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Meeting Summary – Primary Care Strategy Meeting: Catalyzing Primary Care to Increase Colorectal Cancer Screening 

The NCCRT and the American Cancer Society ACS, supported by the Centers for Disease Control and Prevention CDC and Stand Up to Cancer, held the Primary Care Strategy Meeting: Catalyzing Primary Care to Increase Colorectal Cancer Screening on August 12, 2022. Leading experts and partners met to propose strategies for increasing the uptake of colorectal cancer (CRC) screening in primary care settings. 

This post-meeting summary includes an overview of the current state of CRC screening in the primary care setting, successes in advancing CRC screening in primary care despite ongoing challenges, an overview of NCCRT tools and research available to support primary care clinicians, strategic planning for overcoming prioritized barriers, and the successful partnership between NCCRT and the American Association of Medical Assistance (AAMA). 

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Steps for Increasing Colorectal Cancer Screening Rates: A Manual for Primary Care Practices

Colorectal cancer screening saves lives, yet nearly 1 in 3 adults ages 50 and older is not getting screened as recommended.

Through a step-by-step format, this newly updated manual provides evidence-based, expert-endorsed strategies to improve colorectal cancer screening rates in primary care practices. The 2022 edition includes:

  • An expanded scope to include all primary care settings
  • Current screening guidelines and new screening modalities
  • Expert-endorsed strategies
  • Samples, templates, and tools
  • Updated literature references

As a companion to the new edition, we will release ten extensive case studies from diverse and exemplary clinical practices later this fall.

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Background and Goals

The first edition, published in 2014, was one of the NCCRT’s most popular resources and has been instrumental in helping primary care practices throughout the United States achieve improvements in their colorectal cancer screening rates.  

The goal of this manual is to offer evidence-based, expert-endorsed recommendations for planning and implementing strategies in primary care practices to improve colorectal cancer screening rates. This manual provides a succinct step-by-step guide for primary care teams to improve colorectal cancer screening and outcomes in practice. These simple steps will assist teams to effectively:

  • Agree on and implement an office screening strategy
  • Provide education on appropriate and high-quality screening
  • Help patients to complete timely, recommended screening
  • Track follow-up of screening and results
  • Build networks among primary care, specialty care, and health systems
  • Provide examples of workflows from successful programs

View the NCCRT’s July 25, 2022 Steps Guide update webinar recording and slide set for an introduction to the new edition and testimonials from two primary care clinician champions on how the manual can be used to transform colorectal cancer screening delivery.  

Acknowledgement

The NCCRT would like to thank the numerous people who generously offered their time and expertise to the development of this updated second edition.

NCCRT is especially grateful to the advisory committee, who generously offered their time and expertise to develop this guidebook’s research and content, to HealthEfficient for serving as the lead author on this second edition, and to the Centers for Disease Control and Prevention for their support.

See the Acknowledgements section on page two of the Steps Guide for a comprehensive list of the many contributors.

This publication was supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $825,000 with 100 percent funded by CDC/HHS. 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.


Spread The Word

Sample Facebook & LinkedIn Posts

A primary care clinician recommendation is the most powerful influence on a patient’s decision to get screened for cancer. The National Colorectal Cancer Roundtable’s newly updated Steps Guide is your one-stop-shop for strategies to increase colorectal cancer screening. Get started now at https://nccrt.org/StepsGuide

Timely colorectal cancer screening is more important than ever now that major guidelines recommend screening start at age 45. The National Colorectal Cancer Roundtable’s newly updated Steps Guide provides a succinct step-by-step guide for primary care teams to improve colorectal cancer screening and outcomes in practice. https://nccrt.org/StepsGuide

Colorectal cancer screening saves lives. Learn how you can increase screening rates in primary care with the National Colorectal Cancer Roundtable’s newly updated Steps Guide: https://nccrt.org/StepsGuide

The lifetime risk of developing colorectal cancer is about 1 in 24 for men and 1 in 25 for women, yet nearly 1 in 3 adults ages 50 and older is not getting screened as recommended. The National Colorectal Cancer Roundtable’s newly updated Steps Guide is your one-stop-shop for strategies to increase colorectal cancer screening in your practice. Get started now at https://nccrt.org/StepsGuide

Only 72% of adults aged 50 and older are up to date with potentially life-saving colorectal cancer screening. Download the National Colorectal Cancer Roundtable’s newly updated Steps Guide to find evidence-based, expert-endorsed strategies to improve colorectal cancer screening rates. https://nccrt.org/StepsGuide

Sample Tweets

A primary care clinician recommendation is the most powerful influence on a patient’s decision to get screened for cancer. The newly updated @NCCRTnews Steps Guide is your one-stop-shop for strategies to increase #CRC screening. https://nccrt.org/StepsGuide #80inEveryCommunity

The lifetime risk of developing colorectal cancer is about 1 in 24 for men and 1 in 25 for women. The new @NCCRTnews Steps Guide is your one-stop-shop for strategies to increase #CRC screening. https://nccrt.org/StepsGuide #80inEveryCommunity #GetScreened

Colorectal cancer screening saves lives. Learn how you can increase screening rates in your practice with the new @NCCRTnews Steps Guide: https://nccrt.org/StepsGuide #80inEveryCommunity #GetScreened

Major guidelines recommend people at average risk start colorectal cancer screening at age 45. Download the new @NCCRTnews Steps Guide for a succinct step-by-step guide to increase #CRC screening in primary care. https://nccrt.org/StepsGuide #80inEveryCommunity #GetScreened

Only 72% of adults aged 50+ are up to date with potentially life-saving colorectal cancer screening. Download the @NCCRTnews Steps Guide for evidence-based, expert-endorsed recommendations to improve #CRC screening rates. https://nccrt.org/StepsGuide #80inEveryCommunity #GetScreened

 

Template Newsletter Blurbs

Brief version:

The National Colorectal Cancer Roundtable’s newly released Steps Guide (www.nccrt.org/StepsGuide) provides evidence-based, expert-endorsed strategies to increase colorectal cancer screening rates in primary care. This 2022 edition offers a much-anticipated update to the signature NCCRT resource that has been instrumental in helping primary care practices throughout the United States achieve improvements in delivering potentially life-saving colorectal cancer screening in the communities they serve.

Extended version:

A primary care clinician recommendation is the most powerful influence on a patient’s decision to get screened for cancer. Download the National Colorectal Cancer Roundtable’s newly released Steps for Increasing Colorectal Cancer Screening Rates: A Manual for Primary Care Practices (www.nccrt.org/StepsGuide) to find evidence-based, expert-endorsed strategies to improve colorectal cancer screening rates in primary care. 

This 2022 edition provides a much-anticipated update to the signature NCCRT resource that has been instrumental in helping primary care practices throughout the United States achieve improvements in delivering potentially life-saving colorectal cancer screening in the communities they serve. Timely colorectal cancer screening is more important than ever now that major guidelines recommend screening for people at average risk start at age 45. 

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Webinar – 2022 NCCRT Steps Guide Update – July 25, 2022

This webinar provided an introduction to the 2022 Steps for Increasing Colorectal Cancer Screening Rates: A Manual for Primary Care Practices, an updated second edition to the first edition that was originally published in 2014. The 2022 edition includes the following updates:

  • An expanded scope to include all primary care settings
  • Current screening guidelines and new screening modalities
  • 10 case studies of exemplary practice sites
  • Updated literature references

The first edition was one of the NCCRT’s most popular resources and has been instrumental in helping primary care practices throughout the United States achieve improvements in their colorectal cancer screening rates.  The 2022 edition will be released in August 2022. 

Speakers:

  • Laura Makaroff, DO, Senior Vice President, Prevention and Early Detection, American Cancer Society
  • Keith Winfrey, MD, MPH, FACP, Chief Medical Officer, New Orleans East Louisiana Community Health Center
  • Michelle Tropper, MPH, Director of Clinical Programs, HealthEfficient
  • Frank Colangelo, MD, MS-HQS, FACP, Chief Quality Officer, Premier Medical Associates
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View Additional Course Information

Continuing Education Courses for Healthcare Providers on Colorectal Cancer Screening

To provide up-to-date information on recommended best practices for colorectal cancer screening, the Centers for Disease Control and Prevention (CDC) partnered with Medscape Education to create two continuing education courses for healthcare providers.

In one of these courses, Screening for Colorectal Cancer: Recommended Best Practices (0.5 CME/CNE credits), David Lieberman, MD, of Oregon Health and Science University, leads a video lecture that explains why colorectal cancer screening is important, how to determine the timing and frequency of colorectal cancer screening, recommended stool-based and direct visualization screening strategies, and how to improve screening quality with a programmatic approach and quality metrics.

The second course, CRC Screening and Surveillance: Optimizing Quality (1.0 CME/CNE credits), is a three-part clinical anthology that includes more detail on these topics and explains the role of primary care providers in stool testing and colonoscopy programs.

These free courses are available for continuing education credit. You can create a free Medscape account and view the courses at: https://www.medscape.org/viewarticle/946291  and https://www.medscape.org/viewarticle/945988.

Evaluation: The courses were developed by nationally recognized experts in colorectal cancer screening, including primary care clinicians, gastroenterologists, and epidemiologists.

Permissions: Made publicly available online through Medscape Education.

Publication date: March 15 and 24, 2021.

Post date: March 31, 2021.

Contact: Submit comments, questions, and suggestions via the links on the Medscape Education website. 

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Summary Report on Links of Care Pilot to Increase Colorectal Cancer Screening for Underserved Patients

The newly released report, Report on a Pilot Project to Increase Colorectal Cancer Screening Rates and Ensure Access to Specialty Care for Underserved Patients, provides an overview of the Links of Care pilot project (2015-2017), which implemented evidence-based strategies to increase screening rates and timely access to specialists after abnormal screenings in three Federally Qualified Health Centers (FQHCs). Participating FQHCs successfully increased CRC screening rates by 8-28 percentage points, secured low- or no-cost colonoscopies from specialty care providers, and implemented patient navigation to ensure timely follow-up to diagnostic services. The report outlines key facilitators to success.

Congratulations to the evaluators and authors that contributed to this publication, Lesley Watson, Kara Riehman, Mary Doroshenk, Rentonia Williams, Vonda Evans, Lynn Basilio, Maryanne Goss, and Roshan Paudel, as well as the numerous individuals that contributed to the pilot projects’ success.

The NCCRT Resources Center also includes two webinars that feature findings from the Links of Care pilot projects, including a 2017 webinar and a 2015 webinar. 

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paying for colorectal cancer screening
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Paying for Colorectal Cancer Screening Patient Navigation Toolkit & Interactive Website

The NCCRT and the Colorado School of Public Health have developed this suite of resources that provide practical advice on paying for and sustaining colorectal cancer screening patient navigation to help health care professionals at every stage of a navigation program. The Toolkit (PDF), originally released in 2017, has been updated in 2019, and we’ve also added an interactive website and technical assistance training modules to further support screening navigation.

The toolkit provides practical advice to help professionals at every stage in a variety of settings sustain navigation. The new, interactive website provides an overview of the fundamentals of sustainability with the Toolkit providing additional case studies, resources and support. In addition, for those agencies and organizations who are ready to apply the principles, an assessment and curriculum has been developed to guide agencies in developing their own plans for sustainability. Contact pnsustaincrc@gmail.com for inquiries about the curriculum. 

The content of the toolkit and curriculum developed was drawn from published and public information about patient navigation, as well as the experiences and expertise of the University of Colorado Cancer Center, the Colorado School of Public Health, the NCCRT Patient Navigation Toolkit Advisory Committee, and over 75 people and organizations who shared their time and expertise. Thank you to all who contributed to the toolkit, and special thanks to NCCRT Steering Committee member Andrea (Andi) Dwyer of the Colorado School of Public Health for her vision and leadership in developing this much requested resource.

View the June 27, 2019 webinar release and download the June 27, 2019 webinar slide deck to learn more. 

Watch the January 10, 2017 webinar introducing the original toolkit for more information.

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Innovative Ways To Increase Colorectal Cancer Screening Among The Underserved – February 20, 2018

This webinar was a repeat of one of our most highly rated workshops from the NCCRT meeting last month. The purpose of the webinar was to move beyond describing the challenges of reaching the underserved to showcasing innovative solutions, including using systems change to increase colorectal cancer screening in a multi-ethnic community; providing an example of how local health departments can team up with academics on community engagement; and partnering with emergency departments to reach rural residents who don’t have a primary care provider.

Speakers:

  • Joseph Ravenell, MD, MS, Assistant Professor of Population Health and Medicine; Associate Dean for Diversity Affairs and Inclusion at NYU School of Medicine; NCCRT Steering Committee (Presenter/Moderator)
  • Karen E. Kim, MD, Professor of Medicine, Dean, Faculty Affairs, Associate Director, Cancer Disparities, the University of Chicago Medicine Comprehensive Cancer Center
  • Jenna Hatcher, RN, PhD, MPH, Director of Diversity and Inclusion, University of Kentucky, College of Nursing
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How To Assure Follow Up Colonoscopy For Positive FIT From The Process Side – January 30, 2018

This webinar was a repeat of one of our most highly rated workshops from the NCCRT meeting last month. The purpose of the webinar was to review evidence and processes to help ensure that patients obtain a follow-up colonoscopy after a positive test result.

Speakers:

  • Kevin Selby, MD, Kaiser Permanente Division of Research
  • Amanda Petrik, Kaiser Permanente Center for Health Research
  • Frank Colangelo, MD, FACP, Premier Medical Associates
  • Jason A. Dominitz, MD, MHS, FASGE, AGAF Department of Veterans Affairs

Note:  This webinar will not address access issues. For advice on securing access to colonoscopy, check out our webinars on Links of Care from 2017 and 2015. For more general guidance on implementing FIT screening programs, view this webinar or check out our new resource on stool based testing.

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Additional Q&A

Colorectal Cancer Screening In American Indian & Alaska Native Communities – November 28, 2017

This webinar explored the opportunities and barriers related to delivering quality colorectal cancer screening and follow-up care in health care settings serving American Indian and Alaska Native (AI/AN) communities. The webinar provided a review of basic basic data on colorectal cancer incidence, mortality, and screening rates in AI/AN populations, an overview of the American Cancer Society and the NCCRT’s work to address this issue, and presentations from two AI/AN-serving healthcare systems about their innovative approaches to increasing colorectal cancer screening.

Learn more about the American Cancer Society and the NCCRT’s work to address this issue in the post-meeting report from the April 2016 one-day summit to explore the challenges and potential solutions to improving access to quality colorectal cancer screening in this population.

Speakers:

  • Kris Rhodes, MPH, Chief Executive Officer, American Indian Cancer Foundation (Moderator)
  • Laura Makaroff, DO, Senior Director, Cancer Control Intervention, American Cancer Society, Inc.
  • Jessica Deaton, RN, BSN, Care Manager, Oklahoma City Indian Clinic
  • Richard Mousseau, MS, Director, Community Health Prevention Programs, Great Plains Tribal Chairmen’s Health Board
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best practices handbook for health plans
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“Thank you! This is exactly the type of information health plans need to pass to one another to improve partnership/collaboration, as the consumer will benefit at the end.”

“I really enjoyed that each of the health plans featured in the toolkit highlights a different intervention or opportunity. That gives our partners many approaches to choose from.”

Colorectal Cancer Screening Best Practices Handbook for Health Plans

Health plans have an essential role to play in the effort to screen more Americans for colorectal cancer, particularly given that seven out of 10 people who are unscreened are covered by insurance.

Colorectal Cancer Screening Best Practices Handbook for Health Plans, provides a first-of-its-kind compilation of best practices, case studies, templates and tools, that will kick start or infuse health plans’ efforts to save more lives and prevent more cancers.

To develop the handbook, the NCCRT convened an advisory group of health plan experts and interviewed high-performing health plans to understand what works and what doesn’t when it comes to increasing screening among members. Thank you to the many individuals and organizations who contributed their time and expertise to developing this much requested resource.

In the future, we hope to update this handbook with more case studies from high-performing health plans. If you have a story to share about how your health plan has worked to raise colorectal cancer screening rates, please email nccrt@cancer.org.

NCCRT’s issue brief, The Importance of Waiving Cost-sharing for Follow-up Colonoscopies, provides additional information on the colonoscopy copay issue.

View the March 28, 2017 webinar introducing the Handbook for a guided tour of the best practices, case studies, and templates and tools found within the handbook, and hear from one of the profiled health plans.