A coalition formed by the New York City Department of Health and Mental Hygiene (DOHMH) which included a team from Mount Sinai to increase colorectal cancer screening rates in New York City resulted in a 40 percent increase in screening rates over four years. 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.
A report spearheaded by Steven Itzkowitz, MD, Professor of Medicine/Oncological Sciences at Icahn School of Medicine at Mount Sinai (ISMMS) and Director of the Gastroenterology Fellowship Training Program of The Dr. Henry D. Janowitz Division of Gastroenterology at The Mount Sinai Hospital and Lina Jandorf, Professor of Oncological Sciences at ISMMS, now provides a framework for how communities might learn from a program initiated by DOHMH to increase screening rates and ensure equal access based on race/ethnicity.
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 continues to be significant differences between states and within states.
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 ethnicity.
"The increased screening rates from 2003 to 2012 translates to an additional 833,000 New Yorkers who have undergone screening colonoscopy and represents an important public health intervention," said Dr. Itzkowitz, author of the report. "By making screening accessible and providing high quality screenings, we can reduce the incidence and mortality of colorectal cancer in men and women." In 2014, the screening rate reached nearly 70 percent.
"We know that routine colorectal screenings save lives, and we continue to educate the public of the importance of this," said Jandorf, co-author of the report. "Thanks to our efforts, screening rates have dramatically increased and lives have been saved."
"This Coalition has demonstrated how public agencies and community stakeholders can partner to successfully increase colonoscopy screening and eliminate ethnic disparities in a large urban diverse population," said Sidney Winawer, MD, C5 Coalition advisory committee member and chairman of gastroenterology at Memorial Sloan Kettering Cancer Center.
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