Characterizing the Risk of Invasive Cervical Cancer

Creation of an integrated database We will use data to characterize in detail the profile of some of the risk steps in three states representing each of the three ACN regions: Northern (Pennsylvania), Northern Central (West Virginia) and Central Highlands (Kentucky) and in identifying specific population sub-groups at highest risk for different ICC "risk steps. This will be the first study to utilize the new ACN-supported database that is unique in its integration of cancer data ftom the population-based cancer registries of each of the three states; We will also create an integrated database merging BRFSS data from the three states, which will be re-grouped and analyzed within and among states. Finally, we will combine and analyze both databases. In more specific terms, the data analysis of existing sources will seek to: a) Characterize the use of the Pap test in the study population, and identify the main barriers to screening based on available BRFSS data. This will be done at the ecologic, individual and It\ixedlevel of analysis. b) Characterize the incidence, mortality, stage and histology distribution of ICC using both internal and external comparisons. c) Examine the link between the BRFSS and the ICC outcome data (incidence, mortality and stage and histology distribution of ICC at diagnosis), at the ecologic level, stratified by several geographic and demographic subgroups. The main goal of this analysis will be to provide an in-depth characterization of the study population as a whole, as well as specific sub-groups at highest risk for ICC. This will range ftom the usage of pap smear screening, follow-up and adherence to abnormal findings, treatment and adherence to subsequent disease-specific recommendation. b) Establishment of Community, Collaborative and Research Partnerships Identification of community partners, which together with the strengthening of collaborations and partnerships in the region, will be used to develop the most appropriate pilot studies, and subsequent follow-up study. The ultimate goal is to have a methodologically strong research plan, together with a well-integrated program in the most affected communities to effectively reduce the burden of ICC in the area. We will seek to identify potential future collaborators and partnerships with groups with experience in cancer control research and intervention, at the national, regional and local level, particularly in Appalachia. This will include but not be limited to the Appalachia Cancer Network (ACN), Cancer Information Service (CIS) and Kentucky Cancer Program (KCP. We are particularly interested in local groups that can be active partners in the community as well as local chapters and staff of the American Cancer Society. The ultimate objective is to create a cohesive and solid framework from which to develop an effective epidemiologic study of ICC in the ACN region with the clear goal of designing successful intervention strategies to decrease the burden of ICC.