Colon cancer screening practices in New York City, 2003: results of a large random-digit dialed telephone survey.
BACKGROUND
New York City (NYC) has one of the highest concentrations of gastroenterologists in the country, yet only 33% of colorectal cancers in NYC are diagnosed early, and approximately 1500 New Yorkers die from colorectal cancer each year.


METHODS
Using data from a large, local, random-digit dialed telephone survey (n = 9802), the authors of the current study described types of colorectal cancer screening modalities and characteristics of adults undergoing screening within a recommended timeframe. Multivariate analyses were used to examine demographic, behavioral, socioeconomic, and neighborhood-level predictors of screening participation, with particular attention to factors associated with colonoscopy, the recommended screening modality in NYC.


RESULTS
Fifty-five percent of NYC adults aged > or = 50 years reported a recent colorectal cancer screening test, and 42% reported a colonoscopy within the past 10 years. After multiple statistical adjustments, groups with the lowest likelihood of screening were the poor (odds ratio [OR], 0.66; 95% confidence interval [CI], 0.53-0.83) and uninsured (OR, 0.31; 95% CI, 0.20-0.48), as well as Asians (OR, 0.46; 95% CI, 0.29-0. 72), and current smokers (OR, 0.62; 95% CI, 0.50-0.78). Colonoscopy was less frequently reported by non-Hispanic Black New Yorkers and by women; both groups reported higher use of fecal occult blood tests. Less than 10% of adult New Yorkers reported a sigmoidoscopy in the past 5 years.


CONCLUSIONS
Low screening uptake in NYC leaves nearly 1 million New Yorkers, particularly poor and uninsured adults, at risk for undetected colorectal cancer. Colonoscopy screening programs in NYC should address health care and socioeconomic barriers and target racial and ethnic minorities and women.
Thorpe
Lorna E
LE
Division of Epidemiology, New York City Department of Health and Mental Hygiene, New York, New York 10013, USA. lthorpe@health.nyc.gov
Mostashari
Farzad
F
Hajat
Anjum
A
Nash
Denis
D
Karpati
Adam
A
Weber
Thomas
T
Winawer
Sidney
S
Neugut
Alfred I
AI
Awad
Amir
A
Zevallos
Mabel
M
Remy
Prospere
P
Frieden
Thomas
T
D000368:Aged; D003110:Colonic Neoplasms / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009519:New York City / Q000453:epidemiology; D012812:Sigmoidoscopy; D012959:Socioeconomic Factors; D013689:Telephone; D013997:Time Factors