Purpose To examine the policies state governments pursued and enacted across the United States in the 5-year period after the U.S. Food and Drug Administration licensed the human papillomavirus (HPV) vaccine in 2006, including the timing and number of bills introduced, the policies proposed, and the legislative success of HPV vaccine policy proposals.

Background: This study investigated the role of key individual- and community-level determinants to explore persisting racial/ethnic disparities in breast cancer stage at diagnosis in California during 1990 and 2000. Methods. We examined socio-demographic determinants and changes in breast cancer stage at diagnosis in California during 1990 and 2000. In situ, local, regional, and distant diagnoses were examined by individual (age, race/ethnicity, and marital status) and community (income and education by zip code) characteristics. Community variables were constructed using the California Cancer Registry 1990-2000 and the 1990 and 2000 U.S. Census. Results: From 1990 to 2000, there was an overall increase in the percent of in situ diagnoses and a significant decrease in regional and distant diagnoses. Among white and Asian/Pacific Islander women, a significant percent increase was observed for in situ diagnoses, and significant decreases in regional and distant diagnoses. Black women had a significant decrease in distant -stage diagnoses, and Hispanic women showed no significant changes in any diagnosis during this time period. The percent increase of in situ cases diagnosed between 1990 and 2000 was observed even among zip codes with low income and education levels. We also found a significant percent decrease in distant cases for the quartiles with the most poverty and least education. Conclusions: Hispanic women showed the least improvement in breast cancer stage at diagnosis from 1990 to 2000. Breast cancer screening and education programs that target under-served communities, such as the rapidly growing Hispanic population, are needed in California. © 2013 Flores et al.; licensee BioMed Central Ltd.

BACKGROUND: Ethnic minorities, especially African Americans and Latinos, bear a disproportionate burden of colorectal cancer (CRC), as reflected in incidence, cancer stage, and mortality statistics. In all ethnic groups, first-degree relatives (FDRs) of CRC cases are at an elevated disease risk. However, underuse of CRC screening persists and is particularly evident among minority groups. The current study tested a stepped intervention to increase CRC screening among an ethnically diverse sample of FDRs of CRC cases. METHODS: A statewide cancer registry was used to recruit CRC cases and through them their FDRs. Relatives who were not current on CRC screening were randomized to intervention or usual-care control arms. The stepped intervention consisted of ethnically targeted and individually tailored print materials followed by telephone counseling for those unscreened at 6 months. RESULTS: The study sample of 1280 individuals consisted of 403 Latino, 284 African American, 242 Asian, and 351 white FDRs. Statistically significant effects were observed for the cumulative print plus telephone intervention at 12 months (26% in the intervention vs 18% in the control group) and the print intervention alone at 6 months (15% in the intervention vs 10% in the control group). The effect of the print intervention alone versus the cumulative interventions was not statistically significantly different. Stratified analyses indicated that the intervention was effective among white, Latino, and Asian individuals, but not among African-Americans. CONCLUSIONS: Overall, the intervention was effective in increasing screening rates. Oversampling racial/ethnic minorities allowed for the examination of effects within subgroups, revealing no effect among African American individuals. This finding illustrates the importance of including sufficient numbers of participants from diverse ethnic subgroups in intervention research to enable such stratified analyses. Cancer 2015;121:2951-2959.

Introduction: Mixtecs and Zapotecs are indigenous populations from Mexico. Many are unable to read and write, and speak only their native nonwritten languages, Mixteco and Zapoteco. About one-half of California's indigenous farm worker population is estimated to be Mixteco-speaking (82,000-125,000), and about 20,000 Mixtecs and a smaller number of Zapotecs live in Ventura County. Objectives: A community-academic partnership conducted mixed-methods research with the aims of 1) collecting preliminary data on women's health needs, 2) training promotoras to assist with this effort, and 3) engaging community members and obtaining their input through community dialogues. Methods: Promotoras who were bilingual in Spanish and either Mixteco or Zapoteco were trained to conduct surveys that included questions on breast feeding and receipt of breast and cervical cancer screening examinations. Barriers to and facilitators of women obtaining these cancer screening tests were discussed in small groups. Results: In 2013, 813 Mixtec and Zapotec women completed surveys. Although most women reported breast feeding (94%), and receipt of a pelvic examination (85%) and a breast examination (72%), only 44% of women 40years and older had ever heard of and 33% had ever had a mammogram. Community members recommended offering free mammograms on the weekend by female providers, having women accompanied by promotoras who can translate, conducting door-to-door outreach, advertising cancer screening on the radio and providing small incentives to women. Discussion: Trained bilingual promotoras can assist in increasing the capacity of indigenous communities to conduct collaborative research by engaging community members and collecting local data.

Cervical cancer incidence rates vary substantially among racial/ethnic groups in the United States (US) with women of Southeast Asian descent having the highest rates. Up to 70 % of cervical cancers could be prevented by widespread use of the human papillomavirus (HPV) vaccine. However, there is a lack of information about HPV vaccine uptake among Southeast Asian girls in the US. We conducted a telephone survey of Cambodian women with daughters who were age-eligible for HPV vaccination. Survey items addressed HPV vaccination barriers, facilitators and uptake. Our study group included 86 Cambodian mothers who lived in the Seattle metropolitan area. The proportions of survey participants who reported their daughter had initiated and completed the HPV vaccine series were only 29 and 14 %, respectively. Higher levels of vaccine uptake were significantly associated with mothers having heard about the HPV vaccine from a health professional and having received a recent Pap test. Commonly cited barriers to HPV vaccination included lack of knowledge about the HPV vaccine, not having received a physician recommendation for HPV vaccination and thinking the HPV vaccine is unnecessary in the absence of health problems. Linguistically and culturally appropriate HPV educational programs should be developed and implemented in Cambodian American communities. These programs should aim to enhance understanding of disease prevention measures, increase knowledge about the HPV vaccine and empower women to ask their daughter’s doctors for HPV vaccination.