Integrating social and molecular determinants of HPV-associated cancers

项目摘要/摘要 在过去的几十年里，人类乳头瘤病毒(HPV)相关的癌症一直在急剧上升。这个 人乳头状瘤病毒疫苗接种和筛查的发展和实施提供了预防的希望。主要 基因组预测的预防和进步已经改变了HPV相关癌症的格局。 对弱势群体进行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是这些服务不足和 未被充分研究的种群。这项拟议的研究提案的目标是研究社会决定因素如何 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。 马祖尔博士的职业目标是成为一名独立的研究员，他在开发、领导、 以及沟通健康生物学的癌症社会决定因素与社会流行病学之间的研究。在 拟议的培训计划，Mazul博士将在她的癌症流行病学技能的基础上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方面，同时将她的癌症知识扩展到HPV- 相关的癌症生物学。她的培训将直接用于支持和促进她的职业生涯 独立研究人员和拟议的研究计划。 将使用地理空间和社会流行病学方法来理解社会和社会之间的相互作用 以及分子因素。我们将使用来自全国、密苏里州和当地的三个来源的数据 圣路易斯HPV相关癌症病例比较三种最常见的HPV相关癌症 (口咽、颈部和肛门)。三个目标将解决总体假设，即贫穷的社区水平 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.确定 使用地理信息系统和地理信息系统对全国和全州范围内的HPV相关癌症的空间集群 地理空间建模。目的2：测量社区层面的社会和人口因素对HPV的影响- 与癌症分期相关的表现和存活率。目标3：测量患病率和预后意义 在人口学和社会经济多样性的HPV相关癌症人群中HPV基因分型。 这项研究的结果将为复杂的社会和基因组因素提供更细微的评估 与人乳头瘤病毒相关的癌症有关。有了这次培训和经验，马祖尔博士将很好地准备推出 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.