Understanding Health Disparities in cervical dysplasia and cancer through the ide

描述（由申请人提供）：宫颈癌仍然是发展中国家妇女癌症死亡的主要原因之一。在美国按种族分层时，非洲裔美国人和西班牙裔妇女的宫颈癌发病率和死亡率均高于白人妇女。这些差异部分是由于获得医疗保健和筛查，但即使在考虑到这一点之后，非洲裔美国人和西班牙裔妇女的死亡率仍然较高。本基金申请描述了可能有助于开始了解非裔美国人、西班牙裔、高加索妇女之间宫颈癌癌前阶段进展差异的潜在生物标志物。这些生物标志物的鉴定将有助于确定宫颈癌发病率和死亡率差异的生物学基础。此外，这些生物标志物将有助于在许多存在巴氏试验异常的妇女中识别少数处于发展癌症高风险的妇女。这将大大降低发病率，并节省巴氏试验后续程序的费用，同时为真正需要的人提供更好，更积极的护理。 公共卫生相关性：非裔美国妇女宫颈癌的发病率高50%，西班牙裔妇女高66%，死亡率是白人妇女的两倍。种族之间的差异部分可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，表明可能存在对HPV感染的个体易感性。我们研究的总体目标是确定可以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异。

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.