A concerted effort to increase colorectal cancer screening rates led to a dramatic increase in NYC screening colonoscopy rates among average-risk men and women and eliminated racial/ethnic disparities in screening. Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the program may serve as a foundation for other communities to boost cancer screening rates.
Colonoscopies are one of the most effective ways to reduce colorectal cancer incidence and mortality, and there is now a national campaign to reach colorectal cancer screening rates of 80 percent by 2018. While rates are increasing, there continue to be significant differences between states and within states. A report spearheaded by Steven Itzkowitz, MD, and Lina Jandorf, of the Icahn School of Medicine at Mount Sinai, now provides a framework for how communities might learn from a program initiated by the New York City Department of Health and Mental Hygiene to increase screening rates and ensure equal access based on race/ethnicity.
In 2003, an Advisory Committee organized a citywide coalition, called the C5 Coalition (NYC Citywide Colon Cancer Control Coalition) that included physicians, hospitals, ambulatory surgery centers, health care plans, unions, medical societies, and advocacy and survivor groups. Initiatives to increase screening colonoscopy rates, while at the same time targeting communities with the lowest rates, included public education, outreach to health care providers, culturally and linguistically tailored campaigns, and other programs to boost awareness and overcome hurdles to effective screening.
As a result of this concerted effort, the overall screening colonoscopy rate in New York City rose from 42 percent in 2003 to 62 percent in 2007, a rate that was not reached nationally until 2012. Moreover, this was accompanied by a sustained elimination of disparities based on race/ethnicity. "The increased screening rate from 2003 to 2012 translates to 833,000 New Yorkers who have undergone screening colonoscopy and represents an important public health intervention," said Dr. Itzkowitz. In 2014, the screening rate reached nearly 70 percent.