Alatevi, EricJallow, SainabouSchechter, MenachemSey, AlbertOzick, LisaSiba, YahuzaOnaghise, JudeSabbagh, RajaCulpepper-Morgan, JoanBackground Controversy exists as to whether disparities in colorectal cancer (CRC) outcomes in African Americans (AAs) are best resolved by screening at age 45 or by proper use of existing guidelines. In 2004, an aggressive colonoscopy-based CRC screening program was implemented throughout New York City. Our goal was to determine the effect of that program on CRC outcomes in our mostly AA population.Methods CRC cases entered into Harlem Hospital's tumor registry from January 1992 to December 2011 were divided into two cohorts: 1992-2003, the pre-intensive screening era (PSE), and 2004-2011, the intensive screening era (ISE). Each cohort was reviewed for demographics, indication for colonoscopy, tumor location, tumor stage, and mortality. Multivariate analysis was applied to the pooled cohorts to determine factors associated with survival.Results Inclusion criteria were met by 379 patients: 207 PSE and 172 ISE. Racial distribution, gender, age at presentation, and tumor location were not different during the two eras. Over 75% of patients were AA. During the ISE, 84% were insured compared to 34% in the PSE (P<0.0001). Fewer patients died during the ISE (21%) than during the PSE (67%) (P<0.0001). The ISE patients were diagnosed with earlier stages of CRC compared to the PSE. Increased survival was associated with being insured (hazard ratio [HR] 1.91, 95% confidence interval [CI] 1.30-2.81), distal tumors (HR 1.43, 95%CI 1.05-1.95), and being female (HR 1.36, 95%CI 1.01-1.850).Conclusions A multifaceted program reduced CRC outcome disparities in a poor AA community. Aggressive implementation of current colonoscopy screening guidelines still has unrealized potential to reduce CRC mortality disparities in AAs.Keywords Colorectal cancer, screening, colorectal cancer deaths, African AmericansAnn Gastroenterol 2017; 30 (5): 518-525text/htmlapplication/pdfimage/tiffapplication/vnd.openxmlformats-officedocument.wordprocessingml.documenthttp://www.annalsgastro.gr/index.php/annalsgastro/article/view/3280engHellenic Society of Gastroenterology1792-74631108-7471Annals of Gastroenterology; Volume 30, No 5 (2017); 518A decade of improved access to screening is associated with fewer colorectal cancer deaths in African Americans: a single-center retrospective studyinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion2017-08-23Δημοσίευση σε περιοδικόPublication in journalΓαστροεντερολογίαGastroenterologyisi -Gastroenterology & Hepatology covers resources on the anatomy, physiology, biochemistry, and pathology of the digestive system. This category includes specific resources on the prognosis and treatment of digestive diseases; stomach ulcers; metabolic, genetic, infectious and chemically induced diseases of the liver; colitis; diseases of the pancreas and diseases of the rectum.Επιστημονικό άρθροScientific articleΕλληνική Γαστροεντερολογική ΕταιρίαGreek Aggregator OpenArchives.gr | National Documentation Centre (EKT)other