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

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.

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.

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 ncccpcommunications@cdc.gov.

 

Meeting Report: Increasing Colorectal Cancer Screening for American Indians and Alaska Natives

This post meeting report summarizes the presentations, discussions, and strategic planning that took place during the American Cancer Society and NCCRT co-sponsored meeting to discuss increasing colorectal cancer screening in American Indian and Alaska Native (AI/AN) communities that took place on April 25th, 2016 in Traverse City, Michigan. The report provides an overview of the burden of colorectal cancer among AI/AN, summarizes meeting presentations and discussions, and presents the participants’ collaborative “framework for change” tool that identifies goals, priority tactics, barriers, and potential communities of solution and roles.

Learn more by viewing the webinar replay and slide deck from the November 28, 2017 webinar that explored the opportunities and barriers related to delivering quality colorectal cancer screening and follow-up care in health care settings serving AI/AN communities.

Working with Celebrity Ambassadors

In many instances, the unscreened generally know they need to be screened for colorectal cancer, but for whatever reason, the messages they have received about screening have not been enough to move them to action. In these instances, the challenge for the public health community is going beyond providing a rational message about the need for screening and to instead, engage the unscreened at a more emotional level. Finding someone who is well-known — a “celebrity” — to deliver the message is one way to do that.

Mapping 80% by 2018 Progress by State

NCCRT Evaluation and Measurement Task Group co-chair Ann G. Zauber, PhD, researcher at Memorial Sloan Kettering, presented a poster describing 80% by 2018 progress to date at the annual Digestive Disease Week Conference in San Diego in May 2016.

The poster illustrates the progress of the 80% by 2018 initiative by comparing the number needed to screen to reach 80% by 2018 in each state with the number of pledges received in each state.

Citation: Zauber, AG, Meester, RG, Fedewa, S et al. (2016, May). The National Colorectal Cancer Roundtable Campaign to Screen 80% for Colorectal Cancer by 2018: Mapping Progress by State to Focus Screening Effort. Poster presented at the Digestive Disease Week conference, San Diego, CA.

80% by 2018 Impact on Lives Saved by State

Researchers estimate that achieving 80% by 2018 would prevent 277,000 new cases and 203,000 deaths from colon cancer by 2030. A paper published last year calculated the number needing to be screened to achieve 80% by 2018 by state. Researchers have now communicated the estimated number of new colon cancer cases and deaths that would be avoided in each state by 2030.

elected officials

What Can Elected Officials Do To Advance 80% By 2018?

Learn how mayors, governors, and state legislators can be part of the national effort to make sure 80% of adults ages 50 and older are regularly screened for colorectal cancer by 2018.

Email Citseko.staples@cancer.org for a copy of ACS CAN’s 80% by 2018 documents for state or local policy makers.

Study on Medicaid Expansion and Access

A study released by the American Cancer Society Cancer Action Network (ACS CAN) and the NCCRT estimates that in 2017 over 2.7 million low-income men and women aged 50-64 will remain uninsured and continue to lack access to an affordable health care coverage option, including colorectal cancer screening services.

The report, Health Reform and the Implications for Cancer Screening, provides national and state-specific estimates of the number of uninsured men and women in 2017 based on three scenarios: Medicaid expansion decisions as of April 2015, no state Medicaid expansions, and if all states expand Medicaid. Read the ACS CAN report summary.

Many thanks to our partners at ACS CAN for developing the report, and to NCCRT’s Policy Action Task Group members Barry Berger, Joel Brill, Heather Dacus and Holly Wolf for generously sharing their expertise in the review process.