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

几乎所有的宫颈癌都与人类乳头瘤病毒(HPV)感染有关，其中HPV16型和18型约占这种恶性肿瘤的70%。美国印第安人(Al)妇女是美国妇女中宫颈癌发病率最高的国家之一，而且这一比例还在上升。Al妇女的宫颈癌存活率也是所有种族/民族中最差的。高发病率、低存活率和部落差异的原因尚不清楚，但可能是因为巴氏筛查率较低、致癌性HPV感染的患病率较高、15或特别毒力的HPV16或HPV18变种的患病率较高。我们发现，Al女性的高危HPV类型的流行率是白人女性的两倍多。在调整了年龄和异常巴氏试验结果后，Al和白人妇女高危HPV感染的优势比为2.9，Al妇女巴氏试验异常的可能性是白人妇女的4倍。在……里面 在这个研究项目中，我们建议与亚利桑那州的霍皮部落合作，进行两项理论上相互联系的研究，旨在相互补充，涵盖HPV预防和筛查的整个生命周期。第一项研究旨在通过接触母女二人组来提高11-12岁女孩的HPV疫苗接种率。第二项研究检查了霍皮族妇女中高危HPV类型和变种的存在，特别是HPV16和18型。我们在研究1中的具体目标是：1)比较母女教育干预实施2年后，11-12岁霍皮族女孩接种HPV疫苗的人数；2)评估接种HPV疫苗的个体预测因素。在研究2中，我们的目标是：2)比较遵守宫颈癌筛查指南的霍皮族妇女和不遵守指南的霍皮族妇女中高危HPV感染的患病率；以及4)比较筛查依从者和不遵守指南的霍皮族妇女中高危HPV感染的风险和保护因素。我们假设，与坚持筛查的妇女相比，筛查未坚持筛查的妇女具有更多的高危HPV类型、更多的危险因素和更少的保护因素。这项研究通过研究个人、家庭和组织变量如何影响霍皮族妇女和青少年宫颈癌的预防，符合多层次健康差异模型。

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.