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: 3549552
• 负责人: JAMES BERNER
• 金额: $ 38.57万
• 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/3549552
• 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.

一般癌症死亡率和2010年宫颈癌死亡率 特别是阿拉斯加原住民的人数超过了美国普通人。 人口 此外，有证据表明，宫颈癌的发病率正在上升。 癌症和严重的发育异常。 高比率的因素 与宫颈癌风险增加有关;性传播 疾病，包括人类乳头瘤病毒和衣原体感染;以及 吸烟是有记录的。 该项目的长期目标是降低发病率， 阿拉斯加原住民妇女的浸润性宫颈癌死亡率。 的 具体目标是：提高对这种疾病的认识和认识， 风险因素和适当的筛查计划;加强现有的 子宫颈普查计划和癌前病变的跟进护理，以及 以减少危险因素。 该项目将在 主要是在一个大的城市和一个较小的农村IHS服务单位， 阿拉斯加地区原住民健康服务 项目第一年 （第一阶段）将包括知识、态度和信仰调查（KAB） 关于癌症和一般癌症检查，包括子宫颈癌 癌症，随机选择的阿拉斯加土著妇女样本， 从15岁开始的5年，居住地和种族群体。 的 目前的巴氏涂片检查水平，按年龄和居住地分层， 也可以通过可用的计算机化细胞学检查进行评估 筛选数据，以确定当前和未来的目标人群。 一 对进行和不进行随访的妇女进行的单独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科学家正在进行的研究 健康服务评估其他筛查方法，如检测 人乳头瘤病毒（HPV）感染和宫颈造影术 宫颈发育不良和HPV的检查将在I期完成。 第二阶段的干预战略，在项目第二年至第四年期间，将 旨在减少筛选和随访中确定的障碍， 第一阶段和适当地针对传统和新的筛选 被证明实用的方法。 提供及时的后续阴道镜检查 宫颈活检将由受过专门训练的中 一级，妇女保健提供者。 他们将利用HPV检测， 将筛查资源集中在那些受感染的妇女身上， 最高的宫颈发育不良和癌症的风险，他们还将提供 对确诊的宫颈感染进行适当治疗。