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:

Note: We are not able to share the webinar recording at this time since some of the presentations contain unpublished data, but we will post the recording to this webpage as soon as we have permission to do so. 

Webinar – What Do The Data Tell Us: What Can We Learn From The Latest Colorectal Cancer Screening Rate Trends Over Time? –  January 30, 2020

This webinar provided a look at the latest data that informs how we are doing as a nation with our efforts to reach an 80% colorectal cancer screening rate. The webinar included a review of the key colorectal cancer screening data sets: BRFSS, NHIS, HEDIS, and UDS. Participants heard from experts as they gave an update on where we are progressing and where we still need to focus, to help inform your work ahead. (Note: this webinar was a repeat of a panel that was hosted at the 2019 NCCRT Annual Meeting.)


  • Djenaba A. Joseph, MD, MPH, Medical Director, Colorectal Cancer Control Program, Centers for Disease Control and Prevention
  • Stacey Fedewa, Senior Principal Scientist, Surveillance Research, American Cancer Society, Inc.
  • Mary Barton, MD, MPP, Vice President, Performance Measurement, National Committee for Quality Assurance
  • Minh Nguyen, Pharm D, MPH, Public Health Analyst, Health Resources and Services Administration

Colorectal Cancer Screening and Risk Assessment Workflow and Documentation Guide for Health Center NextGen Users

This Guide provides focused documentation to assist users of NextGen software to improve the process of assessing, documenting, tracking, and following up on colorectal cancer screening. The Guide gives particular attention to assessment of personal and family risk and the tracking and follow-up of screening results that are not addressed in the standard NextGen guidance documents.

The Guide was initially developed by Harbor Health Services in collaboration with the Massachusetts League of Community Health Centers and NACHC, with support from the American Cancer Society. 

Colorectal Cancer Screening State Profiles

The Centers for Disease Control and Prevention’s (CDC’s) Colorectal Cancer Screening State Profiles provide state-specific colorectal cancer screening trends from 2012 through 2016, modeled county-level colorectal cancer screening estimates from 2014, and screening prevalence by race/ethnicity, sex, insurance status, and age group for all for all 50 states, DC, and Puerto Rico.

These profiles can help comprehensive cancer control programs, colorectal cancer control programs, and others with planning interventions and sharing current colorectal cancer screening estimates in their state.

Evaluation: Screening statistics come from CDC’s Behavioral Risk Factor Surveillance System, CDC’s National Center for Health Statistics, and other sources. View the footnotes of the state profiles to learn more.

Permissions: Made publicly available online by the Centers for Disease Control and Prevention, with content provided and maintained by the Division of Cancer Prevention and Control.

Publication date: November 14, 2018

Post date: December 6, 2018

Contact: Send comments, questions, and suggestions to


evaluation toolkit

“The 7-step process is helpful. It is a guide/outline that can be used to ensure that you have developed a great program and the ability to evaluate the effectiveness of your program.”

Evaluation Toolkit, Version 4:

How to Evaluate Activities to Increase CRC Screening and Awareness: Evaluation Toolkit – Now With Case Studies That Include Policy and Systems Change!

This latest version of the evaluation toolkit is intended to help organizations and communities evaluate a wide variety of interventions designed to increase awareness and use of colorectal cancer screening. The toolkit will help you learn the seven basic steps to evaluation, whether you are working to increase community demand for colorectal cancer screening, encouraging health care providers to recommend screenings, or trying to implement policy, systems, or environmental (PSE) changes.This toolkit will provide you with:

  • A basic understanding of evaluation strategies.
  • Tools that you can use and adapt to assess baseline screening rates, or the effectiveness or impact of the intervention.
  • Basic skills to collect outcome data to inform and improve decision-making.
  • Tips for incorporating evaluation results into grant proposals, reports, and other dissemination activities.
  • Practical yet comprehensive evaluation references and resources.

Download this comprehensive resource.

Evaluation Tip Sheets – designed to give you a quick overview of the evaluation process.

Click here to download four separate Evaluation 101 learning modules.  These four pre-recorded webinars are designed to walk you through the evaluation process in greater depth.

New! Guidance on Evaluation 80% by 2018 Messaging

Evaluation Toolkit Update

Evaluation Toolkit Update – June 27, 2017

This webinar introduced the new updates to NCCRT’s evaluation toolkit, How to Evaluate Activities to Increase Colorectal Cancer Screening and Awareness. The webinar walked participants through new features in the toolkit, including how to evaluate provider-focused interventions, as well as policy and systems change interventions. The webinar also reviewed the seven steps to program evaluation through the lens of various colorectal cancer screening interventions, while also highlighting new case studies, tools and templates.


  • Cheryl Holm-Hansen, PhD, Senior Research Manager, Wilder Research
  • Amanda Hane, MS, MA, Research Associate, Wilder Research
  • Heather Dacus, DO, MPH, Director, Bureau of Cancer Prevention and Control (BCPC), New York State Department of Health
  • Heather M. Brandt, PhD, CHES, Associate Professor, Health Promotion, Education, & Behavior, University of South Carolina, Arnold School of Public Health
  • Andrea (Andi) Dwyer, The Colorado School of Public Health, University of Colorado Cancer Center and NCCRT Steering Committee/NCCRT Evaluation & Measurement Task Group Co-Chair

Asian Americans Companion Guide & 2017 Communications Updates

Asian Americans Companion Guide & 2017 Communications Updates – February 9, 2017

This webinar introduced new assets for 80% by 2018 communications work, including the new Asian Americans and Colorectal Cancer Companion Guide, advice on earning earned media, advice on engaging celebrities and tips for evaluating your communications efforts. These topics are covered in three resources to help you promote and evaluate 80% by 2018 communication efforts:


  • Karen E. Kim, MD, MS, University of Chicago
  • Kathleen Lobb, The Entertainment Industry Foundation
  • John Patton, National Association of Chronic Disease Directors
  • Amanda Hane, Amherst H. Wilder Foundation

Guidance on Evaluating 80% by 2018 Messaging

Guidance for Evaluating the Effectiveness and Impact of 80% by 2018 Communications Efforts

This resource provides evaluation guidance for organizations that have adapted the tested messaging and other recommendations presented in the 80% by 2018 Communications Guidebook in their educational and communications efforts. While the messages and recommendations were based on market research, it is important that partners evaluate their own use of the messages to ensure that the messages and delivery channels are having the expected impact and to adapt their strategies if necessary.

FluFIT Program

FluFIT programs increase colorectal cancer screening rates by providing a take home fecal immunochemical test (FIT) to eligible patients when they receive their annual flu shot. Thus, the annual flu shot campaign create an opportunity to reach people who are also due for colorectal screening.

The FluFIT website offers program planning and implementational materials, including staff training, work flows, log sheets, sample reminder letters, and sample telephone call scripts. The site also provides patient educational materials, such as clinic posters, and FIT instructions (both printed materials and videos) in several languages. These materials can help prepare a healthcare team to develop the simple systems needed to implement a FluFIT program and jump start program development.

FluFIT programs have been implemented successfully in a variety of clinical settings. Many FluFIT campaigns are run by nurses, pharmacists, or medical assistants. They can be implemented and sustained with limited resources, are well accepted by patients, and can lead to higher screening rates.

Evaluation: FluFIT is a research-tested program. Visit the Publications section of the website to find research articles and reviews of the FluFIT approach.

Evaluation Assets: The Program Materials section of the website includes a sample FluFIT log sheet and sample FluFIT results tracking sheet.

Permissions: Made publicly available online by the Department of Family and Community Medicine, University of California.

Publication date: 2009; updated in 2017

Post date: September 15, 2017

Contact: Send comments, questions, and suggestions to Michael Potter, MD at

New Hampshire Colorectal Cancer Screening Program Patient Navigation Model Replication Manual

The New Hampshire Colorectal Cancer Screening Program (NHCRCSP) patient navigation model has been highly effective in increasing the completion and quality of colonoscopy screening and surveillance among statewide underserved groups. Patients in this program, all of whom were navigated, were 11 times more likely to complete colonoscopy than non-navigated patients in a comparison group. Given this success, the Centers for Disease Control and Prevention (CDC) and the NHCRCSP worked together to develop a manual to help others replicate the model. The manual includes step-by-step instructions for implementing a screening navigation program, including a detailed navigation protocol, guidance on data collection, navigator training, and sample templates and tools.

Intended Audiences: Any organization that conducts colorectal cancer screening or administers a colonoscopy program may benefit from implementing this intervention. Organizations could include health systems, endoscopy centers, primary care practices (including Federally Qualified Health Centers), universities, state or local health departments, and grantee programs. This manual also may be useful for health care providers, pharmacy staff, and other community partners to clarify their roles in the intervention and how it benefits their patients.

Congratulations to former NCCRT Steering Committee member Dr. Lynn Butterly and to all the others who helped create this resource.

Evaluation: A rigorous evaluation was conducted, including a comparison of NHCRCSP-navigated patients to a similar group of non-navigated patients. Learn more on page 8 and in Appendix D. Evaluation results were also published in the journal Cancer.

Permissions: Made publicly available online through the Centers for Disease Control and Prevention.

Publication date: October 2016

Post date: September 18, 2017

Contact: Send comments, questions, and suggestions to or