ClinicalTrials.gg
CompletedNCT02693379Updated Feb 26, 2016

Cervical Cancer Screening in Madagascar Using Smartphone Photos and Mobile Telemedicine

An interventional study of D-VIA in Cervical Precancer, sponsored by Prof. Patrick Petignat. Completed at 1 site in Madagascar. Open to female participants aged 30 Years to 49 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2016-02-26.

Sponsored by Prof. Patrick Petignat · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
1,041
Allocation
Not applicable
Ages
30 Years to 49 Years
Sex
Female
01

Study summary

The purpose of this study is to determine whether smartphone photos may assist health-care worker (on-site) and to evaluate the diagnostic reliability and accuracy of cervical examination with smartphone photos of VIA (D-VIA), on-site and off-site, compared with conventional VIA, for human papillomavirus (HPV) positive women.

Read the detailed description

Background: Cervical cancer is the leading cause of cancer death in females in Madagascar. In this country, a large-scale screening of precancerous lesions with cytology is hardly possible, because of the lack of specialists and infrastructures. Visual inspection of the cervix with application of 5% acetic acid (VIA) is an inexpensive alternative but very subjective since it depends on the examiner's experience. Mobile telemedicine is a very promising tool in order to assist non-expert health-care workers in rural area for cervical cancer screening.

Objective: To assess if Smartphone may assist health-care worker (on-site) and to evaluate the diagnostic reliability and accuracy of cervical examination with smartphone photos of VIA (D-VIA) compared with conventional VIA, for women testing positive for human papillomavirus (HPV).

Material and method: On-site health care workers will be trained in VIA. Prescreened HPV-positive women will be referred to VIA evaluation, during which digital images with a smartphone (D-VIA) will be taken for later evaluation by a VIA specialist in Geneva linked by telemedicine. Women with positive VIA results will be treated with cold coagulation if eligible. Histological results will be considered as gold standard. The results will be analyzed with Cohen's kappa coefficient, Mcnemar's test and Bonferroni's adjustment for multiple comparisons to assess the performance of D-VIA.

Expected results: Based on the results of this project, the investigators will develop an educational training and quality assurance program for health providers for VIA and so contribute to a scaling-up of cervical cancer control. An appropriate triage by VIA will reduce not only an excessive referral rate but also an excessive treatment delay, giving the possibility of a "screen (HPV), see (VIA/D-VIA), and treat" program in a single or two visits.

02

Conditions studied

  • Cervical Precancer

Keywords

  • cervical cancer
  • HPV
  • VIA
  • screening
  • smartphone
  • telemedicine
03

In context

Uterine Cervical Dysplasia

409 studies on the registry are indexed under Uterine Cervical Dysplasia; 76 are open to participants now.

This study's enrollment of 1,041 is above the median of 167 across 285 interventional studies indexed under Uterine Cervical Dysplasia.

Browse Uterine Cervical Dysplasia studies →

Lead sponsor

Prof. Patrick Petignat is the lead sponsor of 7 studies on the registry; 2 are open to participants now.

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

04

Who can participate

Ages eligible
30 Years to 49 Years
Sexes eligible
Female
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • 30-49 years
  • HPV-positive
  • Attending the cervical cancer screening program conducted by the Saint-Damien Health-Care Centre
  • Understands study procedures and accepts voluntarily to participate by signing the form (ICF)

Exclusion criteria

Exclusion Criteria:

  • Previous Hysterectomy
  • Conditions that can interfere with visualization of the cervix
  • Pregnancy > 20 weeks
  • Not able to comply with protocol study.
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
1,041 participants (actual)

Study arms

  • Experimental
    D-VIA

    HPV high risk-positive (16, 18, 45, 31, 33, 35, 39, 51, 52, 56, 58, 59, 66, 68) women had a cervical examination using acetic acid (VIA) application and visual inspection.

    Device: D-VIA

Interventions

  • DeviceD-VIA

    D-VIA images were captured during the cervical examination with a smartphone. Biopsies and cytological samples were taken on all patients and analyzed for gold standard results. Images were shown to off site experts. D-VIA and VIA diagnoses were then compared. Women who were diagnosed on-site as pathological underwent appropriate treatment at the same consultation. Women who were diagnosed as pathological later by histopathological analyses were asked to return to the clinic for treatment.

06

What researchers measure

Primary outcomes

  1. Differences in sensitivity and specificity of VIA examination (control) and digital VIA to detect cervical cancer and pre-cancer

    Sensitivity and specificity will be calculated using histological results as gold-standard. All lesion Cin2 and worse will be considered as pathological.

    Time frame: up to 12 months

Secondary outcomes

  1. Overall agreement between diagnoses based on VIA examination (control) and diagnoses for the same patient based on digital VIA.

    Time frame: up to 12 months

07

Study locations

1 site
  • Saint-Damien Health-Care Centre
    Ambanja, Antsiranana, Madagascar
08

References and documents

Publications

  • Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010 Dec 15;127(12):2893-917. doi: 10.1002/ijc.25516. PubMed 21351269 ↗
  • Marquardt K. [Correlation of cervical cytology and histology]. Pathologe. 2011 Nov;32(6):491-6. doi: 10.1007/s00292-011-1479-2. German. PubMed 21822676 ↗

Individual participant data

Plan to share: Yes — Data will be used for scientific publications and congress presentations.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Feb 26, 2016, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT02693379
Lead sponsor
Prof. Patrick Petignat
Responsible party
Prof. Patrick Petignat (Professor, University Hospital, Geneva) — Sponsor-investigator
First posted
Feb 26, 2016
Start date
Feb 2015
Primary completion
Sep 2015
Completion
Nov 2015
Last update
Feb 26, 2016

Study contacts

Patrick Petignat, Professor
principal investigator · University Hospital, Geneva

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Feb 2016. You cannot join it, but the record below documents what was studied.

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