This career development proposal describes a five-year training and research plan centered on the role of infection in carcinogenesis to build a foundation for a career in cancer prevention research. The candidate's long term career goal is to combine expertise in epidemiology with methods from clinical research and basic science to lead multidisciplinary efforts to clarify the etiologic role of infection in carcinogenesis, identify individuals at higher risk for progression, and develop decision tools to improve cancer outcomes. This goal will be achieved through rigorous didactic training and research activities to develop the candidate's expertise in: 1) molecular biology of cancer and viral pathogenesis;2) translation of molecular prevention of cancer to health care settings;and 3) design and analysis of longitudinal research. Persistent infection with high-risk types of human papillomavirus (HPV) has been established as a necessary, but not sufficient, factor in cervical carcinogenesis. However, the natural history and mechanism of HPV infection in cervical carcinogenesis remain unclear, in part due to limits in current HPV detection methods. The application of a novel, type-specific method for HPV detection in blood provides a breakthrough opportunity to study aspects of HPV infection that may determine risk of cervical disease. Integration of emerging technology for use in early detection and risk assessment, and translation of these technologies into clinical settings, have been identified as high priorities in the National Cancer Institute's strategy for reducing cancer mortality. The overall scientific goal is to determine how high-risk HPV in blood, in concert with HPV cofactors, correlates with cervical disease over time. This proposal integrates multidisciplinary methods to achieve the following research aims: 1) validate a new technique to detect HPV types 16 and 18 at the cervix (Aim 1);2) identify associations of HPV 16 and 18 detected in cervical specimens with detection of these HPV types in blood (Aim 2);and 3) determine 2-year risk of progression in women with low-grade cervical disease who are positive for high-risk HPV types in their blood at baseline relative to women with negative HPV blood status (Aim 3). Collectively, outcomes of this research will advance our understanding of the relationship of HPV in blood with risk of cervical disease. This research is expected to positively impact public health by facilitating new screening approaches that may ultimately reduce morbidity, mortality, and health care costs.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Academic/Teacher Award (ATA) (K07)
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Study Section
Subcommittee G - Education (NCI)
Program Officer
Perkins, Susan N
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Fiscal Year
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Yale University
Obstetrics & Gynecology
Schools of Medicine
New Haven
United States
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Patel, Divya A; Saraiya, Mona; Copeland, Glenn et al. (2013) Treatment patterns for cervical carcinoma in situ in Michigan, 1998-2003. J Registry Manag 40:84-92
Erekson, Elisabeth A; Martin, Deanna K; Zhu, Kejia et al. (2012) Sexual function in older women after oophorectomy. Obstet Gynecol 120:833-42
Patel, Divya A; Zochowski, Melissa; Peterman, Stephanie et al. (2012) Human papillomavirus vaccine intent and uptake among female college students. J Am Coll Health 60:151-61
Patel, Divya A; Rozek, Laura S; Colacino, Justin A et al. (2012) Patterns of cellular and HPV 16 methylation as biomarkers for cervical neoplasia. J Virol Methods 184:84-92
Patel, Divya A; Unger, Elizabeth R; Walline, Heather et al. (2011) Lack of HPV 16 and 18 detection in serum of colposcopy clinic patients. J Clin Virol 50:342-4
Carlos, Ruth C; Dempsey, Amanda F; Resnicow, Ken et al. (2011) Maternal characteristics that predict a preference for mandatory adolescent HPV vaccination. Hum Vaccin 7:225-9
Gariepy, Aileen M; Simon, Erica J; Patel, Divya A et al. (2011) The impact of out-of-pocket expense on IUD utilization among women with private insurance. Contraception 84:e39-42
Carlos, Ruth C; Dempsey, Amanda F; Resnicow, Ken et al. (2010) Feasibility of using maternal cancer screening visits to identify adolescent girls eligible for human papillomavirus vaccination. J Womens Health (Larchmt) 19:2271-5
Patel, Mehul K; Patel, Divya A; Lu, Mei et al. (2010) Impact of marital status on survival among women with invasive cervical cancer: analysis of population-based surveillance, epidemiology, and end results data. J Low Genit Tract Dis 14:329-38
Carlos, Ruth C; Dempsey, Amanda F; Patel, Divya A et al. (2010) Cervical cancer prevention through human papillomavirus vaccination: using the ""teachable moment"" for educational interventions. Obstet Gynecol 115:834-8

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