Gina Ogilvie
MD, MSc, FCFP, DrPH
Dr. Ogilvie is a Tier 1 Canada Research Chair in Global Control of HPV related diseases and prevention, and Professor at the University of British Columbia in the School of Population and Public Health She is also Senior Public Health Scientist for BC Centre for Disease Control and Senior Research Advisor at the BC Women’s Hospital and Health Centre. Dr. Ogilvie is currently principal investigator on over 10 million dollars in research grants and has received funding from NIH, PHAC, CIHR, Michael Smith Foundation for Health Research, Canadian Foundation for Innovation and private foundations including BC Women’s Hospital Foundation, among others.
Her research is focused on both the public health and clinical aspects of reproductive health, sexually transmitted infections, HPV screening and the HPV vaccine, and her findings have been highly influential in setting and directing health policy both in Canada and globally. Among other research projects, she is principal investigator for the ASPIRE program, a global health initiative conducting research and providing women-centered, innovative solutions for cervical cancer prevention and reproductive health in sub-Saharan Africa. She also leads HPV FOCAL, a randomized trial of over 25,000 women comparing primary screening for cervical cancer, and QUEST, a pragmatic randomized trial defining the effectiveness of reduced dosing of the HPV vaccine.
She has published over 150 peer reviewed manuscripts and has provided advice and consultation to national and global institutions including the Canadian Partnership Against Cancer, Public Health Agency of Canada, the World Health Organization and Ministries of Health globally on STI, HIV and HPV vaccine policy and programming. She speaks widely at international and national research and education conferences, and has supervised medical students, residents, and graduate students throughout her career.
Projects
Research around the world has shown HPV testing has the potential to improve the performance of cervical screening programs, thereby enhancing cervical cancer prevention. However, high quality Canadian research studies are needed for public health policy formulation within Canada. HPV FOCAL is the largest randomized trial in Canada assessing the effectiveness and safety of primary HPV testing compared to the Pap test for cervical cancer prevention.
The study recruited over 25,000 BC women, aged 25-65 engaged in cervical cancer screening. Women were randomly assigned to receive the standard of care, cytology (Pap) testing and managed according to provincial guidelines, or they were assigned to primary HPV testing with management determined by the results of HPV testing. This trial is embedded in the BC Cervical Cancer Screening Program, with the ultimate goal of implementing HPV screening provincially in the future.
The final results of the HPV FOCAL trial were published in July 2018. Four years after receiving their first test at study entry, significantly fewer high grade pre-cancer cervical changes were detected in women who had HPV testing at study entry, than in women who had cytology testing at entry. In addition, cervical pre-cancer was found earlier in women who had HPV testing than in women who had cytology testing, which provided the opportunity for earlier treatment.
Funding has been received from the National Institutes of Health to follow women in HPV FOCAL beyond the 4 year study period to provide long term information regarding the use of HPV testing in cervix screening. This trial is known as HPV FOCAL DECADE, and is the first of its kind in North America to evaluate the safety and efficacy of HPV testing up to 10 years.
Researchers
Publications
Ogilvie GS, van Niekerk D, Krajden M, Smith LW, Cook D, Gondara L, Ceballos K, Quinlan D, Lee M, Martin RE, Gentile L, Peacock S, Stuart GCE, Franco EL, Coldman AJ. Effect of Screening With Primary Cervical HPV Testing vs Cytology Testing on High-grade Cervical Intraepithelial Neoplasia at 48 Months: The HPV FOCAL Randomized Clinical Trial. JAMA. 2018 Jul 3;320(1):43-52. doi: 10.1001/jama.2018.7464. Erratum in: JAMA. 2018 Dec 4;320(21):2273.
Coldman AJ, van Niekerk D, Krajden M, Smith LW, Cook D, Gondara L, Ceballos K, Quinlan DJ, Lee M, Elwood-Martin R, Gentile L, Peacock S, Stuart GCE, Franco EL, Ogilvie GS. Disease detection at the 48-month exit round of the HPV FOCAL cervical cancer screening trial in women per-protocol eligible for routine screening. Int J Cancer. 2019 Jun 27. doi: 10.1002/ijc.32524.
Cook DA, Mei W, Smith LW, van Niekerk DJ, Ceballos K, Franco EL, Coldman AJ, Ogilvie GS, Krajden M. Comparison of the Roche cobas® 4800 and Digene Hybrid Capture® 2 HPV tests for primary cervical cancer screening in the HPV FOCAL trial. BMC Cancer. 2015;15:968.
Cervical cancer is the second most common cancer in women living in low and middle income countries, where around 85% of cases occur globally. Uganda has one of the highest cervical cancer rates in the world and the country has not yet implemented a comprehensive national screening program. Screening is offered opportunistically, especially in rural regions, largely as a result of resource constraints. The integration of a self-collected cervical cancer screening program using HPV testing within community-based health systems could reduce individual and health system barriers in Uganda and empower women to take leadership in their own health.
In partnership with the Uganda Cancer Institute, a 2-armed pragmatic cluster randomized trial is being conducted in the rural Mayuge region of Uganda. The goal of this project is to compare the effectiveness of two community-based cervical cancer screening models using self-collected HPV testing: 1) Community health worker recruitment (door-to-door); and 2) community health meetings. Results from this study will inform the national scale-up of cervical cancer screening in Uganda, aligning with the World Health Organization’s target of achieving cervical cancer elimination through the pillar of increased HPV screening coverage.
Since 2007, ASPIRE has conducted various community-based cervical cancer screening initiatives in Kampala, Uganda using self-collection-based HPV testing. The project takes an integrated health services approach to address cervical cancer along other reproductive health issues including sexually transmitted infections and HIV.
Researchers
Publications
Nakisige C, Trawin J, Mitchell-Foster S, Payne BA, Rawat A, Mithani N, Amuge C, Pedersen H, Orem J, Smith L, Ogilvie G. Integrated cervical cancer screening in Mayuge District Uganda (ASPIRE Mayuge): a pragmatic sequential cluster randomized trial protocol. BMC Public Health. 2020 Dec 1;20(1):142. doi:10.1186/s12889-020-8216-9
Moses E, Pedersen HN, Mitchell SM, Sekikubo M, Mwesigwa D, Singer J, Biryabarema C, Byamugisha JK, Money DM, Ogilvie GS. Uptake of community-based, self-collected HPV testing vs. visual inspection with acetic acid for cervical cancer screening in Kampala, Uganda: Preliminary results of a randomized controlled trial. Trop Med Int Health. 2015; 20(10):1355-67.
Ogilvie G S, Mitchell S, Sekikubo M, Biryabarema C, Byamugisha J, Jeronimo J, Miller D, Steinberg M, Money D M. Results of a community-based cervical cancer screening pilot project using human papillomavirus self-sampling in Kampala, Uganda.Int J Gynaecol Obstet 2013; 122 (2): 118–123.
Despite being almost entirely preventable, the World Health Organization estimates that one million women globally currently have cervical cancer. Although Canada is poised to be one of the first countries to eliminate cervical cancer (CC), in 2019, an estimated 1,350 Canadian women will be diagnosed and every day, a woman in Canada will die from this preventable cancer. CC is caused by long-term infection with human papillomavirus (HPV), and is largely preventable through effective vaccination and screening.
Our research team will advance research on HPV vaccine and screening methods to reach the goal of eliminating CC in Canada. Through five ‘research projects’, our team will evaluate the effectiveness of current HPV vaccine schedules and strategies for improving uptake of the vaccine in school based programs. Using the BC Cervix Screening Program and experience from our HPV FOCAL study, we will comprehensively examine the impact of population level recruitment strategies using self-collection and digital infrastructure to increase attendance at care and CC screening coverage. This evaluation will focus on examining how a population level strategy impacts CC screening coverage in underscreened women, particularly communities that face access inequities. In partnership with Indigenous communities, employing a strengths-based approach, we will examine ways to achieve equity in access to screening in First Nations and Métis communities. We will strengthen and broaden our existing collaborative networks to ensure knowledge translation to other jurisdictions across Canada with the ultimate aim of will accelerate Canada’s efforts to becoming the first country, globally, to eliminate of CC.