Integrating social and molecular determinants of HPV-associated cancers

项目总结/摘要 人乳头瘤病毒（HPV）相关的癌症在过去几十年中急剧上升。的 HPV疫苗接种和筛查的发展和实施提供了预防的希望。初级 预防和基因组测序的进展已经改变了HPV相关癌症的前景。 为弱势群体开展有效和公平的预防和治疗工作需要了解 HPV相关癌症的地理、社会和分子决定因素， 研究不足的人群。这项研究计划的目的是研究社会决定因素如何影响 健康影响分子肿瘤标志物并与之相互作用，从而影响HPV相关癌症。 博士Mazul的职业目标是成为一名独立的研究人员，能够独特地开发，进行， 沟通研究，将癌症健康生物学的社会决定因素与社会流行病学联系起来。在 在拟议的培训计划中，Mazul博士将利用她的癌症流行病学技能来发展更多的专业知识 在地理空间分析和社会流行病学方法，同时扩大她的癌症知识到HPV- 相关癌症生物学。她的培训将直接用于支持和促进她的职业生涯， 独立研究员和研究计划。 地理空间和社会流行病学方法将被用来了解社会之间的相互作用， 分子因素。我们将使用来自三个来源的数据，代表国家，密苏里州全州和地方 圣Louis HPV相关癌症病例比较三种最常见的HPV相关癌症 （口咽部、颈部和肛门）。三个目标将解决的总体假设，即贫困的邻里水平 这些因素与分子标志物相互作用，导致HPV相关癌症预后不良。目标1.识别 使用地理信息系统，在全国和全州范围内对HPV相关癌症进行空间聚类， 地理空间建模目的2：测量邻里水平的社会和人口统计学因素对HPV的影响。 相关的癌症分期和生存期。目的3：测量患病率和预后意义 HPV基因型在人口统计学和社会经济学上多样化的HPV相关癌症人群中的分布。 这项研究的结果将为复杂的社会和基因组因素提供更细致的评估 与HPV相关的癌症有关。有了这些培训和经验，Mazul博士将能够很好地 她的独立研究生涯

PROJECT SUMMARY/ABSTRACT Human Papillomavirus (HPV)-associated cancer has been dramatically rising for the last few decades. The development and implementation of HPV vaccination and screening provide the promise of prevention. Primary prevention and advances in genomic prognostication has shifted the landscape of HPV-associated cancers. Efficacious and equitable prevention and treatment efforts for vulnerable groups requires an understanding of geographic, social and molecular determinants of HPV-associated cancers unique to these underserved and understudied populations. The goal of this proposed research proposal is to study how social determinants of health influences and interacts with molecular tumor markers to affect HPV-associated cancers. Dr. Mazul’s career goal is to become an independent researcher who is uniquely positioned to develop, conduct, and communicate research bridging cancer social determinant of health biology with social epidemiology. In the proposed training plan, Dr. Mazul will build upon her cancer epidemiologic skills to develop additional expertise in geospatial analysis and social epidemiologic methods, while expanding her cancer knowledge into HPV- associated cancer biology. Her training will be directly applied to support and advance her career as an independent researcher and the proposed research plan. Geospatial and social epidemiologic methods will be employed to understanding the interaction between social and molecular factors. We will use data from three sources representing national, Missouri statewide and local St. Louis HPV-associated cancer cases to compare the three most common HPV-associated cancers (oropharyngeal, cervical and anal). Three aims will address the overall hypothesis that poor neighborhood-level factors interact with molecular markers and to lead to poor HPV-associated cancer outcomes. Aim 1. Identify nationwide and statewide spatial clusters of HPV-associated cancers using geographic information systems and geospatial modeling. Aim 2: Measure the effect of neighborhood-level social and demographic factors on HPV- associated cancer stage at presentation and survival. Aim 3: Measure the prevalence and prognostic significance of HPV genotype in a demographically and socioeconomically diverse HPV-associated cancer population. Results from this study will provide a more nuanced assessment of the complex social and genomic factors linked with HPV-associated cancer. With this training and experience, Dr. Mazul will be well positioned to launch her independent research career.