HPV Outcomes: Prevention Epidemiology and Surveillance (HOPES)

新墨西哥州是唯一有能力全面监测宫颈癌筛查和人类健康的州。 利用全州妇女电子信息学系统预防乳头瘤病毒(HPV) 强制报告。我们处于独特的地位，可以解决在了解HPV疫苗影响和 在经历了许多差异的多元文化的美国人口中的有效性。我们的项目将完成 需要三个综合的具体目标来为机会主义者提供明确的基准特征 新墨西哥州的宫颈癌筛查计划。在目标1中，我们将建立个体hpv基因分布。 在适当监测预期或意外的基于人群的影响所需的37种HPV基因型中 人乳头瘤病毒疫苗。尽管我们已经在全州范围内对超过6万份宫颈样本进行了采样 针对所有巴氏试验异常的妇女和随机抽样的巴氏试验正常的妇女，我们的 现有资源仅限于对40,000个样本进行HPV基因分型。在这一目标中，我们将实现 通过执行额外的20,000个HPV基因分析来确定目标样本量。我们将描述年龄特定的 基于人群的基因分型和确定CIN2+的特定基因风险 在两年资助期内取得的成果。在目标2中，我们将召集一个病理小组来确定 对包括CIN/AIS在内的约8,000例宫颈活检的共识诊断。一致的诊断结果将是 与通过使用NM HPV对相同样本进行的基于社区的诊断进行比较 PAP注册表(NMHPVPR)数据仓库。我们将创建一个黄金标准幻灯片集，它将支持 未来基于人口的评估的标准化，这是确定现实世界影响的先决条件 以及接种HPV疫苗的有效性。在目标3中，我们将开发一个共享的颈部图像资源 并验证基于图像的诊断与基于玻璃的诊断的使用。因为它的影响 HPV疫苗预计将随着时间的推移而增加，纵向定期评估预计将跨越 几十年了。基于图像的诊断标准将是未来人口评估的关键。

New Mexico (NM) is the only state with the capacity to fully monitor cervical cancer screening and human papillomavirus (HPV) prevention using a state-wide woman-based electronic informatics system under mandated reporting. We are uniquely positioned to address gaps in understanding HPV vaccine impact and effectiveness within a mulit-cultural US population suffering many disparities. Our project will accomplish three integrated specific aims required to provide definitive baseline characterizations of the opportunistic cervical cancer screening program in NM. In Aim 1, we will establish the individual HPV genotype distribution of 37 HPV genotypes needed to appropriately monitor expected or unexpected population-based impact of HPV vaccines. Although we have performed a state-wide sampling of over 60,000 cervical samples targeting all women with abnormal Pap tests and a random sample of women with normal Pap tests, our existing resources were limited to HPV genoytping of 40,000 samples. In this Aim we will achieve the targeted sample size by performing the additional 20,000 HPV genotype assays.We will describe the agespecific population-based genotype distribution and determine the genotype-specific risk for CIN2+ outcomes across the 2 year grant period. In Aim 2, we will convene a pathology panel to determine consensus diagnoses for ~8,000 cervical biopsies including >CIN/AIS. The consensus diagnoses will be compared to community-based diagnoses determined for the same specimens through use of the NM HPV Pap Registry (NMHPVPR) data warehouse. We will create a gold standard slide set that will enable standardization of future population-based assessments, a prerequisite for determining the real-world impact and effectiveness of HPV vaccination. In Aim 3 we will develop a shared image resource of the cervical biopsy tissues and validate the use of image-based versus glass-based diagnoses. Because the impact of HPV vaccines is expected to increase over time, longitudinal periodic assessments will be expected to span several decades. Image-based diagnostic standards will be critical to future population evaluations.