Tailoring Colorectal Cancer Screening Messaging: A Practical Coalition Guide

This resource is targeted at coalition members and leaders who are looking to make highly effective campaigns to increase colorectal cancer (CRC) screening rates in their communities, especially for those hardest to reach. Research shows that tailoring health messaging to a specific community produces greater changes in health behavior, such as CRC screenings. By using this step-by-step guide, coalitions can find practical tips and strategies as well as successful case studies illustrating the process.  

This guide was developed by the ACS NCCRT with funding from the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) cooperative agreement #NU58DP006460. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, CDC/HHS, or the U.S. Government.

ACS NCCRT Blue Star Conversation – September 11, 2023

This Blue Star Conversation features a brief presentation by Daniel Reuland, MD, MPH, Professor of Medicine, University of North Carolina School of Medicine; and  Program Director, Carolina Cancer Screening Initiative, UNC Lineberger Comprehensive Cancer Center, on a recent study: Uptake of colorectal cancer screening after mailed fecal immunochemical test (FIT) outreach in a newly eligible 45-49-year-old community health center population. Speakers will also provide updates on trends in colorectal cancer screening in community health centers and recently released resources to support health center work to increase CRC screening, including the Steps For Increasing Colorectal Cancer Screening Rates: A Manual For Primary Care Practices. This program was hosted by the ACS NCCRT Community Health Center Strategic Priority Team. Afterwards, participants discussed greatest barriers and solutions to increasing CRC screening in the newly eligible population. 

Visit NCCRT’s Events & Webinars page to find information about upcoming programs and events.

Key Links:

NCCRT Blue Star Conversation- March 29, 2022

On March 29, 2022, the NCCRT’s Family History & Early-Age Onset CRC (EAOCRC) Strategic Priority Team hosted the NCCRT’s first Blue Star Conversation, a new interactive program for NCCRT members and CDC grantees. The inaugural conversation, What Proportion of Early-Onset Colorectal Cancer is Potentially Preventable Based on Family History and Genetics?, featured Heather Hampel, MS, LGC, of City of Hope National Medical Center and co-chair of the Strategic Priority Team, who presented findings from the recent publication, A High Percentage of Early-age Onset Colorectal Cancer is Potentially Preventable, published in Gastroenterology. This recording features the expert speaker presentation portion of the program followed by a brief recap of the discussion section (the participant breakout discussions have been omitted).  

Visit NCCRT’s Events & Webinars page to find information about upcoming programs and events. 

Following are key takeaways from the presentation: 

  • ACS guidelines could result in an earlier diagnosis for 41.3% of EAOCRC
  • Surveillance guidelines for patients with a First-Degree Relative (FDR) with CRC are more effective without an age requirement
  • Surveillance guidelines for hereditary CRC are more effective than those for FDR only
  • 4% (117/713) of EAOCRC is potentially preventable
  • 9-14% of EAOCRC patients have a FDR with CRC
  • 16% of EAOCRC patients have a mutation in a cancer susceptibility gene

Key takeaways from the breakout room discussions:

  • The importance of lead time messaging to target different age groups (20- 45 year old);
    • Social media strategies
    • Marketing tools
    • Educational materials
    • Sharing best practices
  • The importance of insurance coverage for earlier screening for patients with a family history of CRC
  • The possibility of family history of CRC becoming a reportable HEDIS measure
  • The need to increase genetic testing within rural areas
  • The development of blood-based testing as a screening mechanism for early-onset patients
  • How TeleVideo has bridged the accessibility for cancer genetic counseling

RELEVANT LINKS:

Below are relevant links referenced in the March 29th webinar:

State-by-State Colorectal Cancer Screening Landscape

This resource, developed by Exact Sciences, provides a snapshot of the colorectal cancer screening landscape in each state while also putting into context how the different states compare with each other in a range of areas. While the majority of the information included is publicly available, it is difficult to find all this information in one place. This resource is intended to help people better understand what the CRC screening landscape – from coverage to screening rates to legislation – looks like in each state.

Evaluation: The last slide includes reference links for the included information. This involved considerable time and research across multiple websites and through research from Exact Sciences’ legal team.

Permissions: Made publicly available online by Exact Sciences.

Publication date: November 2019; updated August 2020

Post date: November 3, 2020

Contact: Submit comments, questions, and suggestions to Bryan Goettel: bgoettel@exactsciences.com.

Colorectal Cancer Burden Shifting To Younger Individuals: A Close Look At What The Most Recent Data Tells Us About Colorectal Cancer Incidence, Mortality, And Screening Rates – May 18, 2020

This webinar provided a close look at the findings from Colorectal Cancer Statistics 2020, a recent American Cancer Society publication released on March 5, 2020. According to the report, the burden of colorectal cancer is swiftly shifting to younger individuals as incidence increases in young adults and declines in older age groups. Additional report findings include the median age of diagnosis has dropped from age 72 in 2001-2002 to age 66 during 2015-2016 and half of all new diagnoses in people 66 or younger. The publication is accompanied by a consumer version, Colorectal Cancer Facts & Figures and a press release is also available. Learn about these findings and more in this webinar featuring report lead author Rebecca Siegel, MPH.

Speakers:

  • Rebecca Siegel, MPH, Scientific  Director, Surveillance Research, American Cancer Society, Inc.
  • Robert Smith, PhD, Senior Vice President, Cancer Screening, American Cancer Society, Inc. (Moderator)

Advanced Colorectal Polyp Brief

The National Colorectal Cancer Roundtable created the Advanced Colorectal Polyp GI Brief to help endoscopists and primary care clinicians identify patients with advanced colorectal polyps, understand the epidemiology and associated risk factors, and most importantly know the risks of colorectal neoplasia for patients with advanced colorectal polyps and their first-degree relatives (parents, siblings, children).

This brief aims to:

  1. Remind endoscopists that patients with an advanced colorectal polyp and their close relatives are at increased risk for advanced colorectal polyps and colorectal cancer;
  2. Keep endoscopists up to date with current guidelines; and,
  3. Provide template letters to communicate colonoscopy and pathology results, risk status, and follow-up recommendations for patients and close relatives.

Supplemental template letters: 

Learn more on how gastroenterologists and endoscopists can play a role in the national efforts to improve colorectal cancer screening rates:

2019 Colorectal Cancer Screening Messaging Guidebook: Recommended Messages to Reach the Unscreened

In 2018, the NCCRT and the American Cancer Society researched screened and unscreened populations to better understand and address screening disparities. The goals of the market research were to:

  • Measure general awareness of colorectal cancer screening methods.
  • Understand the rationale, attitudes, and motivations for being screened or not.
  • Analyze priority populations such as adults aged 50-54, rural dwellers, and the marketplace insured.
  • Identify logical and emotional drivers that could encourage screening.
  • Use the drivers to create and test messages that would motivate unscreened individuals.

This guidebook shares the findings and recommendations gathered from that research and is further designed to help in the education, empowerment, and mobilization of those who are not getting screened for colorectal cancer. Our hope is that our partners can take this research and the recommended messaging provided to strengthen your own communications campaigns, creating resources that resonate with the target audiences even more by using your own creativity, innovation and spokespersons.

The NCCRT would like to thank the Public Awareness and Social Media Task Group members who participated in the conceptualization of this Guidebook’s research and content. Also, a very special thank you to the 80% in Every Community Market Research Advisory Group for their participation, expertise, and oversight. 

Other Guides and Resources: 

The Hispanics/Latinos and Colorectal Cancer Companion Guide and Asian Americans and Colorectal Cancer Companion Guide introduce market research about the unscreened from these populations and include tested messages in Spanish and several Asian languages. The 2017 Communications Guidebook is also still a useful resource for developing your messaging campaigns. 

2019 Messaging Guidebook – Table of Contents (Section Downloads Below)

Other tools were developed during the 80% by 2018 campaign and can still help you promote and evaluate your communications:

More communications tools and resources will be coming soon!

 

Prevent Colon Cancer Throughout Your Life Poster

This poster from the Colon Cancer Prevention Project illustrates steps to prevent colorectal cancer throughout the life course.

The poster can be customized to include a local organization logo. See Contact section below for more information on how to use this resource in your own practice, office, or other location.

Evaluation: The content and messaging was developed based on the American Cancer Society’s 2018 Colorectal Cancer Screening Guideline and other evidence-based sources. 

Permissions: Made publicly available online by the Colon Cancer Prevention Project. See Contact section below for more information. 

Publication date: 2018

Post date: December 18, 2018

Contact:For partnership inquiries or for information regarding how you might use this infographic in your own practice, office, or other location, please contact Katie Pilkington at kpilkington@kickingbutt.org.

 

Risk Assessment and Screening Toolkit to Detect Familial, Hereditary, and Early Onset Colorectal Cancer – June 19, 2018

This webinar introduced a new NCCRT resource for primary care providers, Risk Assessment and Screening Toolkit to Detect Familial, Hereditary and Early Onset Colorectal Cancer.  The new toolkit aims to improve the ability of primary care clinicians to systematically collect, document, and act on a family history of CRC and adenomas polyps, while also educating clinicians on the need for more timely diagnostic testing for young adults who present with alarm signs or symptoms of CRC and ensuring that those patients receive a proper diagnostic work up.  Speakers include:

  • Emily Edelman, MS, CGC, Associate Director, Clinical & Continuing Education, The Jackson Laboratory;
  • Dennis Ahnen, MD, Professor Emeritus, University of Colorado School of Medicine, NCCRT Steering Committee, NCCRT Co-Chair Family History and Early Age Onset CRC Task Group;
  • Paul Schroy, MD, MPH,  Professor of Medicine, Boston University School of Medicine, NCCRT Co-Chair Family History and Early Age Onset CRC Task Group;
  • Thomas Weber, MD, Director of Surgical Oncology, Northwest Region at Northwell Health, NCCRT Chair Emeritus, NCCRT Co-Chair Family History and Early Age Onset CRC Task Group. 

 

Risk Assessment And Screening Toolkit To Detect Familial, Hereditary And Early Onset Colorectal Cancer

Limited or inaccurate family history collection and risk assessment is a major barrier to successful cancer screening. Individuals who have a first-degree relative with colorectal cancer (CRC) are at least two times more likely to develop CRC, with the risk increasing with earlier ages of diagnosis and the number of relatives diagnosed with CRC. Therefore, screening and prevention efforts must focus on those with familial or hereditary risk, which requires collecting the necessary family history information for risk assessment. Primary care clinicians play a pivotal role in identifying people at increased CRC risk and facilitating recommended screening.

This new NCCRT toolkit aims to improve the ability of primary care clinicians to systematically collect, document, and act on a family history of CRC and adenomas polyps, while also educating clinicians on the need for more timely diagnostic testing for young adults who present with alarm signs or symptoms of CRC and ensuring that those patients receive a proper diagnostic work up. This toolkit serves as a comprehensive, step-by-step guide to improve operations within practices and suggests many useful resources and tools to aid these changes. 

Companion Quick Start Guide

Accompanying the full toolkit is a short, quick start guide with recommendations on how to ease into the transition process, while still making the critical improvements necessary for successful system-wide implementation. 

Thank you to the outstanding work and guidance provided from the NCCRT Family History and Early Age Onset Colorectal Cancer Task Group and the smaller project advisory group. Also, thank you to the excellent work from our project developers at The Jackson Laboratory.