Cervical cancer is the second most common cancer among women worldwide disproportionately affecting underserved populations. Almost 80% of the cases occur in developing countries with the highest rates in Latin America and the Caribbean, sub-Saharan Africa, and South and South East Asia.
International Incidence Patterns
![Map showing the international incidence patterns of cervical cancer Map showing the international incidence patterns of cervical cancer](https://webarchive.library.unt.edu/eot2008/20090113180000im_/http://dceg.cancer.gov/images/content/incidence.gif)
Rates per 100,000 woman-years, age-adjusted using the world standard
A vaccine against cervical cancer HPV types could greatly contribute to efforts to overcome health disparities worldwide.
NCI/Costa Rican Human Papilloma Virus (HPV) Vaccine Efficacy Trial![Illustrations of a vaccine bottle, hypodermic needle and viruses Illustrations of a vaccine bottle, hypodermic needle and viruses](https://webarchive.library.unt.edu/eot2008/20090113180000im_/http://dceg.cancer.gov/images/content/vaccine_sm.gif)
- A population-based, randomized, blinded clinical trial will evaluate the efficacy of an HPV16/18 (bivalent) virus-like particle vaccine to protect against the development of high-grade cervical intraepithelial neoplasia.
- The study will include 6,500-8,500 women from the Province of Guanacaste, Costa Rica.
- Women will be enrolled and followed for 4 years.
- Results are expected in 2008.
Two necessary determinants of cervical cancer are persistent infection with oncogenic types of HPV and lack of effective screening for treatable precancerous lesions.
Diagram of stages of HPV infection
HPV Testing to Improve Cervical Cancer Screening in the Mississippi Delta
- A cross-sectional design will be used to validate self-sampling at home with mail-in "kits" and HPV DNA testing for primary cervical screening in four Mississippi Counties to address problems of access for underserved women.
- Screening Population - 250 eligible women (> 30 years old, non-pregnant, non-hysterectomized, non-treated) will be recruited from screening clinics; 250 unscreened women.
- Colposcopy Population - 500 women with abnormal or atypical cytology will be recruited from colposcopy clinics.