Each year more than 1,500 New Yorkers die of colon cancer, more than 1,200 New York City women die of breast cancer and more than 150 die of cervical cancer (New York City Department of Health and Mental Hygiene, 2004b). Only half of New Yorkers age 50 and older report ever having undergone colon cancer screening via sigmoidoscopy or colonoscopy. One in four women aged 40 and older has not had a mammogram in the past two years, and one in seven women report never having had a Pap smear.
Colon cancer is among the most preventable cancers. Colonoscopy not only prevents colon cancer, but also completely removes pre-cancerous adenomatous polyps and the majority of early-stage cancers before they can spread (Walsh, et al., 2003). Almost all cervical cancer deaths can be prevented through screening and early detection, and breast cancer survival improves with early detection (Centers for Disease Control and Prevention, 1992). Risk for many types of cancer (including colorectal, cervical and breast) is greatly reduced by not smoking, maintaining a healthy diet, and engaging in regular physical activity (Jemal, et al., 2004).
Among the activities in which the DOHMH and its partners are engaged are: (1) expanding colon cancer screening efforts in high-prevalence neighborhoods through partnerships with public hospitals and the American Cancer Society, including community outreach, professional education and public health detailing activities; (2) coordinating citywide resources to expand colon cancer screening capacity, educating the public and health care providers on appropriate colon cancer screening guidelines, and monitoring use of colonoscopy procedures to document the increase in utilization; (3) promoting free or low-cost colon, breast and cervical cancer screenings; (4) implementing media campaigns to increase public awareness of the value of cancer screening; (5) promoting reimbursement policies to increase numbers of colonoscopies performed; (6) examining the feasibility of making outpatient colonoscopy a reportable procedure in order to better monitor citywide performance and capacity; and (7) advocating for full coverage of cancer screenings (i.e., colonoscopies, Pap smears and mammograms) by public and private health insurers.
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