Pacific Islanders, American Indians, or of other racial or ethnic backgrounds. To increase the levels of ethnic minority participation in the PLCO Cancer Screening Trial, NCI plans to cosponsor (with CDC) a new screening center to focus on the recruitment of African Americans and initiate another new center to focus on recruitment of Hispanics. A special study sponsored by CDC will assess psychosocial factors that influence older African Americans' decisions to undergo cancer screening. In addition, NCI is sponsoring a study to test literacy and develop culturally appropriate educational materials to encourage cancer screening among low-income African-American women.

The ASCUS/LSIL Triage Study is a 6-year clinical trial designed to determine the proper means of evaluating and managing minor Pap smear abnormalities. Four clinical centers are funded by NCI to enroll approximately 7,200 women with a recent diagnosis of abnormal Pap smears, of which nearly 40 percent are African American or Hispanic. Participants will be randomly assigned to one of three management groups and monitored for 3 years to help determine which patients are likely to experience progression to cancerous conditions.

The South Carolina Colorectal Cancer Screening Study is an NCI-funded Category I study designed to develop new methods of recruiting low-income African-American women into colorectal cancer screening trials and to test literacy and develop culturally appropriate educational materials.

NCI funded a large grant for a multicenter project administered by the Northern California Cancer Center, Pathways to Screening in Four Ethnic Groups. This project developed and evaluated culturally targeted cancer control interventions on the basis of the Pathways to Screening framework, a model of early cancer detection that focuses on the continuum from basic knowledge and attitudes to the procedural and organizational aspects of the delivery process. Pathways models were developed and evaluated for the Hispanic, Vietnamese, African-American, and Chinese-American communities in the San Francisco Bay area. Evaluation will assist in the development of culturally tailored interventions appropriate for racial and ethnic groups in other regions of the United States.