Cancer Control Research
5R01CA058999-05
Miller, Suzanne M.
PSYCHONEUROIMMUNOLOGY OF CERVICAL DYSPLASIA
AbstractThe important role of certain "high risk" types of human papillomaviruses
(HPV's) in the etiology of cervical cancer is well-established. However,
the contributions of possible intervening factors in the progression of
high-risk HPV-related lesions, such as psychosocial, immune, and
neuroendocrine functioning, are virtually unexplored. The proposed project
aims to examine these issues in a group of women with mild dysplastic
lesions of the cervix due to infection with HPV subtypes with high
oncogenic potential. Ongoing research by members of this team has explored
the effects of coping style and psychosocial interventions on adaptation
and adherence to cervical cancer screening protocols in women at high risk
for cervical cancer. The present study will extend this work by examining
the interrelations among psychological, immune, and neuroendocrine factors
in a sample of potentially high risk subjects and exploring the
implications of these factors for health status and disease progression.
Following baseline colposcopic biopsy, subjects will be assessed at
notification of their biopsy status and one and two weeks following
notification. Follow-up assessments will be conducted at 6-month, one-
year, eighteen-month and two-year intervals. We will obtain relevant
psychosocial measures (depression, hopelessness, life stress, daily
hassles, social support, and loneliness) as well as measures of cellular
immune function (T-cell numbers and subsets; NK cell numbers, functional
activity and cytotoxity; response to mitogen stimulation; and local immune
function), neuroendocrine function (cortisol secretion), and medical
outcome (HPV type, histologic evidence of regression, persistence, or
progression of cervical lesions). In addition, the effects of the
patients' demographic, medical history, and behavioral risk factor profile
will be assessed.
The short-term goals of this project are to examine hypotheses about the
relations among psychological variables, immunologic variables,
neuroendocrine variables, and medical outcomes in women with high risk HPV
infection who are being monitored but not receiving treatment. These
relations will be explored both cross-sectionally via regression analyses
and longitudinally via repeated measures analyses of variance and
covariance, while controlling for the impact of relevant risk factors and
behaviors (e.g., smoking, sexual behavior, nutrition, exercise, sleep,
alcohol and drug use). The long-term goals are to develop a predictive
model of disease and to identify mechanisms of progression. Such
understanding will help delineate the implications of
psychoneuroimmunologic factors for cervical dysplasia and enable us to
target individuals at high risk, so that tailored screening and preventive
protocols can be devised.
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