Deficiencies, Opportunities and Geography of Cervical Cancer Screening

宫颈癌筛查的缺陷、机遇和地理分布

基本信息

批准号：
8555413
负责人：
Cosette M Wheeler
金额：
$ 20.92万
依托单位：
UNIVERSITY OF NEW MEXICO HEALTH SCIS CTR
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-09-23 至 2016-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8555413
关键词：
Address California Categories Cervical Cervical Cancer Screening Classification Clinical Data Diagnosis Diagnostic Diagnostic Procedure Disease Effectiveness Epidemiology Evaluation Failure Future Generations Geography Goals Guidelines Health Human Human Papillomavirus Intervention Life Link Malignant Neoplasms Malignant neoplasm of cervix uteri Modeling National Cancer Institute New Mexico Outcome Pap smear Pathology Patients Population Population Study Population Surveillance Poverty Prevention Prevention program Procedures Process Provider Recording of previous events Registries Relaxation Reporting Research Research Project Grants Rural Safety Screening procedure Surveillance Program System Test Result Testing The Sun Transcend Universities Vaccination Vaccines Vagina Visit Vulva Woman Work base care systems cervical cancer prevention health disparity improved indexing innovation member population based programs prophylactic success tumor registry

项目摘要

While prophylactic vaccination is likely to provide important future health gains, cervical cancer screening will need to be continued for the whole generation of women that is already infected with the HPV types included in vaccines. Potential reductions in cervical cancer screening due to misconceptions about HPV vaccine protection or any relaxation of cervical cancer screening could result in an increase in cervical cancer rather than the anticipated reductions. Many alterations in cervical cancer screening are anticipated and needed in the near term and over the long-term, population-based U.S. surveillance is critical to assessing the safety and effectiveness of these changes as well as to address continuing failures In the cervical screening, diagnosis and treatment process. Sustained population-based surveillance enables the assessment of system and practice failures and successes prior to and coincident with a variety of anticipated overlapping changes in cervical cancer prevention programs (e.g. vaccination, lengthened screening Intervals and new HPV tests and applications). In anticipation of the critical need for population-based, woman-based surveillance of U.S. cervical cancer screening, the New Mexico Notifiable Diseases and Conditions (NMAC 7.4.3.12) incorporated mandatory state-wide reporting of all cervical screening (Pap and HPV) and all diagnostic and treatment procedures (cervical, vulvar and vaginal pathology), whether positive or negative or abnormal or normal, respectively. Our innovative surveillance transcends organizations and systems of care enabling the NM-HOPES-PRC Research Project 2 to conduct a comprehensive population-based elaboration of cervical cancer screening processes and its deficiencies (failures) with the goal of enabling future interventions that improve cervical cancer prevention. Data from our cervical cancer screening surveillance unit, the New Mexico HPV Pap Registry (NMHPVPR) will also be linked to the New Mexico Tumor Registry (NMTR) to describe screening, diagnosis and treatment histories of women diagnosed with incident invasive cerviical cancer. The NMTR is a founding member of the U.S. National Cancer Institute's Sun/eillance, Epidemiology, and End Results (SEER) Program. Through partnerships with the University of New Mexico (UNM) Geospatial and Population Studies (GPS) program and the University of Southern California's (USC) GIS Research Lab, we will identify and evaluate the impact of geographic barriers on failures in screening and prevention practices and invasive cervical cancer outcomes. New Mexico offers a rich opportunity in which this surveillance is conducted among diverse multi-cultural populations suffering a variety of health disparities including those attributable to high levels of poverty and rural living.

虽然预防性疫苗接种可能会带来重要的未来健康收益，但宫颈癌筛查将需要继续对已经感染 HPV 类型的整代女性进行治疗在疫苗中。由于对 HPV 疫苗的误解，宫颈癌筛查可能会减少对宫颈癌筛查的保护或放松可能会导致宫颈癌的增加，而不是比预期的减少量。预计并需要对宫颈癌筛查进行许多改变近期和长期，基于人口的美国监测对于评估安全性至关重要这些变化的有效性以及解决宫颈筛查中持续失败的问题，诊断和治疗过程。持续的基于人群的监测能够评估系统和实践的失败和成功发生在各种预期的重叠之前和同时宫颈癌预防计划的变化（例如疫苗接种、延长筛查间隔和新的 HPV 检测和应用）。预计对以人口为基础、以妇女为基础的迫切需求美国宫颈癌筛查、新墨西哥州法定疾病和状况 (NMAC 7.4.3.12) 纳入了所有宫颈筛查（巴氏涂片和 HPV）和所有宫颈筛查的强制性全州报告诊断和治疗程序（宫颈、外阴和阴道病理），无论是阳性还是阴性或分别为异常或正常。我们的创新监测超越了组织和护理系统使 NM-HOPES-PRC 研究项目 2 能够开展全面的基于人口的研究详细阐述宫颈癌筛查过程及其缺陷（失败），目的是使未来改善宫颈癌预防的干预措施。来自我们宫颈癌筛查的数据监测单位，新墨西哥州 HPV 巴氏涂片登记处 (NMHPVPR) 也将与新墨西哥州肿瘤登记处（NMTR）描述被诊断患有癌症的女性的筛查、诊断和治疗史发生浸润性宫颈癌。 NMTR 是美国国家癌症研究所的创始成员之一 Sun/eillance、流行病学和最终结果 (SEER) 计划。通过与大学的合作新墨西哥州 (UNM) 地理空间和人口研究 (GPS) 项目和南方大学加利福尼亚州 (USC) GIS 研究实验室，我们将识别和评估地理障碍对筛查和预防实践的失败以及浸润性宫颈癌的结果。新墨西哥州提供在遭受疾病困扰的不同多元文化人群中进行这种监测的机会很大各种健康差异，包括由高度贫困和农村生活造成的差异。