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

Colorectal cancer screening saves lives, yet more than 1 in 3 adults ages 45 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
  • NEW! Added exemplary case studies

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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.


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Sample Facebook & LinkedIn Posts

Colorectal cancer screening is one of the best ways to reduce the risk of colorectal cancer. Utilize the strategies in our Steps Guide to help increase screening rates in patients, and reference the newly added Case Studies to see their impact. https://nccrt.org/StepsGuide #80inEveryCommunity

Primary care clinicians’ use of our Steps Guide can help increase colorectal cancer screening rates in patients. We’re excited to include newly added case studies give insight into the effectiveness of strategies, all to meet the goal of #80inEveryCommunity. Read more: 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

Colorectal cancer screening is one of the best ways to reduce the risk of colorectal cancer. Utilize the strategies in our Steps Guide to help increase screening rates in patients, and reference the newly added Case Studies to see their impact. https://nccrt.org/StepsGuide #80inEveryCommunity

Primary care clinicians’ use of our Steps Guide can help increase colorectal cancer screening rates in patients. We’re excited to include newly added case studies give insight into the effectiveness of strategies, all to meet the goal of #80inEveryCommunity. Read more: https://nccrt.org/StepsGuide  

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 2023 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 2023 edition of the 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 2023 version 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 as well as ten exemplary case studies. 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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March 2023 Colorectal Cancer Awareness Month Webcast

On March 23, 2023, the NCCRT convened over 350 participants at its eighth annual Colorectal Cancer Awareness Month Webcast to celebrate national achievements and to share the latest state of the field updates. Participants heard from Steven Itzkowitz, MD and Robert Smith, PhD, NCCRT co-chairs; Lisa Richardson, MD, MPH, Director, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention; Rebecca Siegel, Senior Scientific Director, Surveillance Research, American Cancer Society; and other special guests. The webcast also featured our 2023 80% in Every Community National Achievement Awards winners.

Following are several relevant links referenced in the webcast:

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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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80% in Every Community Employer Challenge Guide

Employers have the ability to help save lives from colorectal cancer by encouraging their employees to get screened for colorectal cancer and reduce their risk of getting the disease.

This comprehensive guide provides the tools, resources and messaging for them to effectively increase timely, quality colorectal cancer screening in their workforce and be a part of the 80% in Every Community campaign.

Whether you work at a corporation, cancer center, health plan, non-profit, etc., you can find resources to help you ensure colorectal cancer screening is a priority in your workplace. It’s never too earlier to start planning your activities for March, National Colorectal Cancer Awareness Month!

Just getting started? View the short brief, How Can Employers Save More Lives from Colorectal Cancer?, for an introduction to increasing screening in the workplace. 

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2022 Messaging Guidebook for Black & African American People: Messages to Motivate for Colorectal Cancer Screening 

Black and African American people experience disproportionately high incidence and mortality rates from colorectal cancer (CRC), with CRC death rates almost 40% higher than those of white people. While screening is only one element of the work that needs to be done to address these CRC disparities, it is important to promote screening in the best way possible.

The 2022 Messaging Guidebook for Black & African American People: Messages to Motivate for Colorectal Cancer Screening is intended to provide you with information and tools to help you work towards closing disparity gaps by using effective, tailored cancer screening messaging to help motivate people to get screened.

 

Learn More

Background and Goals

The guidebook is a supplement to the 2019 Colorectal Cancer Screening Messaging Guidebook: Recommended Messages to Reach the Unscreened. Based on the 2019 market research findings, the NCCRT and the American Cancer Society set out to gain a deeper understanding of the barriers to screening that Black and African American people face through our market research. The overall goal of the research was to: 

  • Gain a deeper understanding of the barriers to being screened 
  • Understanding healthcare behaviors and perceptions 
  • Understand how systemic racism and social injustice impact the Black community’s experiences within the healthcare system 
  • Uncover different motivators to encourage screening
  • Identify preferred and trusted information sources 
  • Gather reactions to potential messaging and messaging aspects to identify what elements of messaging will be most effective

This guidebook shares the findings and recommendations gathered from that research and is further designed to help educate, empower, and mobilize those not getting screened for colorectal cancer. Our vision is that our partners and advocates in the field use this guidebook to strengthen their communication campaigns and create resources that resonate with Black and African American communities.

View the June 21, 2022 webinar introducing the messaging guidebook.

Additional NCCRT market research and messaging guidance:

Acknowledgement

The NCCRT would like to thank the Public Awareness & Social Media Strategic Priority Team members and Advisory Committee, who generously offered their time and expertise to develop this guidebook’s research and content. We want to extend a special thank you to Quest Diagnostics, the Association of Black Gastroenterologists and Hepatologists, and Elevance Health Foundation for their support and guidance in conducting the market research and developing this guidebook.

Spread the Word

Sample Facebook/LinkedIn Posts

Black and African American adults experience disproportionally higher incidence and mortality rates from colorectal cancer. The National Colorectal Cancer Roundtable’s newly released messaging guidebook provides market-research findings and research-tested messages to encourage unscreened Black and African American adults to seek colorectal cancer screening. https://www.nccrt.org/Black-Messaging-Guidebook  

Only 65% of Black adults aged 50 and older are up to date with potentially life-saving colorectal cancer screening. Download the newly released National Colorectal Cancer Roundtable messaging guidebook to uncover motivators and potential messaging mechanisms to encourage regular colorectal cancer screening among Black and African American adults. https://www.nccrt.org/Black-Messaging-Guidebook

Sample Tweets

Black & African American adults experience disproportionally higher incidence & mortality from #colorectalcancer. This new @NCCRTnews messaging guidebook can help strengthen your communications to promote #CRC screening. https://www.nccrt.org/Black-Messaging-Guidebook #80inEveryCommunity #getscreened

1 in 3 Black adults aged 50+ are not up to date with potentially life-saving #colorectalcancer screening. Download the new @NCCRTnews messaging guidebook for research-tested messages to encourage #CRC screening: https://www.nccrt.org/Black-Messaging-Guidebook #80inEveryCommunity #getscreened

Template Newsletter Blurbs

Brief version:

The National Colorectal Cancer Roundtable’s newly released 2022 Messaging Guidebook for Black & African American People: Messages to Motivate for Colorectal Cancer Screening  highlights new market research focused on identifying barriers to colorectal cancer screening, understanding preferred and trusted sources for receiving healthcare information, and research-tested messages to help encourage unscreened Black and African American people to seek colorectal cancer screening.

Long version:

The National Colorectal Cancer Roundtable’s newly released 2022 Messaging Guidebook for Black & African American People: Messages to Motivate for Colorectal Cancer Screening  highlights new market research focused on identifying barriers to colorectal cancer screening, understanding preferred and trusted sources for receiving healthcare information, and research-tested messages to help encourage unscreened Black and African American people to seek colorectal cancer screening.

Black and African American people experience disproportionately high incidence and mortality rates from colorectal cancer, with colorectal cancer death rates almost 40% higher than those of white people. While screening is only one element of the work to address these colorectal cancer disparities, it is essential to promote screening in the best way possible. This new guidebook is intended to provide recommendations to enhance marketing and communication efforts while providing tools to strengthen communication campaigns that resonate with Black and African American communities. 

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How Can Survivors & Families Save More Lives from Colorectal Cancer?

This newly updated brief shares how survivors and families can help advance the national effort to reach colorectal cancer screening rates of 80% and higher in adults ages 45 and older.

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How Can Employers Save More Lives From Colorectal Cancer?

This newly updated brief shares how employers can help advance the national effort to reach colorectal cancer screening rates of 80% and higher in adults ages 45 and older.

Ready to take your work to increase colorectal cancer screening in the workplace to the next level? Download the NCCRT’s 80% In Every Community Employer Challenge Guide for a comprehensive, step-by-step guide including tools, resources and messaging to effectively increasing timely, quality colorectal cancer screening in the workplace.

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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. 

 

 

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March 2022 Colorectal Cancer Awareness Month Webcast

On March 8th, 2022, the NCCRT convened over 300 attendees at its seventh annual Colorectal Cancer Awareness Month Webcast to celebrate national achievements and to share the latest state of the field updates.

The webcast opened with an overview of the landscape of colorectal cancer screening in 2022, including information on ongoing impacts from COVID and recent policy successes. The program then featured the NCCRT’s six 80% in Every Community National Achievement Award honorees, who shared about their strategies and successes in reaching under-represented communities for colorectal cancer screening and breaking down barriers to screening at both the community and state policy level.

The webinar included leaders thought-leaders and policy experts, including:

  • Steven Itzkowitz, MD, Gastroenterologist and Professor, Icahn School of Medicine at Mount Sinai; NCCRT Chair
  • Robert Smith, PHD; Senior Vice President, Cancer Screening; American Cancer Society; NCCRT Co-chair
  • Lisa Richardson, MD, MPH, Director, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention; NCCRT Steering Committee
  • Donald Moore, CEO, Pueblo Community Health Center, 2022 80% in Every Community National Achievement Award Grand Prize Recipient
  • Linda Thurman-Sanchez, RN, Clinical Programs Nursing Manager, Pueblo Community Health Center, 2022 80% in Every Community National Achievement Award Grand Prize Recipient
  • Keith Winfrey, MD, MPH, CMO, New Orleans East Louisiana Community Health Center; NCCRT Steering Committee; 2019 80% by 2018 National Achievement Award Grand Prize Recipient
  • Shivan Mehta, MD, MBA, Associate Chief Innovation Officer, Penn Medicine; Assistant Professor of Medicine, University of Pennsylvania, 2022 80% in Every Community National Achievement Award Honoree
  • Joseph Ravenell, MD, Associate Professor in the Departments of Population Health and Medicine at NYU Grossman School of Medicine
  • Mia Ackerman, Member, Rhode Island House of Representatives
  • Desiree Berenguer Carton, Director, Regional Integrated Marketing, American Cancer Society Northeast Region (Host)

Following are several relevant links referenced in the webcast:

 

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March 2021 Colorectal Cancer Awareness Month Webcast

On March 16th, 2021, NCCRT hosted a webcast featuring Richard Wender, MD, and Robert Smith, PhD, NCCRT co-chairs; Lisa Richardson, MD, MPH, Director of CDC’s Division of Cancer Prevention and Control; Rebecca Siegel, MPH, Senior Scientific Director, Surveillance Research, American Cancer Society; Folasade May, MD, PhD, MPhil, UCLA Health, our 2021 80% in Every Community National Achievement Awards grand prize honoree; and other special guests. The webcast also featured our 2021 80% in Every Community National Achievement Awards winners.