Oncology Central

City-wide effort boosts colorectal cancer screening rates and eliminates racial disparities in screening

In 2003, the Citywide Colon Cancer Control Coalition (C5) was formed to improve colorectal cancer (CRC) screening in adults aged 50 years or older. In that time, colonoscopy screening, a common method for detecting CRC, has jumped from 42 to almost 70% in New York City (NYC). This successful public health effort has been outlined in a recently published paper in Cancer [1]. The authors hope that by sharing their techniques, they may help provide a framework for public health initiatives in other urban centres.

Earlier this year, the US National Colorectal Cancer Roundtable rallied behind an initiative to increase nationwide CRC screening rates to 80% by 2018. One model suggests that this could avoid 200,000 CRC deaths in the lead up to 2030 [2].

There is no doubt that the C5 initiative has taken a huge step in the right direction: “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 Steven Itzkowitz, professor of medicine/oncological sciences at Mount Sinai School of Medicine (NY, USA), and senior author on the Cancer paper [3].

With the help of the NYC Department of Health and Mental Hygiene, C5 surveyed 10,000 individuals and identified communities with poor CRC screening [4]. C5 launched educational health programs across a range of languages and mediums to target these groups. The coalition also utilized community health workers, to ensure patients attended their screening sessions. “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,” Sidney Winawer, C5 Coalition advisory committee said in a statement.

Despite this achievement, CRC mortality still differs by race in NYC. There is hope that this difference will be diminished by improving access to treatments. Nonetheless, screening discrepancies between communities still exist elsewhere in the country. As Mary T Basset, Commissioner of NYC’s Health Department stated at the Ninth Annual C5 Summit, “Much has been achieved, Much work remains” [5].

Sources: Itzkowitz SH, Sidney J, Winawer et al. New York Citywide Colon Cancer Control Coalition: A public health effort to increase colon cancer screening and address health disparities. Cancer, DOI: 10.1002/cncr.29595 (2015); Meester RG, Doubeni CA, Zauber AG et al. Public health impact of achieving 80% colorectal cancer screening rates in the United States by 2018. Cancer, DOI: 10.1002/cncr.29336 (2015); Cancer News Room Press release; Thomson Reuters Press Release; 9th Annual C5 Meeting Welcome


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