Optimising Cervical Screening After The Introduction Of HPV Vaccination In Australia: Modelling Of Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$316,089.00
Summary
This research project will aid decision-making about how best to perform cervical screening in Australia after the introduction of vaccination against the human papillomavirus (or HPV). The project will use computer simulation techniques to explore different scenarios for vaccination and screening and to determine the optimal approach. This project involves a group of international collaborators with expertise in a number of areas including cancer epidemiology, screening for cancer, and computer ....This research project will aid decision-making about how best to perform cervical screening in Australia after the introduction of vaccination against the human papillomavirus (or HPV). The project will use computer simulation techniques to explore different scenarios for vaccination and screening and to determine the optimal approach. This project involves a group of international collaborators with expertise in a number of areas including cancer epidemiology, screening for cancer, and computer simulation methods. HPV is the virus responsible for the development of cervical cancer, and clinical trials have demonstrated that HPV vaccines administered to adoloescent girls are very effective at preventing disease that might have led to cancer in the future. However, Australia currently has a very effective Pap smear screening program, and in the first phase after the introduction of vaccination it will be important for women to continue being screened as usual. In the long term, HPV vaccination is expected to reduce the need for Pap smears. The research will involve a very detailed simulation of how HPV is transmitted in the Australian population, and how this will change after vaccination. The simulation will address questions of importance for any future public HPV vaccination program, such as whether males should be vaccinated as well as females. The simulation will also be used to determine the optimal starting age and frequency of Pap smears in the future. The outcomes of the research will be very important for policy-makers. In the long term, this research will ensure that the best recommendations are formulated for the timing and frequency of Pap smears after HPV vaccination is introduced.Read moreRead less
Evaluation Of Primary HPV Testing For Cervical Screening In Australia
Funder
National Health and Medical Research Council
Funding Amount
$701,037.00
Summary
The overall aim of the project is to use simulation modelling to perform a detailed evaluation of new approaches to cervical screening in Australia, taking into account the implementation of the National HPV Vaccination Program. The project involves collaboration between Australian researchers and investigators at the National Cancer Institute USA. We will integrate local and international data to lead the world in understanding how cervical screening should best be performed in the context of H ....The overall aim of the project is to use simulation modelling to perform a detailed evaluation of new approaches to cervical screening in Australia, taking into account the implementation of the National HPV Vaccination Program. The project involves collaboration between Australian researchers and investigators at the National Cancer Institute USA. We will integrate local and international data to lead the world in understanding how cervical screening should best be performed in the context of HPV vaccination.Read moreRead less
Infrared Spectroscopic Imaging In The Diagnosis Of Cervical Cancer
Funder
National Health and Medical Research Council
Funding Amount
$291,600.00
Summary
In Victoria alone around 500000 Pap smears a year are examined for evidence of cancer of the cervix or conditions that may lead to cancer. This is a time consuming, labour intensive and costly process with a relatively high failure rate. A number of alternative techniques have been explored in the last decade with a view to providing a diagnostic technique that is free of human error, more reliable than the Pap method and easily used. An alternative technique based on using infrared light to pro ....In Victoria alone around 500000 Pap smears a year are examined for evidence of cancer of the cervix or conditions that may lead to cancer. This is a time consuming, labour intensive and costly process with a relatively high failure rate. A number of alternative techniques have been explored in the last decade with a view to providing a diagnostic technique that is free of human error, more reliable than the Pap method and easily used. An alternative technique based on using infrared light to probe smears shows promise in providing such an easily automated reliable method. We, and others have spent a number of years exploring this technique and have solved a number of the problems associated with it. Based on our work in the field and the work of others we now wish to develop a methodology using an infrared micro-imaging spectrometer combined with multivariate statistics that can be used to diagnose cervical cancer and the conditions that lead to cervical cancer.Read moreRead less
Screening For Chlamydia Trachomatis With Routine Pap Smears In General Practice: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$350,500.00
Summary
Genital chlamydia infection is the most commonly reported infectious disease in Australia. Notifications have increased three fold since 1995; five-fold in the ACT and surveillance data underestimate the true incidence of the disease in the community. Chlamydia is associated with immediate morbidity in men and women including urethritis, epididymo-orchitis, cervicitis, and pelvic pain and long-term complications including pelvic inflammatory disease, ectopic pregnancy and tubal factor infertilit ....Genital chlamydia infection is the most commonly reported infectious disease in Australia. Notifications have increased three fold since 1995; five-fold in the ACT and surveillance data underestimate the true incidence of the disease in the community. Chlamydia is associated with immediate morbidity in men and women including urethritis, epididymo-orchitis, cervicitis, and pelvic pain and long-term complications including pelvic inflammatory disease, ectopic pregnancy and tubal factor infertility. The economic costs of Chlamydial infection in Australia have been estimated to be as high as $160 million each year. In the ACT 73.8% of chlamydial infections occur in the 20-40 year old group. Between 60 and 70% of women in this age range participate in Pap screening every two years. While targeted screening for Chlamydia in women is effective in the US, there are few studies that investigate its value in an Australian setting. In this randomised controlled clinical trial we aim to test the novel hypothesis that the routine offer of chlamydia testing to women between 20 and 40 years who undergo Pap screening significantly increases the detection of Chlamydia in that population. This is the first randomised-controlled trial of its type and is an extension of a current non-randomised pilot study of linked Chlamydia-Pap screening in the primary care setting. The aim is to determine if the program can be incorporated more widely in the ACT. The study will: Measure the impact of linked chlamydia-Pap screening on chlamydia screening participation rates More accurately determine the epidemiology of genital chlamydial infection in this age group and social setting; Undertake an economic evaluation of this approach; Determine if promoting the Pap smear as an opportunity for chlamydial screening increases the uptake of Pap screening in younger women Aid in the development of a National Chlamydia Screening strategyRead moreRead less
The Population Impact Of Human Papillomavirus Vaccination On Circulating Genotypes
Funder
National Health and Medical Research Council
Funding Amount
$249,259.00
Summary
Infection with human papillomavirus (HPV) is very common. Persistent infection can cause abnormal changes to cervical cells as found on Pap smears and if untreated, over time can develop into cervical cancer. Recently, a vaccine was introduced in Australia for women aged 12-26. To monitor the effectiveness of this vaccine, young women aged 18-22 will be asked to self-collect a sample for HPV detection which will determine if HPV types targeted by vaccine are reducing in prevalence.
Perinatal Outcomes Following Treatment For Cervical Dysplasia
Funder
National Health and Medical Research Council
Funding Amount
$98,600.00
Summary
A very high proportion of women in Australia have regular cervical screening ('pap' tests) for early detection of any early abnormal changes of the cervix. Women with abnormalities are referred for further investigation and some go on to have the areas with abnormalities treated either by surgical removal of small amounts of tissue or by other heat or laser treatments of affected areas. Many women having these treatments are of child-bearing age and may not have had children, or may seek to have ....A very high proportion of women in Australia have regular cervical screening ('pap' tests) for early detection of any early abnormal changes of the cervix. Women with abnormalities are referred for further investigation and some go on to have the areas with abnormalities treated either by surgical removal of small amounts of tissue or by other heat or laser treatments of affected areas. Many women having these treatments are of child-bearing age and may not have had children, or may seek to have more children after treatment. There are unanswered questions about the extent to which any or all of these treatments might, by changes to the cervix, lead to preterm birth in any subsequent pregnancy. In the proposed study, records relating to women referred from 1982 to 2000 for assessment and possible treatment of cervical abnormalities at a major hospital will be linked to Victorian birth records from 1983 to 2001. This will allow a comparison of preterm birth in the group of women referred with cervical abnormalities, with preterm births in the Victorian population, and comparing women who do and don't have treatment, taking into account other important factors such as the mother's age, and her previous pregnancies. The information will be of value to women themselves, to gynaecologists and to screening services.Read moreRead less
Effective Immunotherapy For HPV Associated Cervical Cancer Precursor Lesions
Funder
National Health and Medical Research Council
Funding Amount
$482,640.00
Summary
Vaccines to prevent cervical cancer are currently being developed. These will be used to prevent infection with the causal virus, papillomavirus. However, there are very many people world wide who already have papillomavirus infection, which could turn into cancer at any point over the next 30 years. Therefore, there is a need for a vaccine that could be given along with the preventative vaccine, which would treat existing infections. This study addresses the characteristics of the immune respon ....Vaccines to prevent cervical cancer are currently being developed. These will be used to prevent infection with the causal virus, papillomavirus. However, there are very many people world wide who already have papillomavirus infection, which could turn into cancer at any point over the next 30 years. Therefore, there is a need for a vaccine that could be given along with the preventative vaccine, which would treat existing infections. This study addresses the characteristics of the immune response required to treat existing papillomavirus infections, since this is not currently known.Read moreRead less
Non-viral Vectors For Targeted Delivery Of RNAi Nucleotides To Cervical Cancers
Funder
National Health and Medical Research Council
Funding Amount
$415,738.00
Summary
RNA interference (or gene silencing) is a new technique whereby we are able to turn off the expression of a particular gene either temporarily or permanently. Cancer is basically a genetic disease where certain protective genes are lost or cancer-causing genes expressed. Gene silencing holds great promise in the treatment of genetic disorders, infectious diseases and cancer. Cervical cancer is caused by infection with the human papillomavirus and the expression of two cancer-causing genes. Using ....RNA interference (or gene silencing) is a new technique whereby we are able to turn off the expression of a particular gene either temporarily or permanently. Cancer is basically a genetic disease where certain protective genes are lost or cancer-causing genes expressed. Gene silencing holds great promise in the treatment of genetic disorders, infectious diseases and cancer. Cervical cancer is caused by infection with the human papillomavirus and the expression of two cancer-causing genes. Using RNA interference we can turn off the expression of these two genes which results in the death of the cancer cell. We are also able to cure mice of tumours derived from human cervical cancer. The major issue with gene silencing is how to deliver it effectively to patients. Here we are investigating novel nanoparticulate systems to deliver this new gene-inhibiting drugs preferentially to the tumour site.Read moreRead less