explore perceptions about food and to develop strategies to improve 5 A Day messages tailored to the African-American community. Results of this research are found in messages in radio segments, media newsletters, and other outreach activities.

Chemoprevention Trials

NCI is sponsoring more than 60 chemoprevention trials to test compounds that may block, suppress, or retard cancer. Although none appear to be focused on issues of chemoprevention among ethnic minority or medically underserved populations, NCI provided information on two such trials that are "of extreme importance to several special population groups" and are therefore classified by NCI as Category II studies (National Cancer Institute, 1998b, p. 61). The Breast Cancer Prevention Trial, initiated in April 1992, tested the effects of tamoxifen in the prevention of breast cancer among high-risk subjects. Similarly, the Prostate Cancer Prevention Trial is designed to test the effectiveness of finasteride in the prevention of prostate cancer. Both studies, however, suffer from disproportionately low ethnic minority enrollment (see Chapter 4).

Secondary Prevention (Early Detection)
Breast Cancer Screening

The Breast Cancer Screening Consortium, funded through an NCI interactive grant mechanism, is a five-site study focused on identifying means of increasing the utilization of screening programs by women over age 50 who have not adhered to recommended screening guidelines. Telephone counseling and other interventions are examined in this study. NCI provided no information regarding the enrollment of ethnic minority or medically undeserved women in this trial. A smaller study, the Increasing Breast Screening Among Nonadherent Women study, evaluated the effectiveness and cost effectiveness of tailored telephone counseling and other intervention strategies in five regions of the United States in increasing the rates of breast cancer screening among nonadherent women, including elderly ethnic minority women. NCI classifies this study as a Category I and II study.

PLCO Cancer Screening Trial

The PLCO Cancer Screening Trial is a large-scale randomized study to determine whether screening tests will reduce the number of deaths related to prostate, lung, colorectal, and ovarian cancers. As of 1997, 89 percent of the participants in this Category II trial were white, 4.4 percent were African American, 1.4 percent were Hispanic, 4.3 percent were Asian American, and less than 0.5 percent were



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