Human papillomavirus and cervical cancer behavioral surveillance in the US§


  • During the completion of this article, Dr. Tiro was supported by the National Cancer Institute's Cancer Prevention Fellowship Program and the Division of Cancer Control and Population Sciences.

    We thank Tim McNeel and William Waldron from Information Management Systems and David Woodwell from the National Center for Health Statistics for their assistance in preparing this article.

  • The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the National Cancer Institute or the Centers for Disease Control and Prevention.

  • §

    This article is a US Government work and, as such, is in the public domain in the United States of America.


In the US, federal and state behavioral surveillance systems routinely monitor self-reported sexual behavior and Papanicolaou (Pap) test use to identify high-risk populations, trends, and disparities and to guide and evaluate interventions for cervical cancer prevention and control. Clinical uptake of human papillomavirus (HPV) vaccination and testing necessitates the expansion of behavioral surveillance systems. Cervical disease is the main focus of HPV-related behavioral surveillance because of greater cancer incidence and mortality relative to other susceptible organs, and the availability of effective technologies for prevention and control. In the current study, a framework is presented for the types of behaviors to monitor, their conceptual and operational definitions, target populations, and evidence supporting the reliability and validity of self-report measures. An overview is also provided of 8 population-based and 2 provider-based data systems that are nationally representative and accessible for behavioral surveillance research. Ongoing surveillance at the national, state, and local level is critical for monitoring the dissemination of HPV technologies and their impact on reducing disparities in the detection of precursor lesions, incidence of invasive cancer, and mortality. Cancer 2008;113:(10 suppl):3013–30. Published 2008 by the American Cancer Society.