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CompletedNCT02270021Updated Sep 25, 2019

Decreasing Over Screening and Treatment of Cervical Precancers in Young Women

An interventional study of Provider Mobile Application (ProvAPP) and ProvAPP + Patient Educational Tool (Tab) in Cervical Cancer, sponsored by University of California, San Francisco. Completed at 2 sites in United States. Open to female participants aged 21 Years to 29 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2019-09-25.

Sponsored by University of California, San Francisco · Not applicable, Interventional, and Screening

Phase
Not applicable
Study type
Interventional
Enrollment
42
Allocation
Randomized
Ages
21 Years to 29 Years
Sex
Female
01

Study summary

The goal of this study is to prevent over screening and over treatment of young women for cervical precancers, which can result in psychological distress and has been associated with future risk of premature deliveries. Current national guidelines recommend that routine screening be performed at less-frequent intervals and that excisional cervical therapies are discouraged in young women. The objectives of this study are to examine physician- and patient-based interventions designed to decrease over screening and over treatment by increasing adherence to US guidelines for women under 30 years.

Read the detailed description

In this study, we compare two different intervention arms that are designed to prevent over screening and over treatment by increasing adherence to the new US cervical cancer screening guidelines and the American Society for Colposcopy and Cervical Pathology (ASCCP) guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. Specifically, the interventions will focus on the newly recommended cervical cancer screening intervals and decreasing the number of colposcopy procedures and cervical procedures for abnormal cytology.

This is a cluster randomized trial with individual clinics serving as the clusters. Clinics from the California Family PACT provider network who serve at least 200 female clients per year under 30 years of age will be randomized to one of two arms: 1) ASCCP mobile application (ProvAPP)-based intervention for providers, or 2) ProvAPP + Patient education Tool (Tab) intervention. These groups will be compared to a control comparison group of 28 clinics chosen using propensity score matching based on clinic characteristics such as county and private versus public from the Family PACT claims data. The ProvAPP intervention is for clinicians' mobile phones and will help them maneuver through current guidelines based on patient age and condition. An existing application from the ASCCP will be updated to include screening guidelines and to be more user-friendly. The patient-based Tab intervention will be a patient education tool accessible via URL on a tablet device at the time of check-in to assist in asking questions and evaluating treatment options. The tool will be developed with input from women age 21-29 as well as other stakeholders including Latinas Contra Cancer and the National Cervical Cancer Coalition. It is hypothesized that the ProvAPP+Tab approach will be most successful; all interventions will be more successful than no intervention.

Family PACT serves predominantly uninsured women and 40% of clients are Latina. We plan to enroll 7 sites (ProvAPP) and 7 sites (ProvAPP+Tab) into the other intervention arm with an average of 2,800 women to 3,500 women aged 21-29 years per arm (14 sites) with a similar number of sites and women randomly chosen for the comparison arm (28 sites) resulting in a total of 39 sites and 8,400-10,500 women. We will use Family PACT claims data to examine, by age, the number of and average interval between cytology specimens, colposcopy examinations, and the number of excisional procedures.

02

Conditions studied

  • Cervical Cancer

Keywords

  • Pap smear
  • Screening
  • Women
  • Human papillomavirus
  • Cervical precancer
  • Guideline adherence
03

In context

Uterine Cervical Neoplasms

1,881 studies on the registry are indexed under Uterine Cervical Neoplasms; 567 are open to participants now.

This study's enrollment of 42 is below the median of 100 across 1,377 interventional studies indexed under Uterine Cervical Neoplasms.

Browse Uterine Cervical Neoplasms studies →

Lead sponsor

University of California, San Francisco is the lead sponsor of 2,132 studies on the registry; 375 are open to participants now.

Of its 262 completed or terminated interventional studies of FDA-regulated products, 196 (75%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
21 Years to 29 Years
Sexes eligible
Female
Accepts healthy volunteers
Yes

Eligibility criteria

Inclusion Criteria - Patients:

  • English or Spanish speaking
  • Women
  • Age 21-29 years
  • History of one or more of the following: abnormal Pap smear, normal Pap smear, no Pap smear, cervical cancer

Exclusion Criteria - Patients:

  • Language other than English or Spanish
  • Male
  • Younger than 21 or older than 29

Inclusion Criteria - Clinics:

  • Family PACT provider
  • Not a Planned Parenthood affiliate
  • Located in one of ten identified Southern California study counties
  • Sends cytology/histology specimens to Quest Diagnostics West Hills
  • Clinical care visits occurred to at least 200 women age 21-29 years in fiscal year 2011/2012
  • Has a calculated average cytology interval of less than 30 months (based on last three years)

Exclusion Criteria - Clinics:

  • Not a Family PACT provider
  • Planned Parenthood affiliate
  • Not located in one of ten identified Southern California study counties
  • Sends cytology/histology specimens to a lab other than Quest Diagnostics West Hills
  • Clinical care visit occurred to less than 200 women age 21-29
  • Has a calculated average cytology interval of more than 30 months
05

Study design

Phase
Not applicable
Primary purpose
Screening
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
42 participants (actual)

Study arms

  • Experimental
    Provider Mobile Application (ProvAPP)

    Mobile phone application for providers.

    Other: Provider Mobile Application (ProvAPP)

  • Experimental
    ProvAPP + Patient Educational Tool (Tab)

    Patient educational tool; plus the Mobile phone application for providers.

    Other: ProvAPP + Patient Educational Tool (Tab)

  • No intervention
    ProvAPP Control Group

    Clinics in this group are those NOT randomized - receiving no intervention. These clinics will be chosen at random for comparison using Family PACT claims data.

  • No intervention
    ProvAPP+Tab Control Group

    Clinics in this group are those NOT randomized - receiving no intervention. These clinics will be chosen at random for comparison using Family PACT claims data.

Interventions

  • OtherProvider Mobile Application (ProvAPP)

    Mobile phone application to maneuver clinicians through the cervical cancer screening and treatment guidelines based on patient age and condition.

  • OtherProvAPP + Patient Educational Tool (Tab)

    Patient Educational Tool (Tab): A patient educational tool (mobile tablet) will educate women on cervical cancer screening and treatment. Patients' self-assessment using a tablet at the time of clinic check-in will help them to understand current guidelines and their choices for treatment if they have abnormal cytology. It will allow them to assess the risks and benefits of screening intervals and of treatment choices. ProvAPP: Mobile phone application to maneuver clinicians through the cervical cancer screening and treatment guidelines based on patient age and condition.

06

What researchers measure

Primary outcomes

  1. Rate of Cervical Cancer Screening

    Rate of women 21-29 years who received cervical cytology tests.

    Time frame: Change from baseline screening rate (3 months prior to intervention) to 15-18 months after start of intervention

Secondary outcomes

  1. Rate of Colposcopy

    Rate of women 21-29 years who receive colposcopy for cervical cancer screening over the total number of women 21-29 years.

    Time frame: Change from baseline colposcopy rate (3 months prior to intervention) to 15-18 months after start of intervention

07

Study locations

2 sites
  • University of California, Los Angeles
    Los Angeles, California 90095, United States
  • University of California, San Francisco
    San Francisco, California 94143, United States
08

References and documents

Publications

  • Moscicki AB, Chang C, Vangala S, Zhou X, Elashoff DA, Dehlendorf C, Sawaya GF, Kuppermann M, Duron Y, Wyand FL, Navarro SK, Thiel de Bocanegra H. Effect of 2 Interventions on Cervical Cancer Screening Guideline Adherence. Am J Prev Med. 2021 May;60(5):666-673. doi: 10.1016/j.amepre.2020.11.015. Epub 2021 Feb 23. PubMed 33632649 ↗

Study documents

  • Protocol and statistical analysis plan · Sep 30, 2015

Documents are hosted by the registry — open the source record to download them.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 25, 2019, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT02270021
Lead sponsor
University of California, San Francisco
Collaborators
Patient-Centered Outcomes Research Institute, Latinas Contra Cancer, National Cervical Cancer Coalition, California Department of Health Services, American College of Obstetricians and Gynecologists, American Society for Colposcopy and Cervical Pathology
Responsible party
Sponsor
First posted
Oct 21, 2014
Start date
Jul 24, 2014
Primary completion
Apr 30, 2018
Completion
Aug 30, 2019
Last update
Sep 25, 2019

Study contacts

Anna-Barbara Moscicki, MD
principal investigator · University of California, San Francisco

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Sep 2019. You cannot join it, but the record below documents what was studied.

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