The American Journal of GASTROENTEROLOGY VOLUME 106 | NOVEMBER 2011 www.amjgastro.com nature publishing group THE RED SECTION 1880 Introduction Over the past three decades, mortality due to colorectal cancer (CRC) has decreased in the United States, yet racial disparities in incidence and mortality between blacks and whites have increased (1). According to national data, the 2000 CRC incidence was 55 per 100,000 among whites, compared with 61 per 100,000 among blacks (2). By 2006, incidence had dropped for both groups, but the ratio of incident cases among blacks compared with whites increased from 1.12 in 2000 to 1.19 in 2006, and the mortality rate ratio increased from 1.40 to 1.46 (2). Te widening of mortality disparities might be due to diferences in the frequency and time- liness of CRC screening (3). A recent report by the Centers for Disease Control and Prevention showed that whites had higher rates of CRC screening than all other racial groups in 2006 (4), despite the fact that CRC screening has been increasing nationally since 2000 (5). An analysis of colonoscopy screening practices in New York City (NYC) in 2003 demonstrated signifcant disparities in colo- noscopy screening among racial and ethnic groups, as well as by income and insurance status (6). At that time, nearly half of non- Hispanic whites (48%) had received a colonoscopy in the past 10 years, compared with 38% of non-Hispanic blacks and 29% of His- panics (6). Similarly, New Yorkers with household incomes below $25,000 had a colonoscopy screening rate of 34%, vs. 59% among Increased Screening Colonoscopy Rates and Reduced Racial Disparities in the New York Citywide Campaign: An Urban Model Catherine A. Richards, MPH 1 , Bonnie D. Kerker, PhD 2 , Lorna Torpe, PhD 3 , Carolyn Olson, MPH 2 , Marian S. Krauskopf, MS 4 , Lynn S. Silver, MD, MPH 4 , Tomas K. Weber, MD 5 and Sidney J. Winawer, MD 6 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. Am J Gastroenterol 2011;106:1880–1886; doi:10.1038/ajg.2011.191 1 Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA; 2 Division of Epidemiology, New York City Department of Health and Mental Hygiene, New York, New York, USA; 3 Epidemiology and Biostatistics Program, City University of New York School of Public Health at Hunter College, New York, New York, USA; 4 Division of Health Promotion and Disease Prevention, New York City Department of Health and Mental Hygiene, New York, New York, USA; 5 Department of Surgery, State University of New York Health Sciences Center Brooklyn and Veterans Affairs Medical Center, New York, New York, USA; 6 Gastroenterology and Nutrition Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York, USA. Correspondence: Bonnie D. Kerker, PhD, Bureau of Epidemiology Services, NYC Department of Health and Mental Hygiene, 125 Worth Street, Room 315, CN 6, New York, New York 10013, USA. E-mail: bkerker@health.nyc.gov