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).

About the NM Pap Registry

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.


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 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.

Landy R, Mathews C, Robertson M, Wiggins CL, McDonald YJ, Goldberg DW, Scarinci IC, Cuzick J, Sasieni PD, Wheeler CM. A state-wide population-based evaluation of cervical cancers arising during opportunistic screening in the United States. Gynecol Oncol. 2020 Nov;159(2):344-353. doi: 10.1016/j.ygyno.2020.08.033. Epub 2020 Sep 22. PMID: 32977987

Castle PE, Adcock R, Cuzick J, Wentzensen N, Torrez-Martinez NE, Torres SM, Stoler MH, Ronnett BM, Joste NE, Darragh TM, Gravitt PE, Schiffman M, Hunt WC, Kinney WK, Wheeler CM; New Mexico HPV Pap Registry Steering Committee; p16 IHC Study Panel. Relationships of p16 Immunohistochemistry and Other Biomarkers With Diagnoses of Cervical Abnormalities: Implications for LAST Terminology. Arch Pathol Lab Med. 2020 Jun;144(6):725-734. doi: 10.5858/arpa.2019-0241-OA. Epub 2019 Nov 13. PMID: 31718233

Drolet M, Bénard É, Pérez N, Brisson M; HPV Vaccination Impact Study Group. Population-level impact and herd effects following the introduction of human papillomavirus vaccination programmes: updated systematic review and meta-analysis. Lancet. 2019 Aug 10;394(10197):497-509. doi: 10.1016/S0140-6736(19)30298-3. Epub 2019 Jun 26. PMID: 31255301

Landy R, Sasieni PD, Mathews C, Wiggins CL, Robertson M, McDonald YJ, Goldberg DW, Scarinci IC, Cuzick J, Wheeler CM; New Mexico HPV Pap Registry Steering Committee. Impact of screening on cervical cancer incidence: A population-based case-control study in the United States. Int J Cancer. 2019 Dec 13. doi: 10.1002/ijc.32826. [Epub ahead of print. PMID:31837006

Castle PE, Adcock R, Cuzick J, Wentzensen N, Torrez-Martinez NE, Torres SM, Stoler MH, Ronnett BM, Joste NE, Darragh TM, Gravitt PE, Schiffman M, Hunt WC, Kinney WK, Wheeler CM; New Mexico HPV Pap Registry Steering Committee; p16 IHC Study Panel. Relationships of p16 Immunohistochemistry and Other Biomarkers With Diagnoses of Cervical Abnormalities: Implications for LAST Terminology. Arch Pathol Lab Med. 2019 Nov 13. doi: 10.5858/arpa.2019-0241-OA. [Epub ahead of print] PMID:31718233

Adcock R, Cuzick J, Hunt WC, McDonald RM, Wheeler CM; New Mexico HPV Pap Registry Steering Committee. Role of HPV Genotype, Multiple Infections, and Viral Load on the Risk of High-Grade Cervical Neoplasia. Cancer Epidemiol Biomarkers Prev. 2019 Nov;28(11):1816-1824. doi: 10.1158/1055-9965.EPI-19-0239. Epub 2019 Sep 5. PMID:31488417

Kamineni A, Tiro JA, Beaber EF, Silverberg MJ, Wheeler CM, Chao CR, Chubak J, Skinner CS, Corley DA, Kim JJ, Balasubramanian BA, Paul Doria-Rose V; PROSPR consortium. Cervical cancer screening research in the PROSPR I consortium: Rationale, methods and baseline findings from a US cohort. Int J Cancer. 2019 Mar 15;144(6):1460-1473. doi: 10.1002/ijc.31940. Epub 2018 Dec 20. PMID:30353911

Castle PE, Wheeler CM, Campos NG, Sy S, Burger EA, Kim JJ; New Mexico HPV Pap Registry Steering Committee. Inefficiencies of over-screening and under-screening for cervical cancer prevention in the U.S. Prev Med. 2018 Jun;111:177-179. doi:10.1016/j.ypmed.2018.03.011. Epub 2018 Mar 14. PMID:29548787

Cuzick J, Myers O, Lee JH, Shi Y, Gage JC, Hunt WC, Robertson M, Wheeler CM; New Mexico HPV Pap Registry Steering Committee. Outcomes in Women With Cytology Showing Atypical Squamous Cells of Undetermined Significance With vs Without Human Papillomavirus Testing.  JAMA Oncol. 2017 Oct 1;3(10):1327-1334. doi: 10.1001/jamaoncol.2017.1040. PMID:28655061

 Habbema D, Weinmann S, Arbyn M, Kamineni A, Williams AE, M C M de Kok I, van Kemenade F, Field TS, van Rosmalen J, Brown ML. Harms of cervical cancer screening in the United States and the Netherlands. Int J Cancer. 2017 Mar 1;140(5):1215-1222. doi: 10.1002/ijc.30524. PMID: 27864938

Gage JC, Hunt WC, Schiffman M, Katki HA, Cheung LA, Myers O, Cuzick J, Wentzensen N, Kinney W, Castle PE, Wheeler CM; New MexicoHPVPapRegistry Steering Committee. Similar Risk Patterns After Cervical Screening in Two Large U.S. Populations: Implications for Clinical Guidelines. Obstet Gynecol. 2016 Dec;128(6):1248-1257. PMID:27824767

Benard VB, Castle PE, Jenison SA, Hunt WC, Kim JJ, Cuzick J, Lee JH, Du R, Robertson M, Norville S, Wheeler CM; New MexicoHPVPapRegistry Steering Committee. Population-Based Incidence Rates of Cervical Intraepithelial Neoplasia in the Human Papillomavirus Vaccine Era. JAMA Oncol. 2016 Sep 29. doi: 10.1001/jamaoncol.2016.3609. [Epub ahead of print] PMID:27685805

Tosteson AN, Beaber EF, Tiro J, Kim J, McCarthy AM, Quinn VP, Doria-Rose VP, Wheeler CM, Barlow WE, Bronson M, Garcia M, Corley DA, Haas JS, Halm EA, Kamineni A, Rutter CM, Tosteson TD, Trentham-Dietz A, Weaver DL; PROSPR consortium. Variation in Screening Abnormality Rates and Follow-Up of Breast, Cervical and Colorectal Cancer Screening within the PROSPR Consortium. J Gen Intern Med. 2016 Apr;31(4):372-9. doi: 10.1007/s11606-015-3552-7. PMID: 26658934 Free PMC Article

McDonald YJ, Goldberg DW, Scarinci IC, astle PE, Cuzick J, Robertson M, Wheeler CM. Health Service Accessibility and Risk in Cervical Cancer Prevention: Comparing Rural Versus Nonrural Residence in New Mexico. J Rural Health. 2016 Aug 24. doi: 10.1111/jrh.12202. [Epub ahead of print] PMID:27557124

Gage JC, Hunt WC, Schiffman M, Katki HA, Cheung LC, Cuzick J, Myers O, Castle PE, Wheeler CM; New MexicoHPVPapRegistry Steering Committee. Risk Stratification Using Human Papillomavirus Testing among Women with Equivocally Abnormal Cytology: Results from a State-Wide Surveillance Program. Cancer Epidemiol Biomarkers Prev. 2016 Jan;25(1):36-42. doi: 10.1158/1055-9965.EPI-15-0669. Epub 2015 Oct 30. PMID: 26518316 Free PMC Article

Kim JJ, Campos NG, Sy S, Burger EA, Cuzick J, Castle PE, Hunt WC, Waxman A, Wheeler CM; New MexicoHPVPapRegistry Steering Committee. Inefficiencies and High-Value Improvements in U.S. Cervical Cancer Screening Practice: A Cost-Effectiveness Analysis. Ann Intern Med. 2015 Oct 20;163(8):589-97. doi: 10.7326/M15-0420. Epub 2015 Sep 29. PMID:26414147

Stoler MH, Ronnett BM, Joste NE, Hunt WC, Cuzick J, Wheeler CM; New MexicoHPVPapRegistry Steering Committee. The Interpretive Variability of Cervical Biopsies and Its Relationship to HPV Status. Am J Surg Pathol. 2015 Jun;39(6):729-36. doi: 10.1097/PAS.0000000000000381. PMID:25602796  Free PMC Article

Cuzick J, Myers O, Hunt WC, Saslow D, Castle PE, Kinney W, Waxman A, Robertson M, Wheeler CM; New MexicoHPVPapRegistry Steering Committee. Human papillomavirus testing 2007-2012: co-testing and triage utilization and impact on subsequent clinical management. Int J Cancer. 2015 Jun 15;136(12):2854-63. doi: 10.1002/ijc.29337. Epub 2014 Dec 1. PMID:25447979 Free PMC Article

Joste NE, Ronnett BM, Hunt WC, Pearse A, Langsfeld E, Leete T, Jaramillo M, Stoler MH, Castle PE, Wheeler CM; New MexicoHPVPapRegistry Steering Committee. Human papillomavirus genotype-specific prevalence across the continuum of cervical neoplasia and cancer. Cancer Epidemiol Biomarkers Prev. 2015 Jan;24(1):230-40. doi: 10.1158/1055-9965.EPI-14-0775. Epub 2014 Nov 2. PMID:25363635

Castle PE, Hunt WC, Langsfeld E, Wheeler CM; New MexicoHPVPapRegistry Steering Committee. Three-year risk of cervical precancer and cancer after the detection of low-risk human papillomavirus genotypes targeted by a commercial test. Obstet Gynecol. 2014 Jan;123(1):49-56. doi: 10.1097/AOG.0000000000000013. PMID:24463663

Kinney W, Hunt WC, Dinkelspiel H, Robertson M, Cuzick J, Wheeler CM; New MexicoHPVPapRegistry Steering Committee. Cervical excisional treatment of young women: a population-based study. Gynecol Oncol. 2014 Mar;132(3):628-35. doi: 10.1016/j.ygyno.2013.12.037. Epub 2014 Jan 4. PMID:24395062 Free PMC Article

Cuzick J, Myers O, Hunt WC, Robertson M, Joste NE, Castle PE, Benard VB, Wheeler CM; New MexicoHPVPapRegistry Steering Committee. A population-based evaluation of cervical screening in the United States: 2008-2011. Cancer Epidemiol Biomarkers Prev. 2014 May;23(5):765-73. doi: 10.1158/1055-9965.EPI-13-0973. Epub 2013 Dec 3. PMID:24302677 Free PMC Article

Wheeler CM, Hunt WC, Cuzick J, Langsfeld E, Robertson M, Castle PE; New MexicoHPVPapRegistry Steering Committee. The influence of type-specific human papillomavirus infections on the detection of cervical precancer and cancer: A population-based study of opportunistic cervical screening in the United States. Int J Cancer. 2014 Aug 1;135(3):624-34. doi: 10.1002/ijc.28605. Epub 2014 Apr 15.  PMID:24226935 Free PMC Article

Wentzensen N, Nason M, Schiffman M, Dodd L, Hunt WC, Wheeler CM; New MexicoHPVPapRegistry Steering Committee. No evidence for synergy between human papillomavirus genotypes for the risk of high-grade squamous intraepithelial lesions in a large population-based study. J Infect Dis. 2014 Mar;209(6):855-64. doi: 10.1093/infdis/jit577. Epub 2013 Oct 31. PMID:24179110 Free PMC Article

Gage JC, Joste N, Ronnett BM, Stoler M, Hunt WC, Schiffman M, Wheeler CM. A comparison of cervical histopathology variability using whole slide digitized images versus glass slides: experience with a statewide registry. Hum Pathol. 2013 Nov;44(11):2542-8. doi: 10.1016/j.humpath.2013.06.015. Epub 2013 Sep 25. PMID: 24075599 Free PMC Article

Gage JC, Schiffman M, Hunt WC, Joste N, Ghosh A, Wentzensen N, Wheeler CM; New MexicoHPVPapRegistry Steering Committee. Cervical histopathology variability among laboratories: a population-based statewide investigation. Am J Clin Pathol. 2013 Mar;139(3):330-5. doi: 10.1309/AJCPSD3ZXJXP7NNB. PMID: 23429369 Free PMC Article

Wheeler CM, Hunt WC, Cuzick J, Langsfeld E, Pearse A, Montoya GD, Robertson M, Shearman CA, Castle PE; New MexicoHPVPapRegistry Steering Committee. A population-based study of human papillomavirus genotype prevalence in the United States: baseline measures prior to mass human papillomavirus vaccination. Int J Cancer. 2013 Jan 1;132(1):198-207. doi: 10.1002/ijc.27608. Epub 2012 Jun 20. PMID:22532127 Free PMC Article