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. 
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.
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    
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

 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 .