Data Transparency Measure:
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.
UDS Definition 2017
Denominator (Universe) :
- Patients 50 through 75 years of age with a medical visit during the measurement period
Note: Include patients born on or after January 1, 1942, and on or before December 31, 1966
- Patients with one or more screenings for colorectal cancer. Appropriate screenings are defined by any one of the following criteria: Fecal occult blood test (FOBT), including fecal immunochemical test (FIT), during the measurement period
- Flexible sigmoidoscopy during the measurement period or the four years prior to the measurement period
- Colonoscopy during the measurement period or the nine years prior to the measurement period
- Denominator Patients with a diagnosis of colorectal cancer or a past history of total colectomy
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.
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:
- Watch this webinar on creating effective patient and provider reminder systems - https://youtu.be/kJXN-VKpZsw
- Patient Education Material and Outreach - Love Your Butt
- Steps for Increasing Colorectal Cancer Screening Rates: A Manual for Community Health Centers
- National Colorectal Cancer Roundtable: Tools and Resources
- American Cancer Society - ColonMD: Clinicians' Information Source
For more information on this measure, refer to the links below:
|CRC Procedures - Central City Concern||2018-01-31||548.64 KB||12|
|Colorectal Cancer Screening Interventions: Health Disparities and Engaging Hard to Reach Populations - Supplemental from Learning & Sharing Session - Sept. 2017||2017-09-21||8.19 MB||65|
|Learning & Sharing Session: Colorectal Cancer Screening Interventions: Health Disparities and Engaging Hard to Reach Populations - Sept. 2017||2017-09-21||2.32 MB||84|
|Team-based Care and CRC - Supplemental from QMIC - Jul. 2017||2017-07-24||7.52 MB||139|
|QMIC: Team-based Care: Building Care Teams that Deliver on Health Outcomes - Jul. 2017||2017-07-24||2.41 MB||143|
|QMIC: Part II: How to Roll Out an Effective Screening Program, No Matter What the Measure - Oct. 2016||2016-12-28||1.95 MB||289|
|Data/QI Review Call: Learnings from STOP CRC - Jun. 2016||2016-12-28||1.08 MB||287|
|CRC Shared Decision Making Tools - OHSU Family Medicine at South Waterfront||2017-01-07||1.93 MB||293|
|Patient and Provider Reminder Systems for Colorectal Cancer Screening - Apr. 2016||2016-04-11||2.31 MB||563|
|Learning & Sharing Session: Working with your CCO and Community Partners to Improve CRC Screening Rates - Feb. 2016||2016-02-29||2.48 MB||357|
|CRC Policies and Procedures Examples||2017-01-07||1.7 MB||267|
|QMIC: Colorectal Cancer Screening Policies and Procedures - Jan. 2016||2016-01-27||1.19 MB||497|
|Learning & Sharing Session: Colorectal Cancer Screening - Aug. 2015||2015-10-22||2.69 MB||845|
|Data/QI Review Call: CRC Presentation - Feb. 2015||2015-05-23||985.73 KB||561|