ENHANCING CERVICAL CANCER PREVENTION STRATEGIES AMONG HOPI WOMEN AND ADOLES...

几乎所有的宫颈癌都与人乳头瘤病毒（HPV）感染有因果关系，HPV 16型和18型占这种恶性肿瘤的70%左右。美洲印第安人（Al）妇女是美国妇女中宫颈癌发病率最高的妇女之一，而且这一比率正在上升。在所有种族/族裔群体中，女性宫颈癌存活率最低。发病率高、生存率低和部落差异的原因尚不清楚，但可能是由于巴氏涂片（Pap）筛查率较低，致癌HPV感染的患病率较高，15或特别致命的HPV 16或HPV 18变体的患病率较高。我们发现，Al女性中高危型HPV的患病率是白人女性的两倍多。在调整了年龄和异常Pap检查结果后，Al女性与白人女性高危HPV感染的比值比为2.9，Al女性有异常Pap检查的可能性是白人女性的4倍。在

Almost all cervical cancers are causally related to infections by human papillomavirus (HPV), with HPV types 16 and 18 responsible for ~70% of this malignancy. American Indian (Al) women have one of the highest incidences of cervical cancer among U.S. women, and this rate is increasing. Al women also have the poorest cervical cancer survival of any racial/ethnic group. Reasons for the high incidence, poor survival, and variation by tribe are unknown, but might be explained by lower rates of Papanicolaou (Pap) screening, a higher prevalence of oncogenic HPV infection,15 or a higher prevalence of particularly virulent HPV 16 or HPV 18 variant. We found that the prevalence of high-risk HPV types in Al women was over twice that in White women. After adjusting for age and abnormal Pap results, the odds ratio of high-risk HPV infection in Al versus White women was 2.9 and Al women were 4 times more likely to have an abnormal Pap test. In this Research Project, we propose to partner with the Hopi Tribe in Arizona to conduct 2 theoretically linked studies, designed to complement one another and cover the lifespan of HPV prevention and screening. The first study aims to increase HPV vaccination rates among girls aged 11-12 years by engaging motherdaughter dyads. The second study examines the presence of high-risk HPV types and variants, particularly HPV 16 and 18, in Hopi women. Our specific aims in Study 1 are to 1) Compare the number of Hopi girls ages 11-12 receiving HPV vaccination before and after a 2-year implementation of our mother-daughter educational intervention; and 2) Assess individual predictors of HPV vaccination. In Study 2 we aim to 2): compare the prevalence of high-risk HPV types in Hopi women adherent with cervical cancer screening guidelines to those who are non-adherent; and 4) Compare risk and protective factors for high-risk HPV infection among screening adherent and non-adherent Hopi women. We hypothesize that screening nonadherent women will have more high risk HPV types, more risk factors, and fewer protective factors than those who are adherent. This study fits into the multi-level health disparities model by examining how individual, family, and organizational variables influence cervical cancer prevention among Hopi women and young adolescents.