Understanding Health Disparities in cervical dysplasia and cancer through the ide

描述(申请人提供)：宫颈癌仍然是发展中国家妇女癌症死亡的主要原因之一。在美国，当按种族分层时，非裔美国人和西班牙裔女性患宫颈癌的发病率和死亡率都高于高加索女性。这些差异在一定程度上是由于获得医疗保健和筛查的机会，但即使在考虑到这一点后，非裔美国人和西班牙裔女性的死亡率仍然较高。这项赠款申请描述了潜在的生物标记物，可能有助于开始了解非裔美国人、西班牙裔和高加索女性宫颈癌癌前阶段进展的差异。这些生物标志物的识别将有助于确定所观察到的宫颈癌发病率和死亡率差异的生物学基础。此外，这些生物标记物将有助于在许多巴氏试验异常的女性中识别少数几个有患癌症高风险的人。这将大大减少发病率，并节省巴氏试验后续程序的成本，同时为真正需要的人提供更好、更积极的护理。 与公共卫生相关：非裔美国女性的宫颈癌发病率比非裔美国女性高50%，西班牙裔女性高66%，死亡率是高加索女性的两倍。种族之间的差异在一定程度上可以归因于筛查和获得医疗保健的差异，但在控制这些因素后，这些差异仍然存在，这表明可能存在个人对HPV感染的易感性。我们研究的总体目标是确定能够帮助预测哪些女性患宫颈癌风险最高的生物标志物，从而减少宫颈癌存在的健康差距。

DESCRIPTION (provided by applicant): Cervical cancer remains one of the leading causes of cancer mortality in women in developing nations. When stratified by race in United States, African American and Hispanic women have both higher incidence and mortality from cervical cancer than Caucasian women. These disparities are in part due to access to healthcare and screening, but even after accounting for this, African American and Hispanic women continue to have higher mortality rates. This grant application describes potential biomarkers that may help begin to understand the differences in progression of the preneoplastic stages of cervical cancer between African American, Hispanic, Caucasian women. The identification of such biomarkers will help determine the biological basis for the observed disparities in the incidences as well as mortality of cervical cancer. In addition, these biomarkers will be useful to identify, among the many women who present with Pap test abnormalities, the few that are at high risk of developing cancer. This will allow for considerable reduction in morbidity as well as cost savings in Pap test follow-up procedures, at the same time providing better, more aggressive care to those who truly need it. PUBLIC HEALTH RELEVANCE: The incidence of cervical cancer is 50% higher in African American women and 66% higher in Hispanic women with mortality rates two-fold higher than what is found in Caucasian women. The disparities among races in part can be attributed to differences in screening and access to healthcare, but after controlling for these factors these disparities persist suggesting that there may be individual susceptibilities to HPV infections. The overall goal of our research is to identify biomarkers that can help predict which women are at highest risk for developing cervical cancer, thus reducing the health disparities that exist for cervical cancer.