PREVENTION OF CERVICAL CANCER IN ALASKA NATIVE WOMEN

阿拉斯加原住民妇女预防宫颈癌

• 批准号: 3549553
• 负责人: JAMES BERNER
• 金额: $ 38.06万
• 依托单位: U.S. PHS ALASKA NATIVE MED CTR(ANCHORAG)
• 依托单位国家: 美国
• 财政年份: 1990
• 资助国家: 美国
• 起止时间: 1990-09-30 至 1994-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3549553
• 关键词: Alaska; Alaskan Native American; biopsy; cancer rehabilitation /care; cancer risk; cervical /vaginal smear; cervix disorder; cervix neoplasms; clinical trials; community health services; cooperative study; endoscopy; female; health behavior; human papillomavirus; human subject; mass screening; neoplasm /cancer diagnosis; neoplasm /cancer education; neoplasm /cancer therapy; regional medical planning; uterus preneoplastic state; virus diseases

Mortality rates from cancer, in general, and cervical cancer, in particular, among Alaska Natives exceed those of the general U.S. population. Furthermore, there is evidence of increasing rates of cervical cancer and severe dysplasia in this population. High rates of factors associated with increased risk of cervical cancer; sexually transmitted diseases including human papilloma virus and chlamydia infection; and smoking have been documented. The long term objectives of this project are to reduce the morbidity and mortality from invasive cervical cancer in Alaska Native women. The specific aims are: to promote knowledge and awareness of this disease, its risk factors and appropriate screening programs; to enhance the existing cervical screening program and follow-up care of precancerous lesions, and to effect reduction in risk factors. The project will be conducted primarily in one large urban and one smaller rural IHS Service Unit within the Alaska Area Native Health Service. The first year of the project (Phase I) will include a survey of knowledge, attitudes, and beliefs (KAB) regarding cancer and cancer screening in general, including cervical cancer, of a randomly selected sample of Alaska Native women stratified by 5 years of age starting at age 15, residence, and ethnic group. The current level of Pap smear screening, stratified by age and residence will also be assessed by examination of available computerized cytology screening data to identify present and future target populations. A separate KAB survey of women who do and do not keep follow-up appointments for colposcopy will identify barriers to follow-up care. The assessment of ongoing studies by the Arctic Investigations Laboratory and the Indian Health SErvice to evaluate other screening methodologies such as testing for Human Papilloma Virus (HPV) cervical infections and cervicography for cervical dysplasia and HPV will be completed during Phase I. Phase II intervention strategies, during project years 2 through 4, will be directed toward reducing barriers to screening and follow-up identified in Phase I and appropriately targeting traditional and new screening methodologies of proven utility. Available and timely follow-up colposcopy and cervical biopsy will be provided regionally by specially trained, mid- level, women's health care providers. They will utilize HPV testing to focus screening resources on those women who are infected and are at highest risk of cervical dysplasia and cancer, they will also provide appropriate treatment of diagnosed cervical infections.

癌症死亡率和宫颈癌死亡率， 特别是，阿拉斯加原住民的比例超过了普通美国人。 人口。此外，有证据表明，子宫颈癌的发病率正在上升。 癌症和严重的不典型增生。高因素比率 与宫颈癌风险增加有关的；性传播的 人类乳头瘤病毒和衣原体感染等疾病；以及 吸烟已经被记录在案。 该项目的长期目标是降低发病率和 阿拉斯加土著妇女浸润性宫颈癌的死亡率。这个 具体目标是：促进对这种疾病的认识和认识，其 风险因素和适当的筛查计划；加强现有的 子宫颈筛查计划和对癌前病变的随访护理，以及 以减少风险因素。该项目将被实施 主要在一个大城市和一个较小的农村IHS服务单位 阿拉斯加地区土著医疗服务机构。该项目的第一年 (第一阶段)将包括对知识、态度和信念的调查(KAB) 关于癌症和一般癌症筛查，包括子宫颈癌 癌症，随机选择的阿拉斯加原住民妇女样本，按 5岁，从15岁开始，居住地和种族。这个 目前的巴氏涂片筛查水平，按年龄和居住地分层 也可通过检查现有的计算机细胞学进行评估 筛选数据以确定当前和未来的目标人群。一个 对不遵守和不遵守后续预约的女性进行单独的KAB调查 阴道镜检查将确定后续护理的障碍。评估 北极调查实验室和印度正在进行的研究 医疗服务机构评估其他筛查方法，如检测 人乳头瘤病毒(HPV)宫颈感染和宫颈造影 宫颈异型增生和人乳头瘤病毒将在第一期完成。 在项目第2至第4年期间，第二阶段干预战略将是 旨在减少筛查和跟踪中确定的障碍 第一阶段，适当针对传统筛查和新筛查 经过验证的实用方法。有效和及时的阴道镜随访 宫颈活检将由受过专门培训的中年妇女提供。 在这一层次上，妇女保健提供者。他们将利用HPV检测来 将筛查资源集中在感染和感染的妇女身上 宫颈不典型增生和癌症的最高风险，它们还将提供 诊断为宫颈感染的适当治疗。