Early Detection and Diagnosis

You have full text access to this OnlineOpen article

Randomized controlled trial of human papillomavirus testing versus Pap cytology in the primary screening for cervical cancer precursors: Design, methods and preliminary accrual results of the Canadian cervical cancer screening trial (CCCaST)

  1. Marie-Hélène Mayrand1,2,
  2. Eliane Duarte-Franco1,3,
  3. François Coutlée1,4,
  4. Isabel Rodrigues5,
  5. Stephen D. Walter6,
  6. Sam Ratnam7,
  7. Eduardo L. Franco1,†,*,
  8. for the CCCaST Study Group‡

Article first published online: 29 MAR 2006

DOI: 10.1002/ijc.21897

Issue

International Journal of Cancer

International Journal of Cancer

Volume 119, Issue 3, pages 615–623, 1 August 2006

Additional Information

How to Cite

Mayrand, M.-H., Duarte-Franco, E., Coutlée, F., Rodrigues, I., Walter, S. D., Ratnam, S., Franco, E. L. and for the CCCaST Study Group (2006), Randomized controlled trial of human papillomavirus testing versus Pap cytology in the primary screening for cervical cancer precursors: Design, methods and preliminary accrual results of the Canadian cervical cancer screening trial (CCCaST). Int. J. Cancer, 119: 615–623. doi: 10.1002/ijc.21897

Author Information

  1. 1

    Division of Cancer Epidemiology, Departments of Oncology and Epidemiology & Biostatistics, McGill University,Montreal, QC, Canada

  2. 2

    Département d'Obstétrique-Gynécologie, Université de Montréal, Montreal, QC, Canada

  3. 3

    Department of Family Medicine, McGill University, Montreal, QC Canada

  4. 4

    Département de Microbiologie-Infectiologie, Hôpital Notre-Dame du Centre Hospitalier Universitaire de l'Universitéde Montréal, Montreal, QC, Canada

  5. 5

    Département de Médecine familiale, Université de Montréal, Montreal, QC, Canada

  6. 6

    Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada

  7. 7

    Newfoundland Public Health Laboratory, St. John's, NF, Canada

  1. †

    Fax: +514-398-5002.

  2. ‡

    CCCaST Study Group.Montreal Research Staff: L. Abruzzese, K. Bellegarde, M. Bernardin, F. Ferdinand, G. Kelsal, M. Paquin, S. Piché, J. Poirier, A. Rodrigues, N. Rousseau, C. Schwartz, N. Slavtcheva E. Tunistky.St. John's Research Staff: G. Condon, D. Mason, B. Halfyard, J. McGrath, A. Batstone, W. Shea, C. Leonard, E. Oates, V. Moulton, P. Francis, C. Head, A. Fitzpatrick.Montreal Clinical Collaborators: M.Y. Arsenault, G. Asselin, L. Authier, S. Bagga, P. Bastien, L. Bazinet, F. Beaudoin, P. Beaulieu, M.J. Bédard, S. Belinski, S. Bélisle, J. Benoit, M. Bernard, S. Bianki, L. Biron, F. Bissonnette, R. Bou-Habib, J. Bourque, B. Bradbury, M. Champagne, Y. Charles, P. Choquette, J. N. Couture, H.Q. Dao, J. Desjardins, C. Desjardins, L. Desrosiers, S. DiTommaso, L. Dontigny, M. Doyle, J. Dubé, M.J. Dupuis, F. Durocher, F. Engel, B. Fafard, A. Ferenczy, G. Fortier, A. Fortin, C. Fortin, D. Francoeur, D. Frechette, P. Fugère, G. Gagné, G.P. Gagné, S. Gascon, M.J. Gaudreau, D. Gaudron, K. Gemayel, L. Gilbert, S. Gilbert, J. Gill, I. Girard, A. Gobeil, L. Granger, F. Grou, E. Grou, G. Guertin, J. Guimond, R. Hemmings, N. Ifergan, L. Johnson, C. Johnson, L. Ketchian, Y. Korcaz, C. Lafortune, J. Lalande, J.F. Lanctot, D. Landry, M. Landry, D. Langevin, I. Langlois, L. Lanmy-Monnot, L. Lapensée, L. Larouche, D. Laurin, M.C. Lavigne, Y. Lavoie, M. Leduc, F. Leger, N. Leroux, G. Luskey, N. Mansour, J. Marceau, A. Masse, M.H. Mayrand, I. Mayrand, L.R. McLauchlin, S. Menard, C. Mercer, M. Messier, B. Michon, M. Nadeau, M. Nguyen, S. Ouellet, C. Paquin, R. Paré, S. Peloquin, Y. Piché, R. Pichet, C. Rivard, I. Rodrigues, S. Roman, L. Rusimovic, G. Sanche, D. Souliere, D. Sproule, M. Steben, S. Still, D. Theriault, G. Tondreau, D. Tremblay, T. Minh Dung Vo, V.M. Whitehead, M. Yaffe, A. Di Zazzo, C. Ziegler.Newfoundland Clinical Collaborators: L. Dawson, D. Fontaine, J. Dunne, N. Kum, C. Pike, P. Power, P. Wadden, E. Bannister, E. Callahan, J. Collingwood, P. Crocker, A. Drover, F. Fifield, J. Fitzgerald, B. Grandy, M. Greene, K. Halley, L. Hatcher, J. Hickey, P. Horwood, J. Janes, F. Jardine, L. Kieley, S. King, C. Kirby, E. Mate, S. McGrath, C. McManamon, K. Misik, M. O'Dea, P. O'Shea, C. Peddle, M. Penton, L. Rogers, K. Saunders, P. Skirving, T. Sullivan, J. Verge, M. Watson, M. Young.

*Division of Cancer Epidemiology, McGill University, 546 Pine Avenue West, Montréal, Québec, Canada H2W 1S6

Publication History

  1. Issue published online: 8 MAY 2006
  2. Article first published online: 29 MAR 2006
  3. Manuscript Accepted: 18 JAN 2006
  4. Manuscript Received: 7 OCT 2005

Funded by

  • Canadian Institutes of Health Research
  • Canadian Institutes of Health Research (CIHR). Grant Number: MCT-54063
  • National Cancer Institute of Canada
  • CIHR
  • Fonds de la Recherche en Santé du Québec

SEARCH

SEARCH BY CITATION

ARTICLE TOOLS

View Full Article (HTML) Get PDF (403K)

Keywords:

  • cervical intra-epithelial neoplasia;
  • screening;
  • cytology;
  • HPV DNA testing;
  • randomized controlled trial

Abstract

Since infection with oncogenic human papillomavirus (HPV) has been considered a necessary cause of cervical cancer, tests for oncogenic HPV types have been proposed as adjuncts or replacements to Pap cytology. We designed the Canadian Cervical Cancer Screening Trial (CCCaST) to compare the relative efficacy of HPV DNA testing and Pap cytology in primary screening for cervical cancer and its high-grade precursors. CCCaST randomized women aged 30–69 years in Montreal (Quebec) and in St. John's (Newfoundland) to 1 of 2 screening groups: focus on Pap (conventional) or focus on HPV testing (Hybrid Capture 2). Women in both arms received both tests, but were randomized as to their order, the first test being the index test. Women with an abnormal Pap test or a positive HPV test underwent colposcopy and biopsy, as did a random sample of women with a negative index test. CCCaST enrolled 9,667 women between October 2002 and October 2004. At enrolment, 2.8% had an abnormal Pap test, 6.1% had a positive HPV test and 1.1% were abnormal in both tests. ASC-US was the most frequent cytological abnormality, representing 64% of abnormal Pap results. The frequency of abnormal Pap and HPV results decreased with increasing age and the proportion of HPV-positive results increased with the severity of Pap abnormality. Efficacy analysis will determine if the extra referrals with HPV DNA testing will translate into a relevant increase in high-grade cervical cancer precursor detection. Because of its design, CCCaST will provide sound evidence for formulating cervical cancer screening strategies. © 2006 Wiley-Liss, Inc.

View Full Article (HTML) Get PDF (403K)