LEADERSHIP/ADMIN CORE

大约15种HPV类型导致几乎所有的宫颈癌;然而，目前的HPV疫苗覆盖了 只有2种HPV类型导致约70%的浸润性宫颈癌，并且对已建立的宫颈癌没有治疗效果。 使妇女处于危险之中的感染。因此，所有妇女都需要进行某种常规宫颈筛查， 可预见的未来重要的是，今天活着的大多数妇女没有接种疫苗，因此， 有患宫颈癌的风险。美国预防服务工作组关于宫颈癌的建议 近十年来，筛查没有更新，宫颈癌的性能指标 筛查的重点是人口覆盖率，而不是对筛查呈阳性的妇女进行随访， 诊断测试为了改善美国宫颈癌的预防，我们建议在 全州范围内，系统，提供者和患者水平，包括有针对性的医疗记录审查失败， 筛查过程;基于人口的筛查、诊断和治疗的地理空间绘图;以及 在临床环境中应用基于社区的参与式方法（CBPR），以识别障碍， 护理过程中的促进者，包括那些可能实现以患者为中心的新型筛查的促进者 选项.我们的协调，多学科计划的基石是新墨西哥州HPV巴氏登记 它超越了组织监测的局限性，要求全州范围内对所有宫颈癌进行监测， 癌症筛查、诊断和治疗。新墨西哥州有很高比例的种族多样性 (i.e.,美国印第安人和西班牙裔），农村，贫困，医疗权利被剥夺和健康差异 宫颈癌的高危人群。本申请的具体目的是：1）建立新的 墨西哥HPV结局、实践有效性和监测（NM-HOPES）PROSPR研究中心; 2)建立一个可持续的筛查过程文件股，提供患者在筛查过程中的数据。 宫颈癌筛查护理课程;以及3）整合并资助3个研究项目， 目的是通过比较有效性评价， 真实世界的宫颈癌筛查实践和结果与指南和创新。

Approximately 15 HPV types cause virtually all cervical cancers; however, the current HPV vaccines cover only 2 HPV types causing -70% of invasive cervical cancer and have no therapeutic effect on established infections that place women at risk. Thus, all women will need some kind of routine cervical screening for the foreseeable future. Importantly, the majority of women alive today have not been vaccinated and therefore are at risk for cervical cancer. The US Preventive Services Task Force recommendation on cervical cancer screening have not been updated for nearly a decade and performance measures for cervical cancer screening focus on population coverage rather than on follow-up among women with positive screening and diagnostic tests. Toward improving US cervical cancer prevention, we propose multi-tiered assessments at the statewide, systems, provider and patient levels including targeted medical record review of failures in the screening process; geospatial mapping of population-based screening, diagnosis and treatment; and application of community-based participatory approaches (CBPR) in clinical settings to identify barriers and facilitators across the processes of care including those that may enable novel patient-centered screening options. The cornerstone of our coordinated, multidisciplinary program is the New Mexico HPV Pap Registry which transcends limitations of organizational monitoring by mandating statewide surveillance of all cervical cancer screening, diagnosis and treatment. New Mexico is home to a high proportion of ethnically diverse (i.e., American Indian and Hispanic), rural, impoverished, medically disenfranchised and health-disparate populations at high-risk for cervical cancer. The specific aims of this application are to 1) Establish the New Mexico HPV Outcomes, Practice Effectiveness and Surveillance (NM-HOPES) PROSPR Research Center; 2) Establish a sustainable Screening Process Documentation Unit providing data on patients during their course of cervical cancer screening care; and 3) Integrate and fund 3 research projects with the overarching aim of informing practice and targeted interventions supported by comparative effectiveness evaluations of real-world cervical cancer screening practice and outcomes versus guidelines and innovations.