Although cervical dysplasia is a major cause of morbidity in women
worldwide, few published studies have assessed the risk factors for its
development. American Indian women are at high risk for development of
both cervical dysplasia and cervical cancer, yet published data are scant
that identify the risk factors for the development of cervical lesions in
this minority group.
To assess the risk factors for the development of moderate dysplasia,
severe dysplasia, and carcinoma in situ in New Mexico's American Indian
women, we propose to conduct a case-control study at several Indian Health
Service-affiliated outpatient clinics. The study design incorporates an
integrated approach to investigate the relationship of numerous exposures
in the development of high-grade dysplastic cervical lesions. Data will
be obtained from study participants through extensive interviews, physical
and colposcopic examinations, microbiologic studies, serologic studies of
antibodies to sexually transmitted disease agents, and laboratory studies
of cervical cytologic and histologic specimens. Interviews will be
specifically directed to assess the associations of sexual behavior, past
sexually transmitted diseases, contraceptive techniques, hygienic
practices, cigarette smoking, and micronutrient consumption in the
development of cervical dysplasia. Laboratory studies will be primarily
directed to assessment of effects of current and past sexually transmitted
infections, plasma micronutrients, and presence of specific HLA alleles in
the development of cervical dysplasia.
This research will identify risk factors for development of high-grade
cervical dysplasia among American Indian women in New Mexico. This
research will also allow comparison of prevalence and patterns of risk
factors for cervical dysplasia in American Indian women with data obtained
from a similar, recently completed study in New Mexico Hispanic and non-
Hispanic white women. Thus, from an etiologic perspective, the
investigation will allow evaluation of heterogeneity of risk factors for
cervical dysplasia among culturally-diverse populations in the same
geographic region. From a public health perspective, this research should
lead to prevention strategies that will ultimately decrease the rates of
cervical dysplasia and cervical cancer, particularly among the high-risk
American Indian women of the Southwest.
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