HPV Outcomes: Prevention Epidemiology and Surveillance (HOPES)

新墨西哥州（NM）是唯一一个有能力全面监测宫颈癌筛查和人类健康的州。 乳头瘤病毒（HPV）预防使用全州范围内的妇女为基础的电子信息系统， 授权报告。我们处于独特的地位，可以解决在理解HPV疫苗影响方面的差距， 在一个多文化的美国人口遭受许多差异的有效性。我们的项目将实现 三个综合的具体目标，需要提供明确的基线特征的机会主义 子宫颈癌筛查项目。在目标1中，我们将建立个体HPV基因型分布 37种HPV基因型需要适当监测预期或非预期的基于人群的影响， HPV疫苗。尽管我们在全州范围内对6万多个子宫颈样本进行了采样 针对所有巴氏试验异常的妇女和巴氏试验正常的妇女随机抽样， 现有资源仅限于对40，000个样本进行HPV基因分型。在这个目标中，我们将实现 通过进行额外的20，000个HPV基因型检测来确定目标样本量。 基于人群的基因型分布，并确定CIN 2+的基因型特异性风险 在两年的资助期内取得的成果。在目标2中，我们将召开病理学小组会议， 约8，000例宫颈活检的一致诊断，包括>CIN/AIS。共识诊断将是 与通过使用NM HPV确定的相同标本的社区诊断相比， Pap登记（NMHPVPR）数据仓库。我们将创建一个黄金标准幻灯片集， 未来基于人口的评估标准化，这是确定实际影响的先决条件 HPV疫苗的有效性。在目标3中，我们将开发一个共享的颈椎图像资源 活检组织，并验证基于图像与基于玻璃的诊断的使用。因为 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 几十年基于图像的诊断标准对未来的人口评估至关重要。

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.