Utilization of cervical cancer prevention tools and role of high-risk HPV type in the persistent cervical cancer disparities experienced by American Indian/Alaska Native women

宫颈癌预防工具的利用以及高危 HPV 类型在美洲印第安人/阿拉斯加原住民妇女经历的持续性宫颈癌差异中的作用

• 批准号: 10452479
• 负责人: Amanda S Bruegl
• 金额: $ 25.15万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10452479
• 关键词: Address; Adopted; Age; Alaska Native; American Indians; Area; Australia; Award; Biopsy; Centers for Disease Control and Prevention (U.S.); Cervical; Cervical Cancer Screening; Cervix Uteri; Clinical; Colposcopy; Communities; Country; Coupled; Cross-Sectional Studies; Data; Development; Diagnosis; Discipline of obstetrics; Disease; Dysplasia; Early treatment; Educational Curriculum; Epidemiology; Exhibits; Female; Focus Groups; Foundations; Gender; Goals; Gynecology; HPV-High Risk; Health; Health Personnel; Health Sciences; Heterogeneity; High Prevalence; Human Papilloma Virus Vaccination; Human Papilloma Virus Vaccine; Human Papillomavirus; Human papillomavirus 16; Immunization Programs; Incidence; Intervention; K-Series Research Career Programs; Lead; Learning; Lesion; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Mentors; Mentorship; Minority; Mission; National Cancer Institute; National Health and Nutrition Examination Survey; Not Hispanic or Latino; Oregon; Pacific Northwest; Pap smear; Patients; Play; Population; Prevalence; Prevention; Primary Prevention; Procedures; Public Health; Publishing; Recommendation; Reproducibility; Research; Resources; Risk Factors; Role; Scientist; Smoking; Socioeconomic Status; Study models; Teacher Professional Development; Time; Time trend; Training; Universities; Urban Population; Vaccinated; Vaccination; Vision; Visual; Woman; Wood material; Youth; base; burden of illness; cancer health disparity; cancer type; career; cervical cancer prevention; clinical care; clinical research site; data registry; disparity elimination; experience; follow-up; health disparity; healthcare community; high risk; male; member; mortality; prevent; professor; reservation-based; screening; surveillance strategy; tool; trend; tribal organization; vaccine acceptance; vaccine efficacy

PROJECT SUMMARY Dr. Bruegl is an Assistant Professor in the Department of Obstetrics and Gynecology at Oregon Health and Science University and a national Robert Wood Johnson Foundation Harold Amos Minority Faculty Development Fellow. Her long-term career goal is to eliminate the disparities in cervical cancer incidence and mortality in the American Indian/Alaska Native (AI/AN) population; a goal that aligns with the mission and vision of the National Cancer Institute. AI/AN women are 1.5 times more likely to be diagnosed with cervical cancer and 2X as likely to die of the disease compared to Non-Hispanic White women. Multiple risk factors contribute to the development of cervical cancer including not accessing pap smear screening, smoking, socioeconomic status, and acquisition of high-risk subtypes of the human papillomavirus (hrHPV). This proposal seeks to look deeper in to these persistent health disparities by critically evaluating the utilization and applicability of cervical cancer prevention tools such as HPV vaccination, pap smear screening, and distribution of high-risk HPV (hrHPV) types in the AI/AN population. HPV vaccination is a primary prevention tool to prevent cervical cancer and its precursor lesions with U.S. recommendations to vaccination youth ages 11-12. There are 14 types of high-risk HPV (hrHPV) associated with cancer and types 16 and 18 contribute to ~70% of cancer cases. One of the proposed study goals is to fully evaluate the HPV vaccination rates and trends and pap smear rates among Oregon AI/AN. This data will to identify communities with high and low vaccination rates and focus groups of healthcare providers and community members will occur to identify barriers and facilitators of HPV vaccination. There are few studies evaluating the prevalence of hrHPV subtypes in AI/AN women and data suggest that the distribution of the 14 types differ from the general U.S. population, which can lead to real clinical consequences. First, vaccination may provide inadequate coverage for prevalent subtypes. Second, colposcopy, an office-based procedure to more fully evaluate the cervix, is less sensitive at detecting dysplasia due to non hrHPV 16 and 18 subtypes. A greater prevalence of other hrHPV subtypes in the AI/AN population can lead to missed, early-stage disease. A cross-sectional study will be performed to determine the prevalence and distribution of hrHPV among AI/AN women. As part of the NCI mentored clinical scientist research career development award training award, Dr. Bruegl will participate in a robust educational curriculum to successfully meet her goal of becoming an independent clinician scientist. She has identified created a robust mentorship team and identified specific learning objectives to help her meet this goal.

项目摘要 Bruegl博士是俄勒冈州健康妇产科妇产科系的助理教授 科学大学和国家罗伯特·伍德·约翰逊基金会哈罗德·阿莫斯少数族裔教师 开发研究员。她的长期职业目标是消除宫颈癌发生率的差异和 美洲印第安/阿拉斯加本地人（AI/AN）人口的死亡率；与任务相吻合的目标 国家癌症研究所的愿景。 AI/A A A A/A AN诊断出患有宫颈癌的可能性高1.5倍，死亡的可能性为2倍。 与非西班牙裔白人妇女相比。多种风险因素有助于发展 宫颈癌，包括无法访问子宫颈抹片检查，吸烟，社会经济状况和收购 人乳头瘤病毒（HRHPV）的高风险亚型。该提议试图更深入地看待这些建议 通过严格评估宫颈癌预防的利用率和适用性，持续的健康差异 HPV疫苗接种，PAP涂片筛查和高危HPV（HRHPV）类型等工具等工具 人工智能/一个人口。 HPV疫苗接种是预防宫颈癌及其前体的主要预防工具 对美国疫苗接种青少年11-12岁的疫苗接种建议的病变。有14种高风险HPV类型 （HRHPV）与癌症和16型和18型相关的癌症病例约70％。提议的之一 研究目标是充分评估俄勒冈州的HPV疫苗接种率，趋势和子宫颈抹片检查率 ai/an。这些数据将确定疫苗接种率高和低疫苗接种率的社区以及焦点组 将发生医疗保健提供者和社区成员，以确定HPV疫苗接种的障碍和促进者。 很少有研究评估AI/A和妇女中HRHPV亚型患病率的研究表明， 14种类型的分布与美国一般人群不同，这可能导致真正的临床 结果。首先，疫苗接种可能会提供普遍的亚型覆盖范围。第二， 阴道镜检查是一种基于办公室的程序，可更全面地评估子宫颈，对检测发育不良的敏感性较小 由于非HRHPV 16和18亚型。 AI/A A的其他HRHPV子类型的患病率更高 可能导致遗失的早期疾病。将进行横断面研究以确定患病率 和HRHPV在AI/A AN妇女中的分布。 作为NCI指导的临床科学家研究职业发展培训奖的一部分，Bruegl博士 将参加强大的教育课程，以成功地实现成为独立的目标 临床医生。她已经确定了创建了一个强大的指导团队，并确定了特定的学习 帮助她实现这一目标的目标。