$2.9 million to reduce colorectal cancer screening disparities in Vietnamese Americans

The Vietnamese REACH for Health Initiative coalition, under the leadership of the Northern California Cancer Center was recently awarded a $2.9 million grant from the National Institute of Health to evaluate the effectiveness of a colorectal cancer lay health worker and media intervention in increasing colorectal cancer screening among Vietnamese Americans aged 50-74 in Santa Clara County, California.

This community-based participatory research also includes the University of California, San Francisco, and four community-based organizations.

"Vietnamese Americans have lower rates of colorectal cancer screening, have lower incomes, and are more medically underserved than non-Hispanic whites," said Bang H. Nguyen, Dr. P.H. who is Principal Investigator of the study and Research Scientist at the Northern California Cancer Center. In California, the proportions screened – using either a Fecal Occult Blood Test (FOBT), sigmoidoscopy or colonoscopy, or any CRC screening test – are 29%, 36%, and 52% among Vietnamese Americans respectively, compared to 58%, 57%, and 75% among non-Hispanic whites.

Colorectal cancer (CRC) is the fourth most common cancer in the United States and the third most common cancer in both Vietnamese American men and women. Colorectal cancer ranks second in mortality among cancers in all races and ethnicities. Screening for CRC is effective in identifying pre-cancerous polyps and early cancers; with early detection and prompt treatment, incidence rates decline and survival rates increase. The five-year relative survival rate is about 90% for those diagnosed at the localized stage.

The project will recruit and train 64 lay health workers to conduct educational sessions with 640 community members, with half randomly assigned to receive education in CRC screening and the other half to receive education in nutrition. The media intervention will distribute Vietnamese-language health education information through print and electronic media.

"If this intervention is found to be effective, it could be applied throughout the United States to further reduce disparities in CRC screening in Vietnamese Americans," said Dr. Nguyen.

The Vietnamese Reach for Health Initiative Coalition includes 18 organizations and individuals representing cancer services, cancer survivors, health maintenance organizations, county health departments, employment services, refugee and immigrant resettlement service providers, healthcare providers, and researchers in Northern California. The coalition's mission is to reduce the burden of cancer among Vietnamese in Santa Clara County, California.

"Because many Vietnamese Americans 50 years of age and older maintain their traditional culture and language," said Vietnamese REACH for Health Initiative coalition chair MyLinh Pham, "we need a culturally and linguistically appropriate screening intervention to reduce the disparity in CRC screening, and ultimately reduce both incidence and deaths due to this disease."

The Northern California Cancer Center will serve as the lead agency and provide fiscal, research, management, and intervention coordination services. Four community-based organizations will be selected to provide the lay health worker services. The University of California, San Francisco will be subcontracted to provide research, coalition coordination and data collection services.

"This is very practical research, which if successful could improve colorectal screening rates for Vietnamese Americans throughout the United States and thus save thousands of lives," said Donald Nielsen, Northern California Cancer Center CEO. "With the large and growing diversity of cultures in the United States culturally competent research of the type proposed by NCCC's Dr. Nguyen is critical to solving the nation's healthcare disparity crisis."