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

What Can Gastroenterologists & Endoscopists Do To Advance 80% By 2018?

Learn how gastroenterologists and endoscopists 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.

Review the supplement to this brief, Identifying High Risk Patients and Families in Your Practice, for guidance on steps you can take to ensure your patients and their families receive timely and appropriate screening.

Waiving Colonoscopy Co-Pays

Waiving Colonoscopy Co-pays – April 12, 2016

This webinar explained what’s covered with respect to colorectal cancer screening, what’s not covered and how to code for it; provided an update on federal and state efforts to remove cost sharing for colorectal cancer screening; and described a case study in which Gateway Health of Pennsylvania plan removed copays for colonoscopies following positive FIT tests. Learn more about the cost-sharing issue in the brief: The Importance of Waiving Cost-sharing for Follow-up Colonoscopies: Action Steps for Health Plans.


  • Joel Brill, MD, American Gastroenterological Association
  • Caroline Powers, American Cancer Society Cancer Action Network, Inc.
  • Marnie Schilken, MPH, Gateway Health

Links Of Care: Improving Access To Specialists For Community Health Center Patients In The Delivery Of Colorectal Cancer Screening

Links of Care: Improving Access to Specialists for Community Health Center Patients in the Delivery of Colorectal Cancer Screening – August 17, 2015

This webinar examined the common features of model programs that have demonstrated success in delivering colorectal cancer screening and follow-up care to uninsured, underinsured, and low-income adults in their respective communities. Hear directly from leaders of the model programs, who describe elements that were crucial to their success in building strong relationships with gastroenterologists, hospitals and other specialists in the delivery of screening.


  • James Hotz, MD, National Association of Community Health Centers
  • Lynn Butterly, MD, Dartmouth – Hitchcock Medical Center
  • Jason Beers, Operation Access

View the July 27, 2017 webinar update on the Links of Care pilots.