Colonoscopy screening increased by 50 percent in New York City in the past five years, with the biggest increase occurring among minorities.
Much of the improvement is credited to a coalition of doctors, city officials, union workers, and hospital administrators belonging to the New York Citywide Colon Cancer Control Coalition, known as C5.
The Coalition adopted a single colorectal cancer screening recommendation: all people of average risk over the age of 50 have a colonoscopy every ten years. People with a family history or other risk factors would be screened more often.
Funding was available to cover the uninsured.
One factor that led to success was using patient navigators to help patients through each step of the process. The bilingual navigators call patients to remind them of appointments, help them understand preparation for the procedure, and see that they have a ride home after their tests. They now work in all ten city-run hospitals and another six hospitals in New York.
Overall, patient navigators have facilitated nearly 31,000 colonoscopies in the past five years. In their first year, the rates of no-shows for colonoscopies dropped from 67 percent to 10 percent and screening rates tripled.
Rates of people over 50 who have had a colonoscopy rose from 2007 to 2003 from:
- 35 percent of African Americans to 64 percent
- 38 percent of Hispanics to 63.3 percent
- 48 percent of whites to 62.2 percent
- 25 percent of Asians to 53.6 percent
The C5 goal is to have 80 percent of New York City residents over the age of 50 screened with a colonoscopy by 2011.
Information about colonoscopy improvement was announced on June 5, 2008 by Dr. Thomas R. Frieden, New York City Health Commissioner.
SOURCE: Dan Hurley, More People Undergoing Colonoscopy, The New York Times, June 6, 2008.