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.

项目概要 Bruegl 博士是俄勒冈健康与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·阿莫斯少数民族学院 发展研究员。她的长期职业目标是消除宫颈癌发病率和患病率的差异 美洲印第安人/阿拉斯加原住民 (AI/AN) 人口的死亡率；与使命相一致的目标 国家癌症研究所的愿景。 AI/AN 女性被诊断出患有宫颈癌的可能性高出 1.5 倍，死于宫颈癌的可能性高出 2 倍 与非西班牙裔白人女性相比，该疾病的患病率更高。多种风险因素导致疾病的发展 宫颈癌，包括不接受子宫颈抹片检查、吸烟、社会经济地位和获得性宫颈癌 人乳头瘤病毒 (hrHPV) 的高危亚型。该提案旨在更深入地研究这些 通过严格评估宫颈癌预防的利用和适用性来消除持续的健康差异 HPV 疫苗接种、子宫颈抹片检查和高危 HPV (hrHPV) 类型分布等工具 AI/AN 人口。 HPV疫苗接种是预防宫颈癌及其癌前病变的一级预防工具 美国建议 11-12 岁青少年接种疫苗。高危型HPV有14种类型 (hrHPV) 与癌症相关，16 型和 18 型导致约 70% 的癌症病例。提议之一 研究目标是全面评估俄勒冈州的 HPV 疫苗接种率和趋势以及子宫颈抹片率 人工智能/AN。该数据将确定疫苗接种率高低的社区以及重点群体 医疗保健提供者和社区成员将找出 HPV 疫苗接种的障碍和促进因素。 很少有研究评估 AI/AN 女性中 hrHPV 亚型的患病率，数据表明 这 14 种类型的分布与美国普通人群不同，这可以导致真正的临床 结果。首先，疫苗接种可能无法充分覆盖流行的亚型。第二， 阴道镜检查是一种更全面评估子宫颈的办公室检查，但在检测发育不良方面不太敏感 由于非 hrHPV 16 和 18 亚型。 AI/AN 人群中其他 hrHPV 亚型的患病率较高 可能导致漏诊早期疾病。将进行横断面研究以确定患病率 以及 hrHPV 在 AI/AN 女性中的分布。 作为 NCI 指导临床科学家研究职业发展奖培训奖的一部分，Bruegl 博士 将参加健全的教育课程，以成功实现成为独立的目标 临床医生科学家。她确定创建了一支强大的指导团队并确定了具体的学习内容 目标来帮助她实现这一目标。