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WFU School of Medicine Awarded Grant For Cancer Study

The American Cancer Society (ACS) has awarded Wake Forest University School of Medicine a $1 million grant to study the effectiveness of intervention strategies to encourage low-income minority women to be screened for colorectal cancer.

The goal of the study is to examine the effectiveness of a two-pronged intervention delivered by American Cancer Society volunteers to improve colorectal cancer screening knowledge, attitudes and behaviors among low-income minority women age 50 and older.

"We were the principal investigators in a previous National Cancer Institute study which examined the effectiveness of intervention among low-income minority women in increasing the utilization of breast and cervical cancer screenings," said Electra Paskett, Ph.D., associate professor of public health sciences. "The positive results of that study provided the impetus for expanding the study to colorectal screening."

The intervention strategies include clinic-based interventions and community outreach interventions directed at disseminating informational material to women who reside in low-income housing communities. Pilot data regarding colorectal cancer screening already collected from women in the target population will be used to modify the content of the intervention material.

Unlike typical clinical trials, this study will take place in four groups of two cities each and will use a delayed time series design to assess the effect of the intervention on improving rates for colorectal cancer screening. The intervention will begin 12 months earlier in four cities. Six cross-sectional surveys of random samples of women will examine colon cancer screening knowledge, attitudes, and practices in each group of cities. Surveys will be done every six months and a total of 600 women will be surveyed each time. The evaluation component will also include ongoing monitoring of screening rates at identified health care facilities.

This study will utilize an established partnership between investigators at Wake Forest University School of Medicine and the Southeast Division of the American Cancer Society to plan, deliver and evaluate the ability of this intervention to be disseminated by ACS volunteers and to improve colorectal cancer screening among low-income minority women.

Colorectal cancer is the third most common cancer among women. Mortality rates for colorectal cancer are 20-30 percent higher in African-Americans, 5-year survival rates are poorer for African-Americans, and fewer colorectal cancers are detected at localized stages among African-Americans compared to whites. African-American women have a 20 percent higher incidence rate than white women. Reasons for improved survival rates and localized disease rates among whites have been linked to use of early detection tests and changes in lifestyle factors less likely available to low-income populations.

In the general population, colorectal cancer screening rates are far below those for breast, cervical or prostate cancer even though studies have proven that these tests, fecal occult blood test (FOBT) and flexible sigmoidoscopy, can save lives.

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