PILOT PROJECT #2

宫颈癌和HPV疫苗。在美国，宫颈癌的种族差异是 2001-2005年非裔美国妇女宫颈癌发病率和死亡率较高为证 比非西班牙裔白人妇女多(Ries等人，2008年)。在田纳西州，2001-2005年间，宫颈癌 非洲裔美国女性的发病率为10.7/10万，而白人女性为7.8/10万 (数据由TN癌症登记中心提供，2009年)。从1998年到2003年，田纳西州的宫颈癌死亡率 白人减少了25%，但非裔美国人增加了22%(Whiteside等人，2007年)。 已知70%的宫颈癌是由高危HPV16型和18型持续感染引起的。自.以来 FDA已经批准了两种疫苗，用于预防由这些高危因素引起的宫颈癌 对预防HPV感染近100%有效的生殖器HPV类型(Gardasil和Cervarx) 类型16和18型，癌前病变，并导致宫颈癌(未来II研究组，2007； Rumout等人，2007年)。换句话说，每10个新的宫颈癌病例中就有7个是可以通过 在女孩性交并暴露于HPV之前接种疫苗。 美国疾病控制和预防中心(CDC，2007)推荐女性接种HPV疫苗 对于那些在感染前接种疫苗的人来说，11-26岁预防大多数宫颈癌 HPV的高危类型。所有女孩都可以免费接种疫苗(6个月内3剂)。 根据私人保险、医疗补助和/或儿童疫苗(VFC)计划，18岁。在2009年 国家免疫调查，非裔美国人和美国人接种HPV疫苗的比率相似 白人女孩(约44%)，但非洲裔美国人完成三次所需剂量的比率较低 对比白人女孩(分别为23%和29%)。在田纳西州，43.6%的13-17岁青少年患有 接种一剂或多剂HPV疫苗，与全国44.3%的比率相似(CDC，2010年)。

Cervical Cancer and the HPV Vaccine. Racial disparifies 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 neariy 100% efficacious in preventing infecfion of HPV types 16 and 18, precancerous cervical disease, and resulfing 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 bv vaccinating girls before thev become sexually acfive 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 infecfion with one of the high-risk types of HPV. The vaccines (3 doses across six months) are available for free to all giris through age 18 under private insurance, Medicaid and/or the Vaccines for Children (VFC) program. In the 2009 National Immunization Survey, rates of inifiation of the HPV vaccine were similar for African American and white giris (about 44%), but the rate of complefion of the three required doses was lower for African American versus White giris (23% and 29%, respecfively). 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).