Increased screening colonoscopy rates and reduced racial disparities in the New York citywide campaign: An urban model
Increased screening colonoscopy rates and reduced racial disparities in the New York citywide campaign: An urban model
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DOI：
10.1038/ajg.2011.191
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发表时间：
2011-11-01
影响因子：
9.8
通讯作者：
Winawer, Sidney J.
中科院分区：
文献类型：
--
作者：
Richards, Catherine A.;Kerker, Bonnie D.;Winawer, Sidney J.
目的：2003年，针对纽约市结肠镜筛查的低筛查率和显著的社会人口学差异，纽约市卫生和精神卫生部门与全市结肠癌控制联盟一起发起了一项多方面的运动，以增加筛查。我们评估了2003至2007年间，50岁及以上的纽约成年人的结肠镜检查趋势，这是这项活动的前五年。方法：数据来自纽约市社区健康调查，这是一项针对纽约人的年度人口监测。计算了报告及时进行结肠镜检查的成年人的年度患病率估计，其中一次是在过去10年内进行的。结果：总体而言，从2003年到2007年，50岁及以上的纽约人报告及时进行结肠镜检查的比例从41.7%增加到61.7%。2003年观察到的种族/民族和性别差异在2007年消除：非西班牙裔白人、非西班牙裔黑人、西班牙裔、男性和女性的结肠镜检查及时率相似。然而，亚洲人、没有保险的人以及教育程度和收入较低的人在及时接受结肠镜检查方面仍然滞后。结论：在纽约市观察到的结肠镜筛查比率的增加和种族/民族差异的减少表明，多方面、协调的城市运动可以改善临床预防卫生服务的低利用率，减少公共卫生差异。
Objectives: In 2003, in response to low colonoscopy screening rates and significant sociodemographic disparities in colonoscopy screening in New York City (NYC) the NYC Department of Health and Mental Hygiene, together with the Citywide Colon Cancer Control Coalition, launched a multifaceted campaign to increase screening. We evaluated colonoscopy trends among adult New Yorkers aged 50 years and older between 2003 and 2007, the first five years of this campaign.Methods: Data were analyzed from the NYC Community Health Survey, an annual, population-based surveillance of New Yorkers. Annual prevalence estimates of adults who reported a timely colonoscopy, one within the past 10 years, were calculated. Multivariate models were used to analyze changes over time in associations between colonoscopy screening and sociodemographic characteristics.Results: Overall, from 2003 to 2007 the proportion of New Yorkers aged 50 years and older who reported timely colonoscopy screening increased from 41.7% to 61.7%. Racial/ethnic and sex disparities observed in 2003 were eliminated by 2007: prevalence of timely colonoscopy was similar among non-Hispanic whites, Non-Hispanic blacks, Hispanics, men, and women. However, Asians, the uninsured, and those with lower education and income continued to lag in receipt of timely colonoscopies.Conclusions: The increased screening colonoscopy rate and reduction of racial/ethnic disparities observed in NYC suggest that multifaceted, coordinated urban campaigns can improve low utilization of clinical preventive health services and reduce public-health disparities.