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Cancer Control Research

Abstract

DESCRIPTION: (Applicant's Description) The role of certain types of human papillomavirus (HPV) in the etiology of cervical cancer is well-established. However, the influence of psychosocial, behavioral and immunologic factors on cancer risk and development needs further exploration. The proposed project aims to elucidate the potential links between psychological (e.g., distress, coping processes) and behavioral (e.g., cigarette smoking) risk factors and novel immunologic measures (e.g., T -cell proliferative responses to HPV proteins) in women with mild dysplastic lesions of the cervix due to infection with highly oncogenic subtypes of HPV. Specifically, the proposed project is designed to identify potential behavioral and immunologic correlates of psychological distress and coping, with a particular emphasis on the effects of avoidant coping strategies on cancer risk and development. Sixty-two women referred for a follow-up colposcopy will complete baseline psychosocial assessments and provide a blood sample (for immune assays) prior to their colposcopy. In addition, HPV typing of cervicovaginal cells will be conducted at baseline. Follow-up assessments will be conducted at 6-months and 12-months post-baseline. Psychosocial assessments include measures of psychological distress, cancer-specific intrusive and avoidant ideation, and a variety of coping strategies. Relevant immune measures include numbers and percentages of circulating lymphocytes, as well as T -cell proliferative responses to synthetic peptides derived from HPV 16, a specific marker of immunocompentence and one that has been shown to be associated with viral clearance and cervical disease regression. In addition, medical outcome (regression, persistence, or progression of cervical lesions), demographic variables, and behavioral risk factors (e.g., smoking) will be assessed. The identification of potential interrelations among psychosocial, behavioral, and immunologic variables has important implications for cancer prevention and control, as this information 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.