Colorectal Cancer

Data Transparency Measure:
Colorectal Cancer
What is colorectal cancer?
Colorectal cancer is term used to describe cancer that starts in either the colon or the rectum, although these cancers can be referred to separately as well. The colon and rectum are parts of the gastrointestinal (GI) system, or digestive system, and serve to absorb fluid and form solid waste that later passes through your body. While different parts of the body, the cancer that affects these organs are similar in nature.
Most colorectal cancers begin as a growth, also known as a polyp, that forms on the inner lining of the colon or retcum. Not all polyps are pre-cancerous, but if cancer does form, it can eventually transition into the walls of the colon or recturm. The stage of colorectal cancer is identified by how deeply it has spread into the walls and if it has spread outside the walls. The most common type of colorectal cancer is called adenocarcinomas, which starts in the glands that make mucus to lubricate the colon or rectum. This type of cancer makes up more than 95% of colorectal cancers. 
Facts about colorectal cancer:
The American Cancer Society reports that:
  • About 1.2 million Americans are living with colorectal cancer.
  • Third most common and second deadliest form of cancer in the United States for both men and women.
  • Colorectal cancer affects both men and women, but the risk for women is slightly lower (1 in 23) than for men (1 in 21). 
  • Treatment for colorecal cancer accounts for the second highest medical cost in the United States.
  • Only 39% of colorectal cancer cases are diagnosed at the localized stage. 
  • Incidents of colorectal cancer and death rates have been decreasing for more than 20 years.
Why screen?
Screening and early detection contributes to the decreased rates of colorectal cancer diagnoses and death rates. By screening for colorectal cancer, you can better identify and remove polyps before cancer develops, decect cancer in the early stages of formation and reduce the cost of treating cancer that has developed. According to research conducted by the American Cancer Society, survival rates when diagnosed at the localized state are 90% and signficantly reduce to 13% when diagnosed at the distant state (when the cancer has spread to other parts of the body). 
Common screening methods indluce flexible sigmoidoscopy, colonoscopy, fecal occult blood test (FOBT) and fecal immunochemical test (FIT). There are many barriers to getting patients screened including lack of education among patients at to why it's important/benefits of screening, fear or discomfort among patients, the time and cost of screening, access to screening and lack of clinical systems and workflows to support screening. 
What action can we take as a clinic to improve this measure?
There are many actions you can take to improve this measure, including: 
  • Conduct patient and provider education on the importance of screening and various screening methods
  • Determine your baseline screening rates, choose a test and develop a screening strategy 
  • Conduct PDSA cycles on your screening strategy to ensure effectiveness
  • Identify internal champions and potential partners for improving this measure 
  • Developing effective policies and procedures around colorectal cancer screening processes
  • Create patient and provider reminder and tracking systems for overdue screenings
  • Take a patient-centered approach to screening to reduce fear and discomfort
 Helpful materials for taking action:
For more information on this measure, refer to the links below:
Resources and Tools for Increasing Colorectal Cancer Screening Rates:
Name Date File size Hits    
QMIC: Part II: How to Roll Out an Effective Screening Program, No Matter What the Measure - Oct. 2016 Version:1 2016-12-28 1.95 MB 93
Data/QI Review Call: Learnings from STOP CRC - Jun. 2016 Version:1 2016-12-28 1.08 MB 94
CRC Shared Decision Making Tools - OHSU Family Medicine at South Waterfront Version:1 2017-01-07 1.93 MB 92
Patient and Provider Reminder Systems for Colorectal Cancer Screening - Apr. 2016 Version:1 2016-04-11 2.31 MB 228
Learning & Sharing Session: Working with your CCO and Community Partners to Improve CRC Screening Rates - Feb. 2016 Version:1 2016-02-29 2.48 MB 171
CRC Policies and Procedures Examples Version:1 2017-01-07 1.7 MB 86
QMIC: Colorectal Cancer Screening Policies and Procedures - Jan. 2016 Version:1 2016-01-27 1.19 MB 214
Learning & Sharing Session: Colorectal Cancer Screening - Aug. 2015 Version:1 2015-10-22 2.69 MB 505
Data/QI Review Call: CRC Presentation - Feb. 2015 2015-05-23 985.73 KB 308

 Have an article, workflow, tool or anything else that you would like to share with other clinics about this measure? Email the Data Transparency Team at .