CERVICAL CANCER SCREENING IN OLDER WOMEN

老年女性的宫颈癌筛查

• 批准号: 2372190
• 负责人: GEORGE F SAWAYA
• 金额: $ 7.43万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-08-08 至 2001-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2372190
• 关键词: cancer risk; cervical /vaginal smear; cervix neoplasms; clinical research; diagnosis design /evaluation; female; hormone therapy; human data; human old age (65+); human subject; neoplasm /cancer diagnosis; neoplasm /cancer epidemiology; pathologic process; postmenopause; women's health

DESCRIPTION (Applicant's Description): George F. Sawaya, M.D. is a full-time faculty member in the Department of Obstetrics, Gynecology and Reproductive Sciences at the University of California, San Francisco (UCSF). Dr. Sawaya's main interest is in evidence-based medicine, especially as it pertains to women's health. He has recently completed a two-year fellowship in epidemiology, biostatistics and research design at UCSF. Specifically, he is interested in cervical cancer screening in older women. He is strongly committed to an academic career in women's health. This proposal has four specific aims: 1) to determine the efficacy of cervical smear screening in preventing invasive cervical cancer in women >60, 2) to determine differences in compliance and disease characteristics between women >60 compared to women <60 diagnosed with invasive cervical cancer, 3) to d e t e r mine the annual incidence of cervical smear abnormalities in postmenopausal women, and 4) to determine risk factors, including use of hormonal replacement therapy, for developing cervical smear abnormalities in postmenopausal women. The first two aims will be achieved by analyzing data from the Kaiser Permanente Cervical Cancer Project. This database contains cervical smear information on 649 women diagnosed with invasive cervical cancer from 1988-1994, 130 of whom are aged 60 and older. The two studies using this dataset are designed to provide information on differences in compliance, disease characteristics and protection afforded by cervical smear screening between older women and younger women. The second and third aims will be achieved by analyzing existing data from the Heart Estrogen-progestin Study, a randomized, placebo-controlled trial of hormonal replacement therapy (HRT) in 2763 postmenopausal women. All women had normal cervical smears at trial entry and are screened annually. Determination of the incidence of smear abnormalities in this population is crucial to cost-effectiveness and decision analyses of screening protocols. Identification of risk factors would allow for more targeted screening and fewer false positive smears. Moreover, the independent risk of HRT will be assessed. Dr. Sawaya has assembled a multidisciplinary team of nationally-known sponsors who are enthusiastic about his research plan and are committed to his successful completion of this project. They are dedicated to assisting him in achieving his goal of becoming an excellent clinical investigator.

描述（申请人的描述）：George F. Sawaya，医学博士是一位 妇产科专职教员 加州大学旧金山分校 (UCSF) 的生殖科学。 Sawaya 博士的主要兴趣是循证医学，特别是因为它 关系到女性的健康。 他最近完成了为期两年的奖学金 加州大学旧金山分校流行病学、生物统计学和研究设计专业。 具体来说， 他对老年妇女的宫颈癌筛查感兴趣。 他是 坚定致力于女性健康领域的学术事业。 该提案有四个具体目标：1）确定 宫颈涂片筛查预防女性浸润性宫颈癌 >60, 2) 确定依从性和疾病特征的差异 诊断为侵入性宫颈癌的 >60 岁女性与 <60 岁女性之间的比较 癌症，3) 确定宫颈涂片的年发病率 绝经后妇女的异常，4) 确定危险因素， 包括使用激素替代疗法来进行宫颈涂片检查 绝经后妇女的异常。 前两个目标将实现 通过分析凯撒永久宫颈癌项目的数据。 这 数据库包含 649 名被诊断患有宫颈癌的妇女的宫颈涂片信息 1988年至1994年间患浸润性宫颈癌，其中130名年龄在60岁及以上。 使用该数据集的两项研究旨在提供以下信息： 依从性、疾病特征和提供的保护方面的差异 通过对老年妇女和年轻妇女进行宫颈涂片筛查。 这 第二个和第三个目标将通过分析现有数据来实现 心脏雌激素-孕激素研究，一项随机、安慰剂对照试验 对 2763 名绝经后妇女进行激素替代疗法 (HRT)。 所有女性 参加试验时宫颈涂片检查正常，每年进行筛查。 确定该人群涂片异常发生率的方法是 对于筛选方案的成本效益和决策分析至关重要。 识别风险因素将有助于进行更有针对性的筛查和 更少的假阳性涂片。 此外，HRT 的独立风险将是 评估。 Sawaya 博士组建了一支由全国知名人士组成的多学科团队 对他的研究计划充满热情并致力于 他成功地完成了这个项目。 他们致力于协助 他实现了成为一名优秀临床研究者的目标。