HPV-related diseases for over 30 years. I have worked nationally and internationally in all cervical cancer
prevention continuum aspects. I have changed women's health care by calling out the decreased quality of life
that former and current screening and follow-up techniques cause all women (item 4 below), but particularly
people of minority groups (including American Indian and Native American people) and transgender status. I
created the first quality of life measurements for cryosurgery and electrosurgery that translated into utilities for
cost-effectiveness modeling. My work documented the first quantification of pain and cramping associated with
cervical treatments for CIN 2/3 disease. As a part of ALTS, I led the quality-of-life group documenting changes
in perceived quality of life when moving to HPV triage after an ASCUS cytology (one less follow-up test, one
less speculum exam, and one less medical bill). I brought a primary care perspective to the new Bethesda
system for cervical cytology nomenclature. I served on the U.S. Preventive Services Task Force (2016 term)
and the ACS cervical cancer screening guideline committees (2007, 2002, 1996), as well as being an invited
contributor to the WHO Classification of Tumours (2022). I led the engineering development to show that
fluorescence and reflectance predicted areas for biopsy, resulting in high-grade disease. I performed the cost-effectiveness
analysis for this advance, which was the bright spot for LMIC lesion detection. I have provided
evidence of the 3q26 chromosomal gain, providing a 90% increase in efficiency in reassuring women with LSIL
cytology that if their test was negative, they did not need colposcopy – both improving their quality of life and
reducing costs. I serve on the NCI Enduring Cervical Cancer Screening and Management Guidelines to ensure
new biotechnologies correlate with risk modification of CIN 3+ disease. I continue to work with NCI on the Last
Mile Initiative to evaluate self-sampling for HPV detection as an advance in screening sensitivities that will
increase comfort with screening, the accuracy of risk stratification, and accessibility. My cost-effectiveness
models indicate that this translational innovation would meet the triple aim: improved experience of care,
improved health outcomes, and reduced costs. My team published the results from three large health
surveillance databases that women 45-65 years old are least likely to have cervical cancer screening, verified
by a second community-based study. Of greatest impact, I was the first author of the first population-based prophylactic HPV vaccine trial showing efficacy, immunogenicity, and safety cited thousands of times. My 10-year review of efficacy and immunogenicity has over 75,000 unique downloads. The Association for American
Physicians has inducted me into its physician-scientist organization for my work.