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NMHPVPR - The New Mexico HPV Pap Registry

About the New Mexico HPV Pap Registry

The New Mexico HPV Pap Registry (NMHPVPR) monitors the complete continuum of cervical cancer prevention in New Mexico and is, to our knowledge currently, the only population-based cervical screening registry in the United States. Using clinically relevant electronic medical records (EMR), detailed information including text dictations is generated for cervical cancer screening, diagnosis and treatment delivered throughout New Mexico. All results of tests are transmitted to the NMHPVPR under state regulations. This unique public health resource serves as the cornerstone of the NM-HOPES-PROSPR Research Center's Cervical Cancer Screening Process Documentation Unit (SPDU).

NMHPVPR Steering Committee Meeting, Taos 2011
NMHPVPR Steering Committee Meeting, Taos 2011
Left to right: Thomas Leete, Linda Gorgos, Deborah Thompson, David Espey, Jane Kim, Alan Waxman, Debbie Saslow, Nancy Joste, W. Curtis Hunt, Ann Powell, Steven Jenison, Orrin Myers, Walter Kinney, Cosette Wheeler, Tenchan Wheeler, Jack Cuzick, Lee Fernando, Mark Schiffman, Claudia Rosales, Michael Kopciuch, Danielle Rodriguez

The NMHPVPR information systems, which are fully electronic, transcend organizational structures of healthcare such as health plan and payers as well as diagnostic laboratory, medical facility and formal or informal community-based health care organizations. Reporting to the NMHPVPR is conducted at a national, regional and state-wide level and is based at the individual woman and provider levels. By comparison to organizational systems such as Managed Care Organizations (MCO), which suffer both loss from area out-migration and loss to membership due to personal decisions or changes in employer insurance agreements, the NMHPVPR only suffers out-migration from the entire state of New Mexico.

History

In 2002, Dr. Wheeler, the NM-HOPES-PROSPR Research Center Director was a co-leader of US studies demonstrating successful proof-of-principal efficacy of the monvalent HPV 16 vaccine, the prototype of the Merck Quadrivalent HPV vaccine. During this same period, she was part of the NCI ALTS team demonstrating effective utility of HPV testing in the triage of ASC-US (equivocal) screening Pap tests. Realizing the directions that cervical cancer prevention would gradually turn toward, in 2004, Dr. Wheeler began working with the New Mexico Department of Health (NM-DOH) to consider the importance of statewide surveillance for cervical screening including Pap and HPV testing and resultant diagnostic and treatment outcomes. Documenting US cervical screening programs would be essential to understanding benefit, harms and effectiveness (including costs) of HPV-based screening innovations but also would be requisite to rational integration of screening and vaccination. Furthermore, without such evidence, both screening and vaccination would be undertaken as if they had no relation to one another, a clinical redundancy of breathtaking expense.

In 2006, after 2 years of important discussions and ground work to demonstrate the feasibility of and capacity for statewide fully electronic surveillance of the cervical screening process, the NM-DOH in partnership with the University of New Mexico (UNM) established the New Mexico HPV Pap Registry (NMHPVPR). Dr. Wheeler , the NM-HOPES-PRC Director championed, created and developed the visionary NMHPVPR which today, under state administrative code (NMAC 7.4.3.12) requires all cervical screening (Papanicolaou (Pap) and HPV tests) as well diagnostic and treatment (all cervical, vulvar and vaginal pathology) to be reported through the New Mexico Notifiable Diseases and Conditions.

The NMHPVPR cervical cancer screening and prevention surveillance program was created in the interest of the health of all women to determine the public health significance and cost effectiveness of longitudinal changes in clinical practice impacting HPV-related cervical disease outcomes. The NMHPVPR was also intended to inform unanticipated or adverse events related to changes in screening and HPV vaccination practices. As a designee of the NM-DOH, the NMHPVPR is an authorized public health authority. The NM-DOH authorizes the NMHPVPR to collect and evaluate data under the Notifiable Diseases and Conditions (NMAC 7.4.3). The NMHPVPR is also authorized to collect and evaluate HPV vaccine administrative data. Through linkage of HPV vaccine data to the NMHPVPR cervical screening, diagnosis and treatment data, behaviors and outcomes can be monitored in recipients of HPV vaccines. The NMHPVPR is a one-of-a-kind population-based cervical screening registry with linkages to HPV vaccine administrative data that offers a novel US model for public health surveillance and prevention.

NMHPVPR Steering Committee Meeting, Photo 2, Taos 2011
Left to right: Danielle Rodriguez, Michael Kopciuch, Thomas Leete, Deborah Thompson, Linda Gorgos, Steven Jenison, Ann Powell, Walter Kinney, Nancy Joste, Cosette Wheeler, Mark Schiffman, Orrin Myers, W. Curtis Hunt, Jane Kim, Jack Cuzick, Alan Waxman, Claudia Rosales, Marissa Bacchi, Debbie Saslow, David Espey, Lee Fernando