Informations générales (source: ClinicalTrials.gov)
Anal Follow-up of Patients With a Gynecological History of High-grade Lesion and More Induced HPV (Cohorte_HPV)
Observational
Fondation Hôpital Saint-Joseph (Voir sur ClinicalTrials)
septembre 2022
décembre 2032
29 juin 2024
Human Papillomavirus (HPV) infection is the most common sexually transmitted infection in
the world. It is currently estimated that 4.5% of all cancers worldwide are attributable
to HPV, representing 630,000 new cases per year. HPV is responsible for more than 98% of
pre-cancerous and cancerous lesions of the cervix and vagina and 88% of anal cancers.
Although prevention of HPV infection has been available since 2007, there are
approximately 3000 new cases of cervical cancer in France each year. Women benefit from
organized screening for cervical cancer.
HPV is also responsible for anal cancer in more than 90% of cases, mostly caused by HPV
16/18. Its incidence is lower with 1162 cases in women in 2018 but is increasing strongly
(+88% in women since 1990).
As with cervical cancer, there are precursors to anal cancer: high-grade intraepithelial
lesions. Early diagnosis of these lesions could potentially reduce the incidence of anal
cancer, but there are still few data in the literature. The prevalence of anal carriage
in patients with a history of cervical dysplasia or cervical cancer is estimated in
studies to be 20% with a risk of high grade anal lesions of 8%.
The relative risk of developing anal cancer in women with a history of high-grade
cervical lesions is about 5 per 100,000, 15 per 100,000 for those with a history of
cervical cancer, and 42 and 48 per 100,000 respectively for women with HPV-induced
pre-cancer and cancerous lesions of the vulva.
The different means of cervico-vaginal screening: screening samples: HPV test, cytology,
some biomarkers: double labelling p16/ki67, E6-E7 mRNA and clinical examination with or
without colposcopy (examination of the cervix with a magnifying glass) are used at the
gynecological level but also at the anal level with as examination: simple anuscopy and
high resolution anuscopy. Some scientific societies have established surveillance
algorithms for certain risk groups, but there are no clinical practice recommendations
yet for women with a history of gynecological HPV-induced lesions.
A proctology follow-up protocol for at-risk patients is proposed to patients based on
cervico-vaginal surveillance recommendations and data in the literature, pending clinical
practice guidelines. The frequency of these examinations depends on the patient's age and
the existence of other risk factors for the development of anal HPV lesions. Depending on
these elements, follow-up is proposed every 3 years, 5 years, or annually.
The objective of this work is therefore to propose proctological surveillance to this
population considered at risk, according to age, smear results and HPV test.
Etablissements
| Les établissements d'Île-de-France dont les données sont issues de ClinicalTrials.gov Origine et niveau de fiabilité des données | |||||
|---|---|---|---|---|---|
| GH PARIS SITE SAINT JOSEPH | Helene BEAUSSIER, PharmD, PhD | Contact (sur clinicalTrials) | |||
Critères
Femme
Inclusion Criteria:
- Patient whose age ≥ 18 years
- Patient with a high-grade or higher HPV-induced gynecological lesion
- Patient participating in the proctology follow-up protocol
- French-speaking patient
- Patient whose age ≥ 18 years
- Patient with a high-grade or higher HPV-induced gynecological lesion
- Patient participating in the proctology follow-up protocol
- French-speaking patient
- Patient with a history of induced high-grade anal HPV lesion and above
- Patient under guardianship or curatorship
- Patient deprived of liberty
- Patient under court protection
- Patient objecting to the use of his/her data for this research