The important role of certain types of human papillomavirus (HPV) in the etiology of cervical cancer is well-established. However, the contribution of possible psychosocial and immunological factors to the progression of high-risk HPV-related cervical lesions needs further exploration. The proposed project aims to examine the potential interrelations between psychosocial (i.e., stress, coping processes) and immunologic (e.g., natural killer cell activity) measures in women with mild dysplastic lesions of the cervix due to infection with highly oncogenic subtypes of HPV. Specifically, two studies are proposed. Study 1 is designed to identify potential behavioral and immunologic correlates of stress and coping, with a particular emphasis on the effects of avoidant coping strategies on cancer risk and development. Eighty-four women referred for a follow-up colposcopy will complete baseline psychosocial assessments and provide a blood sample (for immune assays) prior to their colposcopy. Follow-up assessments will be conducted at 6-months and 12-months post-baseline. Psychosocial assessments include measures of stressful life events, cancer-specific intrusive and avoidant ideation, and a variety of coping strategies. Relevant immune measures include T-cell numbers, natural killer cell numbers and functional activity, and lymphocyte proliferative response to mitogen stimulation. In addition, medical outcome (regression, persistence, or progression of cervical lesions), demographic variables, and behavioral risk factors will be assessed. Study 2 will provide a preliminary evaluation of a relaxation and coping skills intervention that is designed to reduce cancer-related distress and provide effective coping skills for facilitating adherence to screening recommendations. The identification of potential interrelations among psychosocial, behavioral, and immunologic variables has important implications for cancer prevention and control programs as they can be used to guide the development of psychological and behavioral interventions aimed at reducing distress and avoidance, which may lead to improved behavioral, immunologic, and health outcomes.
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| Fang, Carolyn Y; Miller, Suzanne M; Mills, Megan et al. (2003) The effects of avoidance on cytotoxic/suppressor T cells in women with cervical lesions. Psychooncology 12:590-8 |
| Fang, Carolyn Y; Miller, Suzanne M; Malick, John et al. (2003) Psychosocial correlates of intention to undergo prophylactic oophorectomy among women with a family history of ovarian cancer. Prev Med 37:424-31 |
| Fang, C Y; Manne, S L; Pape, S J (2001) Functional impairment, marital quality, and patient psychological distress as predictors of psychological distress among cancer patients' spouses. Health Psychol 20:452-7 |
