Field Strategies To Increase Colorectal Cancer Screening And Promote Colorectal Cancer Health Equity In Communities Across The US – January 24, 2023

This webinar was a repeat of one of our most highly rated concurrent sessions from the NCCRT 2022 Annual Meeting. The purpose of the webinar was to offer fresh ideas and strategies by learning from three community-facing health systems that are utilizing various tools to establish, implement, and advance colorectal cancer screening interventions that are tailored for the populations they serve. 

Speakers:

  • Moderator: Annie Thibault, Director, Colorectal Cancer Prevention Network
  • Tiffany Taylor, MBA, FACHE, Ambulatory Administrative Director, Department of Family Medicine, Charleston Area Medical Center
  • Einas Batarseh, MD, MPH, Chief Resident Internal Medicine/Preventive Medicine – PGY 4, University at Buffalo, the State University of New York
  • Koosh Desai, MD, Assistant Clinical Professor of Medicine, Curriculum Director, SWGA Campus, Medical College of Georgia, Augusta University

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.

Learn More

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.  

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

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

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

 

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. 

Mailed FIT Implementation Guide

The Mailed FIT Implementation Guide provides a roadmap for how health systems and other entities can design and carry out mailed fecal immunochemical test (FIT) outreach programs, including information on key partnerships and what to have in place before launching a program. The guide was produced in partnership with the National Association of Chronic Disease Directors, the Kaiser Permanente Center for Health Research, and supported by the Centers for Disease Control and Prevention. 

The goal of this guide is to provide clinic and health system administrators and staff with the information needed to make informed decisions and successfully implement an outreach program. The guide details the process for planning and implementing an outreach program by addressing: Prerequisites (Technical Resources & Capacity); Getting Ready; Selecting a FIT; Executing a Mailed FIT Outreach Program; and Sustaining the Program. It also includes a section of mailed FIT references and resources.

Evaluation: The evidence provided in the Mailed FIT Implementation Guide is based on two recent primary sources. The first source is the five-year STOP CRC pragmatic trial of mailed FIT outreach in federally qualified health centers (2013-2018), which investigated whether the use of mailed FIT outreach, together with follow-up colonoscopy for abnormal FIT results, could increase CRC screening rates above those obtained with the usual care approach of opportunistic screening within 26 federally qualified community health center clinics in Oregon and California. The findings showed a significant improvement in CRC screening rates and an overall FIT return rate of 21%. The second source of evidence is from the 2019 CDC-sponsored and NACDD hosted Mailed FIT Summit, which included subject matter experts and stakeholders from across the nation. An accompanying journal article published in CA: A Cancer Journal for Clinicians described the Summit goals, process, and findings in detail.

Permissions: Made publicly available online by the National Association of Chronic Disease Directors.

Publication date: Published October 2021, last revised June 14, 2022

Post date: August 22, 2022

Contact: Please send comments or questions to Lorrie Graaf (lgraaf_ic@chronicdisease.org) or Dawn Wiatrek (dwiatrek_ic@chronicdisease.org).

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

How Can Women’s Health Providers Save More Lives from Colorectal Cancer?

This newly updated brief shares how women’s health providers can help advance the shared goal to reach colorectal cancer screening rates of 80% and higher in adults ages 45 and older.

NCCRT would like to thank the American College of Obstetricians and Gynecologists for supporting the development of this resource, and for their longtime commitment to advancing colorectal cancer screening as an NCCRT member. 

 

 

The Dos and Don’ts of Colorectal Cancer Screening

This newly updated one-page flyer may be used to remind clinicians about some of the dos and don’ts when it comes to colorectal cancer screening. Partners have the option to cobrand the flyer with their organization’s logo. Contact your local American Cancer Society to learn more.

The flyer was updated in March 2022 to reflect the colorectal cancer screening starting age of 45 for average risk patients. Partners have the option to use one of two versions in 2022:

  • Age 45: This version references the starting age of 45 with no caveats (for health systems and health plans that are already covering screening at age 45 for all patients). 
  • Age 45 with 2023 caveat: This version references the starting age of 45 and includes an asterisk that explains that some health plans will not be required to follow the May 2021 USPSTF recommendation that lowered the age from 50 to 45 until 2023 (for health systems and health plans serving patients that may not yet have coverage for screening at age 45). 

NCCRT Learning Center

The NCCRT Learning Center is a digital learning platform which features courses, tools, and other resources on colorectal cancer screening delivery and research. Current educational offerings include:

  • The Colonoscopy Needs Calculator—This tool estimates the number of colonoscopies your practice can realistically anticipate with a high-quality stool-based colorectal cancer screening program based on various screening rate goals and other data inputs. It also provides an estimation of what the total colonoscopy need would cost a system as well as a comparison between the costs of treating cancer and costs of providing colonoscopies.
  • The Communications Education Portal—This course houses our suite of market research findings on the unscreened for colorectal cancer and messaging recommendations to more effectively develop communication campaigns and resources for unscreened populations. Learners can peruse the market research findings from start to finish or jump in to find just what you need to educate, empower, and mobilize those who are not getting screened for colorectal cancer.

We plan to populate the NCCRT Learning Center with additional tools and learning modules over time. Users can create an account to track your progress, learn when new content is released, and access more courses as they become available.

 

2021 USPSTF Colorectal Cancer Screening Recommendation Lowers Screening Age from 50 to 45: Implications for NCCRT Partners – June 7, 2021

On May 18, 2021, the United States Preventive Services Task Force (USPSTF) released a final Recommendation, Evidence Summary, and Modeling Study on screening for colorectal cancer. The primary difference from the previous 2016 recommendation is that average risk adults are now recommended to start screening at age 45, in alignment with the American Cancer Society’s 2018 recommendation.

During this NCCRT webinar, a panel of expert speakers discussed:

  • What changed in the new recommendation? And what data informed the decision to lower the screening age to 45?
  • How does the new recommendation impact insurance coverage and what is the timeline?
  • When will the new guideline be reflected in colorectal cancer screening quality measures and national screening rate indicators?
  • What data do we have on screening in 45-49 year olds and what do we know about them?
  • The experiences of one state (Indiana) that began implementing screening at age 45 statewide following legislation to lower the screening age in 2019.

Speakers:

  • Heather Dacus, DO, MPH; Director, Bureau of Cancer Prevention and Control, NYS Department of Health; NCCRT Policy Action Strategic Priority Team Co-chair (Moderator)
  • Robert Smith, PHD; Senior Vice President, Cancer Screening; American Cancer Society; NCCRT Co-chair
  • Anna Schwamlein Howard; Principal, Policy Development, Access to and Quality of Care; American Cancer Society Cancer Action Network
  • Sepheen Byron; Assistant Vice President of Performance Measurement, the National Committee for Quality Assurance 
  • Stacey Fedewa, PhD; Scientific Director, Screening and Risk Factors Surveillance; American Cancer Society
  • Bryan Hannon; Regional Government Relations Director; American Cancer Society Cancer Action Network

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. 

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: