How the Colorectal Cancer Control Program Increases Screening

Colorectal cancer (cancer of the colon and rectum) is a leading cause of cancer death in the United States. But it doesn’t have to be.

Screening tests can find precancerous polyps—abnormal growths in the colon or rectum—so they can be removed during the test, before they turn into cancer. Screening also helps find colorectal cancer early, when treatment works best.

But people are not getting screened for colorectal cancer as often as recommended, if at all. Many adults are not up-to-date with colorectal cancer screening using any of the recommended tests—regardless of whether they have health insurance.

CDC’s Colorectal Cancer Control Program (CRCCP) works with clinics, hospitals, and other health care organizations to use and strengthen strategies that have been shown to increase screening (called evidence-based interventions). CRCCP focuses on increasing screening among people ages 45 to 75 within clinics that serve individuals with lower incomes and where fewer than 60% of patients are up-to-date on screening.

CRCCP collects and uses data to determine whether the program increases screening, and if so, by how much, where, and for which groups. These data guide plans for prevention and early detection.

Implementing Evidence-Based Interventions

CRCCP uses strategies recommended by the Guide to Community Preventive Services focusing on four activities in partner clinics—

Provider Assessment and Feedback

Physicians are the most trusted and preferred source of colorectal cancer information. To make the best use of this resource, these strategies look at how doctors and other health care professionals offer screening to patients. Feedback is then given to these health care providers. Examples include—

Within a clinic, looking at health care providers’ history of recommending appropriate screening and telling providers how they are doing in comparison to other providers.
Among multiple clinics, looking at the percentage of patients who are screened according to recommendations and publishing results compared to a screening goal.

Provider Reminders

Reminders inform health care providers when it’s time for a patient’s screening test, or that the patient is overdue for screening. Reminders can be delivered via e-mail or by—

Using the reminder function in an electronic health record (EHR). Reminders could include the recommendations for colorectal cancer screening.
Creating a system that places clearly visible reminders on paper charts before an office visit.

Patient Reminders

Patient reminders are written (letter, postcard, e-mail, text message) or telephone messages telling patients that they are due for screening. A provider might use the EHR to support this strategy and track responses.

Removing Structural Barriers for Patients

Preventing colorectal cancer saves lives and money.

Patients: Reduces lost wages.
Employers: Lowers health care costs, absenteeism, and costs of hiring and training new workers.
Insurers: Helps avoid high costs associated with late-stage colorectal cancer treatment.

Structural barriers are problems other than money that make it hard for people to get screened. Strategies that reduce these barriers may include—