HPV self-test).
Intervention typeBehavioural
Primary outcome measureParticipation rate measured using patient records at six months after invitations were sent
Secondary outcome measures1. Choice of intervention measured using patient records at the end of the study
2. Cytological diagnoses found in the index Pap smear at the time of analysis
Overall study start date08/03/2016
Completion date31/12/2017

Eligibility

Participant type(s)Patient
Age groupAdult
SexFemale
Target number of participants10,614
Total final enrolment10614
Key inclusion criteriaNon- attendees (defined as women who had not participated in the cervical cancer screening programme during the last six years if aged 30-49 and the last eight years if aged 50-64)
Key exclusion criteriaAll women 30-64 years old that had participated after the last invitation as recommended in the cervical cancer screening program
Date of first enrolment01/04/2016
Date of final enrolment30/09/2017

Locations

Countries of recruitment

  • Sweden

Study participating centre

Linköping University
Department of Obstetrics and Gynaecology
Division of Children's and Women's Health
Faculty of Medicine and Health Sciences
Linköping
58185
Sweden

Sponsor information

Linköping University Hospital
Research organisation

Womens clinic plan 14
University Hospital
Linköping
581 85
Sweden

Phone +46 70 5086031
Email elizabeth.nedstrand@regionostergotland.se
Website http://www.regionostergotland.se/
ROR logo "ROR" https://ror.org/05h1aye87

Funders

Funder type

Government

ALF Grants Region Östergötland

No information available

Results and Publications

Intention to publish date31/12/2020
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planPublication in scientific paper during 2020. Presentation in congress and for staff.
IPD sharing planThe datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 02/07/2020 05/07/2020 Yes No

Editorial Notes

05/07/2020: Publication reference added.
23/01/2020: Trial’s existence confirmed by Regional Ethical Review Board in Linköping, Sweden