Researchers: John Kaldor, Dina Saulo, Skye McGregor (Kirby Institute, University of New South Wales); Suzanne Garland, Sepehr Tabrizi (Department of Microbiology and Infectious Diseases, The Royal Women’s Hospital); Bette Liu (The Sax Institute); Julia Brotherton (Victorian Cytology Service)
Funding: Australian Department of Health and Ageing
Project summary: Between 2013-2014 Aboriginal Health Services are being invited to participate in a follow-up study to gauge the impact of vaccination programs on prevalence of HPV genotypes in Indigenous women attending for Pap testing.
Aims:
To estimate the proportion of Indigenous women who have been vaccinated among 18-26 year old women attending for Pap testing
To estimate and compare the prevalence of HPV types (including vaccine-specific types 6/11/16/18 and other high risk HPV types) among Indigenous women in the post-vaccine era compared to the pre-vaccine era
To ensure a comparable sample, 6 sites who previously participated in the WHINURS study will be approached with the goal of recruited upwards of 220 Indigenous women over the study period. At eligible sites, all women aged between 18-26 years, and presenting for an episode of care that includes a Pap test will be eligible and invited to participate in the study. All women who agree to participate and sign a consent form will, in addition to their routine Pap smear, have part of the sample of the endocervical cells taken for the smear stored in ThinPrep medium and transported to the WHO Reference Lab at the Royal Hospital for Women in Melbourne for HPV DNA testing. Samples will include personal identifiers and a unique person study number so that results can be reported back to clinical sites.
In order to compare the study population sampled to previous studies, all women who consent will also be asked to complete a brief questionnaire asking about their age, postcode of residence, education, number of past partners, age of first intercourse, use of hormonal contraception, smoking,receipt of HPV vaccine and the number of doses. Their doctor/health care worker will also be asked to indicate their most recent pap result. An optional consent section for the study group will request access to the participant’s HPV vaccination status from state and national registers.
All study participants will have standard clinical care and pap test follow-up. The results of the HPV DNA testing will be reported to the doctor/health care worker but as there are no specific guidelines for patients with normal Pap results that are positive for high risk HPV DNA, a clinical algorithm was developed, utilising international evidence and expert opinion, for the WHINURS study. All participants who test positive for the presence of high‐risk HPV DNA will be invited back for a repeat HPV and pap test 12 months after the initial test.
Progress: Ongoing