Compass: Pointing towards elimination of cervical cancer

Amanda Lyons

5/08/2019 2:47:07 PM

Dr Lara Roeske talks to newsGP about a large-scale trial to assess the new screening program and help make it even more effective.

Dr Lara Roeske.
Dr Lara Roeske talks to newsGP about the Compass trial, Australia’s largest clinical trial, which is focused on assessing and improving the new cervical screening program.

While international research supports the refresh of the national screening program from the Pap test to cervical screening test (CST) in December 2017, Australia is undertaking its own assessment through Compass, a randomised controlled trial designed to compare the outcomes of both methods. 
‘Compass is a world-first trial, because there is currently no research or data around the performance of HPV-based screening in the world’s largest cohort of HPV-vaccinated women, here in Australia,’ Dr Lara Roeske, GP and recruitment lead for the trial, told newsGP.
According to Dr Roeske, Compass – which is also the largest clinical trial ever conducted in Australia – aims to achieve a number of objectives.
‘[We aim] to confirm that the CST is a superior screening method, and also look at how HPV-based screening will work optimally in HPV-vaccinated cohorts of women,’ she said.
‘[The trial] also serves as independent data safety and monitoring for the renewed national program.’
Compass will also help guide future decisions and procedures around triaging women who receive positive results within the new screening program.
‘The trial seeks to assess different ways of deciding which women need further investigation after a positive test – so, how we might better triage women who have HPV types non 16 or 18 detected, and more judiciously decide which of them can be safely deferred from colposcopy and followed up in a different way,’ Dr Roeske said.
‘We’re actually trialling a very promising triage tool in the trial known as dual stain cytology to that end.’
Another significant aspect of Compass is its strong general practice focus.
‘Australia has the world’s largest cohort of HPV-vaccinated women, and they are women aged 25–38, who present to general practice routinely for a cervical screening test – this is really the eligible cohort that we’re wanting to study,’ Dr Roeske said.
‘Through the support of GPs, we have recruited almost 75,000 women. The trial would never have reached its size, nor will it realise its success, without the contribution of GPs.
‘We’re very appreciative of their efforts to really support this world-first clinical trial, and ideally improve cervical screening programs here and internationally.’
Dr Roeske hopes the trial can continue to rely on GPs’ support, as Compass remains in active recruitment mode until 30 November.
‘We’re aiming to recruit a further 7000 women to make it a grand total of 82,303 women by the end of this year,’ she said.
‘It is incredibly important that we are able to recruit these women, aged 25–38 years, to ensure that the data and the evidence from the trial is robust.
‘It’s a great time for GPs to talk to women about supporting cervical cancer research, and to also help us progress toward being the first country in the world to eliminate cervical cancer and continue to be at the leading edge of cervical cancer prevention and research.'
In addition to helping advance cervical cancer research and inform future technologies and processes, there are other benefits for GPs as well.
‘GPs can access a QI&CPD activity as part of recruitment of the trial,’ Dr Roeske said.
‘They’re also supported by a team of clinicians, many of whom are also GPs. And participating GPs can ask us all sorts of questions about Compass and the renewed screening program.
‘For GPs that have been recruiting, we will ensure that as study findings emerge, they’ll receive that information. Should any GPs be interested to learn more about how the trial is progressing, they can ring the free-call number and one of the research team would be really pleased to talk to them.’
Ultimately, however, Dr Roeske believes many GPs will find involvement in the trial is its own reward.
‘Many GPs are just very excited about being part of cutting edge research, world-first findings, and championing the cause of cancer prevention and women’s health,’ she said.

Cervical cancer Cervical screening Compass trial General practice research HPV vaccination screening Women’s health

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