PILOT PROJECT #2

宫颈癌与HPV疫苗美国宫颈癌的种族差异 2001-2005年非裔美国妇女宫颈癌发病率和死亡率较高证明了这一点 比非西班牙裔白色妇女更好（Ries等人，2008年）。在田纳西州，2001-2005年期间， 非洲裔美国妇女的发病率为10.7/100，000，而白色妇女为7.8/100，000 (data由TN癌症登记处提供，2009年）。从1998年到2003年，田纳西州的宫颈癌死亡率 在白人中减少了25%，但在非洲裔美国人中增加了22%（Whiteside等人，2007年）。 已知高危型HPV 16和18的持续感染导致70%的宫颈癌。以来 2006年，FDA批准了两种疫苗，用于预防由这些高危人群引起的宫颈癌。 生殖器HPV类型（Gardasil和Cervarix），几乎100%有效预防HPV感染 16型和18型，癌前宫颈疾病，以及由此导致的宫颈癌（FUTURE II研究组，2007; Rumbout等人，2007年）。换句话说，每10例新发宫颈癌病例中就有7例可以通过以下措施预防： 在性活跃和接触HPV之前接种疫苗。 美国疾病控制和预防中心（CDC，2007）建议女性接种HPV疫苗 年龄在11-26岁，以预防大多数宫颈癌，对于那些在感染前接种疫苗的人来说， 高危型HPV所有女孩都可以通过以下途径免费接种疫苗（6个月内接种3剂）： 18岁以下的私人保险，医疗补助和/或儿童疫苗（VFC）计划。在2009 全国免疫调查显示，非洲裔美国人和非洲裔美国人的HPV疫苗接种率相似， 白色女孩（约44%），但非洲裔美国人完成三次所需剂量的比率较低 与白色女孩相比（分别为23%和29%）。在田纳西州，43.6%的13-17岁青少年 接受一剂或多剂HPV疫苗，与全国44.3%的接种率相似（CDC，2010）。

Cervical Cancer and the HPV Vaccine. Racial disparities in cervical cancer in the US are evidenced by higher cervical cancer incidence and mortality rates for 2001-2005 in African American women than non-Hispanic White women (Ries et al., 2008). In Tennessee, during 2001-2005 the cervical cancer incidence was 10.7 per 100,000 for African American women compared to 7.8 per 100,000 for White women (data provided from TN Cancer Registry, 2009). From 1998 to 2003, cervical cancer mortality in Tennessee decreased by 25% among Whites, but increased 22% among African Americans (Whiteside et al., 2007). Persistent infection with high-risk types 16 and 18 of HPV is known to cause 70% of cervical cancers. Since 2006 the FDA has approved two vaccines developed to prevent cervical cancer caused by these high-risk types of genital HPV (Gardasil and Cervarix), which are nearly 100% efficacious in preventing infection of HPV types 16 and 18, precancerous cervical disease, and resulting cervical cancer (FUTURE II Study Group, 2007; Rumbout et al., 2007). In other words, 7 out of 10 new cases of cervical cancer could be prevented by vaccinating girls before they become sexually active and are exposed to HPV. The Centers for Disease Control and Prevention (CDC, 2007) recommends the HPV vaccines for females ages 11-26 to prevent the majority of cervical cancers for those who are vaccinated before infection with one of the high-risk types of HPV. The vaccines (3 doses across six months) are available for free to all girls through age 18 under private insurance, Medicaid and/or the Vaccines for Children (VFC) program. In the 2009 National Immunization Survey, rates of initiation of the HPV vaccine were similar for African American and white girls (about 44%), but the rate of completion of the three required doses was lower for African American versus White girls (23% and 29%, respectively). In Tennessee, 43.6% of adolescents aged 13-17 years had received one or more HPV vaccine doses, similar to the national rate of 44.3% (CDC, 2010).