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.
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