Diet & Activity Community Trial: High-Risk Colon Polyps

描述(由申请人提供)：南卡罗来纳州有一些全国最大的健康差距，其中最戏剧性的是与非裔美国人(AA)癌症发病率的上升有关。结肠癌是最常见的癌症中最致命的一种。它也是最容易通过筛查进行初级预防的一种，结肠镜检查是迄今为止最有效的筛查程序。在过去的两年里，NCI资助的南卡罗来纳州癌症差异社区网络(SCCDCN)与其社区合作伙伴合作，识别并减少癌症差异，这些差异给非裔美国人社区带来了不成比例的负担。这项建议是南卡罗来纳大学和SCCDCN的社区合作伙伴通过我们的社区咨询小组/指导委员会合作的产物，旨在设计和开发一个以社区为基础的参与性研究项目，旨在解决我们州非裔美国人的结肠癌问题。 由于结肠癌经历了结肠息肉阶段，筛查既是一种很好的初级预防手段，也是识别息肉复发高危人群的一种方法，顺理成章地延伸到结肠癌。此外，人们怀疑饮食和体力活动可能会在疾病自然病程的早期就影响结肠癌的发生。这个项目的总体目标，即减少与结肠癌相关的健康差距，将通过以下主要目标实现：1)进行基于信仰的社区设计的、基于教会的筛查，以识别患有结肠息肉的个人；2)移除在筛查过程中发现的息肉(从而防止它们转变为癌症，并为未来的研究提供生物材料)；3)进行由基于信仰的社区和南加州大学科学家合作设计的病例对照研究，以确定与息肉的存在相关的因素；以及4)设计和进行一项研究，以测试社区设计的、以家庭为基础的饮食和体力活动干预的有效性，旨在改变与可口可乐风险相关的炎症标志物水平。 由于这项研究的参与性，以社区为基础，我们确定了第二目标--测试饮食和PA干预对血压和体重的有效性-将在主要研究参与者(即被发现患有息肉的受试者)及其家庭成员中进行研究。这项参与性病例对照研究和干预试验代表了高危社区与在研究设计、实施、分析、解释和发布/传播研究结果的所有方面都非常有经验的学术团队之间的合作。

DESCRIPTION (provided by applicant): South Carolina has some of the largest health disparities in the nation, and the most dramatic of these are associated with elevated cancer rates among African Americans (AA). Colon cancer is the most deadly of the more common cancers. It also is the one most amenable to primary prevention by screening, with colonoscopy being the most effective screening procedure by far. Over the past two years the NCI-funded South Carolina Cancer Disparities Community Network (SCCDCN) has worked with its community partners to identify, and then reduce, cancer disparities that disproportionately burden the African-American community. This proposal is the product of the collaboration developed between the University of South Carolina and SCCDCN's community partners, through our Community Advisory Group/ Steering Committee, to design and develop a community-based participatory research project aimed at addressing the problem of colon cancer in African Americans in our state. Because colon cancer proceeds through the stage of colon polyps, screening represents both an excellent means of primary prevention and way of identifying persons at high risk of polyp recurrence and, by logical extension, colon cancer. Additionally, it is suspected that diet and physical activity may affect colon carcinogenesis very early in the natural history of the disease. The overall goal of this project, i.e., to reduce colon cancer-related health disparities, will be achieved by these Primary Aims: 1) to conduct a faith-based community-designed, church-based screening to identify individuals having colon polyps; 2) to remove polyps detected in the screening process (thereby preventing their transition to cancer and to provide biological material for future studies); 3) to conduct a case-control study designed collaboratively by the faith based community and USC scientists to identify factors associated with the presence of polyps; and 4) to design and conduct a study to test the effectiveness of a community-designed, family-based dietary and physical activity intervention aimed at modifying levels of inflammatory markers associated with CoCA risk. Because of the participatory, community-based nature of this study, we have identified a Secondary Aim - to test the effectiveness of the dietary and PA intervention on blood pressure, and body weight - that will be studied in both the primary study participants (i.e., subjects with polyps detected) and their family members This participatory case-control study and intervention trial represents a collaboration between a high-risk community and an academic team highly experienced in all aspects of research design, implementation, analyses, interpretation, and publication/dissemination of study results.