Colorectal cancer screening among the homeless population of New York City shelter-based clinics

Ramin Asgary, Victoria Garland, Andrea Jakubowski, Blanca Sckell

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objectives. We determined colorectal cancer (CRC) screening rates, predictors, and barriers in 2 major New York City shelter-based clinics. Methods. We extracted screening rates, sociodemographic characteristics, and factors associated with homelessness from medical records of domiciled and homeless patients aged 50 years and older (n = 443) with at least 3 clinic visits between 2010 and 2012. Results. The majority of patients were African American or Hispanic, 76% were male, and 60.7% were homeless (mean = 2.4 years; SD = 2.8 years). Domiciled patients were more likely than homeless patients to be screened (41.3% vs 19.7%; P < .001). Homeless and domiciled patients received equal provider counseling, but more homeless patients declined screening (P < .001). In logistic regression, gender, race, duration of homelessness, insurance status, substance and alcohol abuse, chronic diseases, and mental health were not associated with screening, but housing, provider counseling, and older age were. Conclusions. Proposed interventions to improve CRC screening include respite shelter rooms for colonoscopy prepping, patient navigators to help navigate the health system and accompany patients to and from the procedure, counseling at all clinical encounters, and tailored patient education to address misconceptions.

Original languageEnglish (US)
Pages (from-to)1307-1313
Number of pages7
JournalAmerican journal of public health
Volume104
Issue number7
DOIs
StatePublished - Jul 2014
Externally publishedYes

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Early Detection of Cancer
Colorectal Neoplasms
Population
Homeless Persons
Counseling
Patient Navigation
Insurance Coverage
Patient Education
Colonoscopy
Ambulatory Care
Hispanic Americans
African Americans
Alcoholism
Substance-Related Disorders
Medical Records
Mental Health
Chronic Disease
Logistic Models
Health

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Colorectal cancer screening among the homeless population of New York City shelter-based clinics. / Asgary, Ramin; Garland, Victoria; Jakubowski, Andrea; Sckell, Blanca.

In: American journal of public health, Vol. 104, No. 7, 07.2014, p. 1307-1313.

Research output: Contribution to journalArticle

Asgary, Ramin ; Garland, Victoria ; Jakubowski, Andrea ; Sckell, Blanca. / Colorectal cancer screening among the homeless population of New York City shelter-based clinics. In: American journal of public health. 2014 ; Vol. 104, No. 7. pp. 1307-1313.
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