Objectives-Low CRC screening rates among Asian Americans are contributing to late stage at diagnosis and poor survival outcomes compared to Non-Hispanic whites. We conducted one of the first community-based trials to increase CRC screening in an Asian American population. Methods-FilipinoAmericans (N=548) non-adherent to CRC screening guidelines were randomized into two multi-component intervention arms that included a small-group CRC education session with or without distribution of free FOBT kits or a control condition (small-group education promoting physical activity).Results-Based on intent-to-treat analysis, self-reported CRC screening rates during the 6 month follow-up period were 30%, 25% and 9% for participants assigned to intervention with FOBT kit, intervention without FOBT kit, and the control condition, respectively. Participants randomized to either of the two intervention arms were significantly more likely to report screening at follow-up than control group assignees (odds ratios 4.9 and 3.7 compared to control, both p<.001).Conclusions-A multi-component intervention that includes an educational group session in a community setting can significantly increase CRC screening in Filipino Americans, even when no free FOBT kits are distributed.

BackgroundData from the California Health Interview Survey (CHIS) indicate that levels and temporal trends in colorectal cancer (CRC) screening prevalence vary among Asian American groups; however, the reasons for these differences have not been fully investigated.MethodsUsing CHIS 2001, 2003 and 2005 data, we conducted hierarchical regression analyses progressively controlling for demographic characteristics, English proficiency and access to care in an attempt to identify factors explaining differences in screening prevalence and trends among Chinese, Filipino, Vietnamese, Korean and Japanese Americans (N = 4,188).ResultsAfter controlling for differences in gender and age, all Asian subgroups had significantly lower odds of having ever received screening in 2001 than the reference group of Japanese Americans. In addition, Korean Americans were the only subgroup that had a statistically significant decline in screening prevalence from 2001 to 2005 compared to the trend among Japanese Americans. After controlling for differences in education, marital status, employment status and federal poverty level, Korean Americans were the only group that had significantly lower screening prevalence than Japanese Americans in 2001, and their trend to 2005 remained significantly depressed. After controlling for differences in English proficiency and access to care, screening prevalences in 2001 were no longer significantly different among the Asian subgroups, but the trend among Korean Americans from 2001 to 2005 remained significantly depressed. Korean and Vietnamese Americans were less likely than other groups to report a recent doctor recommendation for screening and more likely to cite a lack of health problems as a reason for not obtaining screening.ConclusionsDifferences in CRC screening trends among Asian ethnic groups are not entirely explained by differences in demographic characteristics, English proficiency and access to care. A better understanding of mutable factors such as rates of doctor recommendation and health beliefs will be crucial for designing culturally appropriate interventions to promote CRC screening.

Introduction With the growing number of adult cancer survivors, there is increasing need for information that links potential late and long term effects with specific treatment regimens. Few adult cancer patients are treated on clinical trials; however, patients previously enrolled in these trials are an important source of information about treatmentrelated late effects. Methods Focusing on colorectal cancer survivors, we used the database from five phase III randomized clinical trials from the National Surgical Adjuvant Breast & Bowel Project (NSABP) to recruit and enroll long term survivors in a study of late health outcomes and quality of life. We describe the challenges to recruitment of patients more than 5 -20 years after treatment. Results Sixty-five NSABP treatment sites were invited to enroll patients in the study. Sixty participated with the potential to recruit 2,408 patients. We received registration forms on only 976 patients (41%) of whom 744 (76%) expressed interest in participating and 708 completed interviews (95% of those expressing interest; 29% of total potential sample). There were multiple barriers to recruitment (difficulty locating patients, lack of institutional commitment, lack of patient interest). Conclusions Patients treated on clinical trials are an important potential source for examining the late effects of cancer treatments. Retrospective recruitment has substantial limitations. In the future, mechanisms should be established for prospective long-term follow-up to identify and understand the frequency and type of late effects associated with cancer treatments. Implications for Cancer Survivors As cancer patients are living longer, it will be important to learn from participants in clinical trials whether or not specific treatment regimens are associated with any serious late effects.

Results: Of the 487 respondents included in this analysis, 257 (53%) had never received any type of colorectal cancer screening. Among the 230 subjects who had ever received a routine screening test, 78 had fecal occult blood test only (16% of the total sample), and 152 had endoscopy with or without fecal occult blood test (31% of the total sample). After controlling

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