The articles in this supplement were commissioned based on participation in evaluating the Centers for Disease Control and Prevention-funded Colorectal Cancer Screening Demonstration Program.
Delivering colonoscopy screening for low-income populations in Suffolk County
Strategies, outcomes, and benchmarks
Article first published online: 18 JUL 2013
© 2013 American Cancer Society
Special Issue: Comprehensive Evaluation of the Centers for Disease Control and Prevention's Colorectal Cancer Screening Demonstration Program, Supplement to Cancer
Volume 119, Issue Supplement S15, pages 2842–2848, 1 August 2013
How to Cite
Lane, D. S., Messina, C. R., Cavanagh, M. F. and Anderson, J. C. (2013), Delivering colonoscopy screening for low-income populations in Suffolk County. Cancer, 119: 2842–2848. doi: 10.1002/cncr.28160
We also thank all the collaborators of the Stony Brook University Medical Center SCOPE (Suffolk County Preventive Endoscopy) Project, who are listed elsewhere in this supplement.
The opinions or views expressed in this supplement are those of the authors and do not necessarily reflect the opinions or recommendations of the journal editors, the American Cancer Society, John Wiley & Sons Inc, or the Centers for Disease Control and Prevention.
- Issue published online: 18 JUL 2013
- Article first published online: 18 JUL 2013
- Manuscript Accepted: 17 AUG 2012
- Manuscript Revised: 16 AUG 2012
- Manuscript Received: 12 JUL 2012
- colorectal cancer;
- cancer screening;
- underserved populations;
- health care quality
Current and pending legislation provides colorectal cancer screening reimbursement for previously uninsured populations. Colonoscopy is currently the screening method most frequently recommended by physicians for insured patients. The experience of the SCOPE (Suffolk County Preventive Endoscopy) demonstration project (Project SCOPE) at Stony Brook University Medical Center provides a model for delivering colonoscopy screening to low-income populations to meet anticipated increasing demands.
Project SCOPE, based in the Department of Preventive Medicine, featured internal collaboration with the academic medical center's large gastroenterology practice and external collaboration with the Suffolk County Department of Health Services' network of community health centers. Colonoscopies were performed by faculty gastroenterologists or supervised fellows. Measures of colonoscopy performance were compared with quality indicators and differences between faculty and supervised fellows were identified.
During a 40-month screening period, 800 initial colonoscopies were performed. Approximately 21% of women screened were found to have adenomatous polyps compared with 36% of men. Five cancers were detected. The majority of the population screened (70%) were members of minority populations. African American individuals had a higher percentage of proximally located adenomas (78%) compared with white individuals (65%) and Hispanics (49%), based on the location of the most advanced lesion. Hispanic individuals had a 36% lower risk of adenomas compared with white individuals. Performance measures including the percentage of procedures with adequate bowel preparation, cecum reached, scope withdrawal time, and adenoma detection rate met quality benchmarks when performed by either faculty or supervised fellows.
Project SCOPE's operational strategies demonstrated a feasible method for an academic medical center to provide high-quality screening colonoscopy for low-income populations. Cancer 2013;119(15 suppl):2842–8. © 2013 American Cancer Society.