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1.  Cervical cancer screening and adherence to follow-up among Hispanic women study protocol: a randomized controlled trial to increase the uptake of cervical cancer screening in Hispanic women 
BMC Cancer  2012;12:170.
In the US, Hispanic women have a higher incidence of, and mortality from, cervical cancer than non-Hispanic white women. The reason for this disparity may be attributable to both low rates of screening and poor adherence to recommended diagnostic follow-up after an abnormal Pap test. The 'Cervical Cancer Screening and Adherence to Follow-up Among Hispanic Women' study is a collaboration between a research institution and community partners made up of members from community based organizations, the Yakima Valley Farm Workers Clinic and the Breast, Cervical, and Colon Health Program of the Yakima District . The study will assess the efficacy of two culturally-appropriate, tailored educational programs designed to increase cervical cancer screening among Hispanic women, based in the Yakima Valley, Washington, US.
A parallel randomized-controlled trial of 600 Hispanic women aged 21–64, who are non-compliant with Papanicolau (Pap) test screening guidelines. Participants will be randomized using block randomization to (1) a control arm (usual care); (2) a low-intensity information program, consisting of a Spanish-language video that educates women on the importance of cervical cancer screening; or (3) a high-intensity program consisting of the video plus a ‘promotora’ or lay-community health educator-led, home based intervention to encourage cervical cancer screening. Participants who attend cervical cancer screening, and receive a diagnosis of an abnormal Pap test will be assigned to a patient navigator who will provide support and information to promote adherence to follow-up tests, and any necessary surgery or treatment. Primary endpoint: Participants will be tracked via medical record review at community-based clinics, to identify women who have had a Pap test within 7 months of baseline assessment. Medical record reviewers will be blinded to randomization arm. Secondary endpoint: An evaluation of the patient navigator program as a method to improve adherence and reduce time to follow-up among participants who receive an abnormal Pap test result. An additional secondary endpoint is the cost-effectiveness of the two different intensity intervention programs.
This culturally sensitive intervention aims to increase compliance and adherence to cervical screening in a Hispanic population. If effective, such interventions may reduce incidence of cervical cancer.
Trial registration
PMCID: PMC3407514  PMID: 22559251
Hispanic women; Pap test; Cervical cancer screening; Cancer disparities
2.  Acupuncture For Hot Flashes In Prostate Cancer Patients 
Urology  2010;76(5):1182-1188.
Hot flashes are a common adverse effect of hormonal therapy for prostate cancer. We sought to determine the effect of acupuncture on hot flash frequency and intensity, quality of life, and sleep quality.
Men who had a hot flash score (HFS) > 4 while on androgen deprivation therapy for prostate cancer received acupuncture with electrostimulation biweekly for 4 weeks, then weekly for 6 weeks using a predefined treatment plan. The primary endpoint was a 50% reduction in HFS after 4 weeks of therapy, calculated from the patient daily hot flash diary. Hot flash related quality of life and sleep quality, and biomarkers potentially related to hot flashes, including serotonin, calcitonin gene-related peptide (CGRP), and urinary 5-HIAA were examined.
Twenty-five men were enrolled between 9/2003 and 4/2007; 22 were eligible and evaluable. After four weeks, 9 of 22 patients (41%, 95%CI 21 to 64%) had a > 50% reduction in HFS. Twelve of 22 patients (55%, 95%CI 32 to 76%) met this response definition at any time during the course of therapy. No patients had a significant increase in HFS on therapy. Reduced HFS was associated with improvement in hot flash related quality of life and sleep quality.
Multiple placebo-controlled trials have demonstrated a 25% response rate to placebo treatment for hot flashes. 41% of patients responded by week 4 and 55% overall in this pilot study providing evidence of a potentially meaningful benefit. Further studies of acupuncture for hot flashes in this population are warranted.
PMCID: PMC2928879  PMID: 20494414
prostate cancer; hot flashes; acupuncture; androgen deprivation therapy

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