Native American women have a 2-3 fold higher incidence of invasive cervical cancer and mortality compared with non-Hispanic white women. The causes of these persistently higher rates of cervical cancer remain unknown. PAP smear screening, HPV infection, sexual history and nutritional status have been related to cervical cancer in other studies. To date, tribal specific incidence and mortality rates for cervical cancer among Native Americans living in Arizona, such as the Hopi, have not been published. The purpose of this investigation is to: 1. Identify cultural and behavioral barriers to cervical cancer control and prevention among Hopi women in the two age groups 18-50 and greater than 50. 2. Develop and evaluate an intervention to increase cervical cancer screening among Hopi women, through a lay health educator cancer education program. 3. Determine the virologic and nutritional risk factors for cervical dysplasia and cancer among Hopi women. Information from these investigations will be used to develop culturally appropriate education materials, training programs for lay health educators and guide for physicians in the prevention and control of cervical cancer among Hopi women specifically, and Native American women in general. This proposal for research will be the major component of a 5 year Academic Investigator Award in which cancer prevention and epidemiology will be the focus. These studies along with continued course work in advanced epidemiology and biostatistics, and experience in teaching will provide the experience and expertise needed to function as a successful, independent investigator in the future.
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