DESCRIPTION (Adapted from the Applicant's Abstract): Epidemiologic research
conducted over the past couple of decades has shown that infection with the
human papilloma virus (HPV) is a cause of most cases of cervical cancer.
Prospective studies have shown that women infected with HPV are more likely to
develop cervical intraepithelial neoplasia (CIN), and that those with
persistent oncogenic type HPV infections are at a significantly increased risk
of developing CIN compared with women transiently infected. In addition,
persistently HPV positive women appear to be four times more likely to have
persistent cervical lesions.
Although HPV infection is a cause of cervical cancer, it may be an insufficient
cause requiring the presence of other factors for the infection to progress to
a significant cervical lesion. Nutritional status may be an important cofactor
affecting both HPV persistence and progression of persistent HPV infection to
CIN. However, the association between nutritional status and cervical
carcinogenesis has not been adequately tested.
The overall goal of this application is to determine, using prospectively
collected HPV and cytology data, the association between serum carotenoid and
tocopherol status and cervical carcinogenesis among a cohort of high risk study
participants in the Brazilian HPV Natural History Cohort (RO1 CA70269). This
project will provide the first prospective analysis of serum carotenoid and
tocopherol concentrations and risk for persistent HPV infection; it will be
based on sensitive and specific methods for assessing type of HPV infection
over a 12 month period, and evaluate subsequent 5 year risk of progression to
CIN. This proposed study is unique in that if focuses on early events in
cervical carcinogenesis: HPV infection, HPV persistence, and progression to
CIN. It is cost-effective, utilizing previously collected serum samples and
questionnaire data. The study utilizes state of the art methods for determining
both PV status and serum carotenoid and tocopherol status. Furthermore, it
incorporates multiple measurements of both HPV status and serum nutrient
concentrations minimizing the probability that measurement imprecision
resulting from temporal fluctuations will obscure the true association between
nutrients status, and HPV persistence and risk of CIN. Results from this study
will efficiently further our understanding of the role of antioxidant nutrients
and cervical carcinogens.
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