City-Wide Effort Boosts NYC’s Colorectal Cancer Screening Rates and Eliminates Racial Disparities in Screening
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.
This report was supported in part by a grant from the Centers for Disease Control and Prevention.
About the Mount Sinai Health System
The Mount Sinai Health System is an integrated health system committed to providing distinguished care, conducting transformative research, and advancing biomedical education. Structured around seven hospital campuses and a single medical school, the Health System has an extensive ambulatory network and a range of inpatient and outpatient services—from community-based facilities to tertiary and quaternary care.
The System includes approximately 7,100 primary and specialty care physicians; 12 joint-venture ambulatory surgery centers; more than 140 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and 31 affiliated community health centers. Physicians are affiliated with the renowned Icahn School of Medicine at Mount Sinai, which is ranked among the highest in the nation in National Institutes of Health funding per investigator. The Mount Sinai Hospital is in the "Honor Roll" of best hospitals in America, ranked No. 15 nationally in the 2016-2017 "Best Hospitals" issue of U.S. News & World Report. The Mount Sinai Hospital is also ranked as one of the nation's top 20 hospitals in Geriatrics, Gastroenterology/GI Surgery, Cardiology/Heart Surgery, Diabetes/Endocrinology, Nephrology, Neurology/Neurosurgery, and Ear, Nose & Throat, and is in the top 50 in four other specialties. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 10 nationally for Ophthalmology, while Mount Sinai Beth Israel, Mount Sinai St. Luke's, and Mount Sinai West are ranked regionally. Mount Sinai's Kravis Children's Hospital is ranked in seven out of ten pediatric specialties by U.S. News & World Report in "Best Children's Hospitals."