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Screening for Colorectal Cancer: Optimizing Quality (CME)

Screening for Colorectal Cancer: Optimizing Quality

This continuing education activity provides guidance and tools for clinicians on the optimal ways to implement screening for colorectal cancer to help ensure that patients receive maximum benefit. There are two versions of this course: one for primary care providers and one for clinicians who perform colonoscopy. Continuing education is available for both versions.

Note (June 15, 2016): The U.S. Preventive Services Task Force (USPSTF) released its 2016 Recommendation Statement for colorectal cancer screening, an update of the 2008 USPSTF recommendation.

The new statement highlights the value of screening and the fact that screening is substantially underused in the United States. In the hope that offering greater choice will increase screening uptake, the new USPSTF statement provides clinicians and patients with the evidence about available screening methods to support informed decision making about screening. Available methods include guaiac and immunochemical fecal occult blood tests, flexible sigmoidoscopy, colonoscopy, multi-targeted stool DNA (FIT-DNA), and CT colonography, with different levels of evidence to support their effectiveness and different advantages and limitations.

Minor revisions to the courses will be made shortly to reflect the updated USPSTF recommendation.

Development Team

These CDC-sponsored continuing education courses were developed by a group of nationally recognized experts in colorectal cancer screening, including primary care clinicians, gastroenterologists, and leaders in public health programs and research.

  • Lynn Butterly, MD. Medical Director, New Hampshire Colorectal Cancer Screening Program; Director of Colorectal Cancer Screening at Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
  • Diane Dwyer, MD. Former Medical Director, Center for Cancer Prevention and Control, Prevention and Health Promotion Administration, Maryland Department of Health and Mental Hygiene, Baltimore, Maryland.
  • David Lieberman, MD. Professor of Medicine and Chief, Division of Gastroenterology and Hepatology, Oregon Health and Science University, Portland, Oregon.
  • Marion Nadel, PhD. Senior Epidemiologist, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Michael B. Potter, MD. Professor, Department of Family and Community Medicine, University of California, San Francisco, California.
  • Paul C. Schroy, MD, MPH. Professor of Medicine, Boston University School of Medicine, Boston, Massachusetts.
  • Jean Shapiro, PhD. Epidemiologist, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Richard Wender, MD. Chief Cancer Control Officer, American Cancer Society, Atlanta Georgia, and Professor, Family and Community Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania.

Primary Care Version (WD2433)

Watch the videos on YouTube:

Part 1Part 2Part 3

Links to the presentations:
To save them on your computer, right-click on the link and select “Save Link As” or “Save Target As.”

Part 1 [PDF-1MB]
Part 2 [PDF-661KB]
Part 3 [PDF-1.5MB]

It may be helpful to print the presentations for reference during and after viewing the videos.

The primary care version is intended for primary care physicians, nurses, and other health professionals.

At the conclusion of this course, learners will be able to—

  1. Explain the importance of offering both stool blood testing and colonoscopy as colorectal cancer screening options.
  2. Select appropriate colorectal cancer testing for each patient, consistent with screening and surveillance guidelines for different population subgroups.
  3. Identify the elements of a high-quality stool blood testing program.
  4. Identify the characteristics of high-quality colonoscopy services.

This three-part course provides: 2.25 CME, 2.0 CNE, or 0.2 CEU.

Part 1 includes—

  • Basic information about colorectal cancer and screening.
  • Factors that affect when and how patients should be screened.
  • Detailed screening and surveillance guidelines based on personal and family history.

Part 2 focuses on—

  • Why stool blood testing should be offered to patients.
  • The elements of high-quality stool testing, such as—
    • Selecting an effective test.
    • Identifying eligible patients.
    • Communicating with patients effectively.
    • High-quality test handling and processing.
    • Ensuring high test completion rates and follow-up after abnormal test results.

Part 3 describes the role of the primary care provider in delivering high-quality colonoscopy, such as—

  • Pre-procedure risk assessment.
  • Safety issues to report to the endoscopist.
  • Guidance on bowel preparation and sedation.
  • Interpreting the endoscopy report.
  • Appropriate follow-up for incomplete exams.
  • Questions to ask the endoscopist to be sure he or she is providing high-quality exams.

Presenters

Parts 1 and 2 are narrated by Richard Wender, MD, Chief Cancer Control Officer of the American Cancer Society (ACS), Professor of Family and Community Medicine at Thomas Jefferson University in Philadelphia, and Chair of the National Colorectal Cancer Roundtable. From 2006 to 2007, Dr. Wender served as national president of ACS. He was a member of ACS’ colon cancer committee, which helped develop the ACS’ colorectal cancer screening guidelines. He also chaired ACS’ Guidelines Committee. Before joining ACS, Dr. Wender was Chair of the Department of Family and Community Medicine and Director of the Family Medicine Residency Program at Thomas Jefferson University.

Part 3 is narrated primarily by David Lieberman, MD, Professor of Medicine and Chief of the Division of Gastroenterology and Hepatology at Oregon Health and Science University. Dr. Lieberman is a member of the Governing Board of the American Gastroenterological Association. He is a past president of the American Society for Gastrointestinal Endoscopy (2001–2002) and served as the Chair of the Multi-Society Task Force on Colorectal Cancer for six years. He directs several large clinical research studies related to colorectal cancer and has published numerous articles related to colorectal cancer screening.

Accreditation Statements

CME: The Centers for Disease Control and Prevention is accredited by the Accreditation Council for Continuing Medical Education (ACCME®) to provide continuing medical education for physicians.

The Centers for Disease Control and Prevention designates this enduring material for a maximum of 2.25 AMA PRA Category 1 Credits.™ Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CNE: The Centers for Disease Control and Prevention is accredited as a provider of Continuing Nursing Education by the American Nurses Credentialing Center’s Commission on Accreditation. This activity provides 2.0 contact hours.

CEU: The Centers for Disease Control and Prevention is authorized by the International Association for Continuing Education and Training (IACET) to offer 0.2 CEUs for this program.

This program is approved for 2.0 contact hours of continuing education by the American Association of Nurse Practitioners. Program ID 15111975. This program was planned in accordance with AANP CE Standards and Policies.

Endoscopist Version (WD2430)

Watch the videos on YouTube:

Part 1Part 2

Links to the presentations:
To save them on your computer, right-click on the link and select “Save Link As” or “Save Target As.”

Part 1 [PDF-1.2MB]
Part 2 [PDF-1.5MB]

It may be helpful to print the presentations for reference during and after viewing the videos.

The endoscopist version is intended for physicians who perform colonoscopy, nurses, and other health professionals.

At the conclusion of this course, learners will be able to—

  1. Select appropriate colorectal cancer testing for each patient, consistent with screening and surveillance guidelines for different population subgroups.
  2. List the consequences of inadequate bowel preparation.
  3. Describe ways to help achieve good bowel preparation.
  4. For polyps identified during colonoscopy, list the polyp characteristics that should be documented in the colonoscopy report.
  5. List key quality indicators that should be monitored to improve colonoscopy performance.

This two-part course provides: 1.5 CME, 1.4 CNE, or 0.1 CEU.

Part 1 includes—

  • Basic information about colorectal cancer and screening.
  • Factors that affect when and how patients should be screened.
  • Detailed screening and surveillance guidelines based on personal and family history.

Part 2 focuses on colonoscopy and includes—

  • Pre-procedure considerations for ensuring that colonoscopy is appropriate.
  • Ways to achieve good bowel preparation.
  • The elements required for complete reporting.
  • Effective communication with referring providers and patients.
  • Monitoring quality indicators to improve performance.

Presenter

Both parts are narrated by David Lieberman, MD, Professor of Medicine and Chief of the Division of Gastroenterology and Hepatology at Oregon Health and Science University. Dr. Lieberman is a member of the Governing Board of the American Gastroenterological Association. He is a past president of the American Society for Gastrointestinal Endoscopy (2001–2002) and served as the Chair of the Multi-Society Task Force on Colorectal Cancer for six years. He directs several large clinical research studies related to colorectal cancer and has published numerous articles related to colorectal cancer screening.

Accreditation Statements

CME: The Centers for Disease Control and Prevention is accredited by the Accreditation Council for Continuing Medical Education (ACCME®) to provide continuing medical education for physicians.

The Centers for Disease Control and Prevention designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits.™ Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CNE: The Centers for Disease Control and Prevention is accredited as a provider of Continuing Nursing Education by the American Nurses Credentialing Center’s Commission on Accreditation. This activity provides 1.4 contact hours.

CEU: The Centers for Disease Control and Prevention is authorized by the International Association for Continuing Education and Training (IACET) to offer 0.1 CEUs for this program.

This program is approved for 1.4 contact hours of continuing education by the American Association of Nurse Practitioners. Program ID 15111976. This program was planned in accordance with AANP CE Standards and Policies.

Continuing Education

Origination Date: March 10, 2015
Expiration Date: March 10, 2017
URL: www.cdc.gov/cancer/colorectal/quality/
Hardware/Software: Computer-Internet
Materials: None
Target Audience: Physicians, nurses, and other health professionals
Prerequisites: None
Format: Web-on-demand
Contact Information: Division of Cancer Prevention and Control (800) CDC-INFO (800-232-4636)

How to Receive Continuing Education

  1. Complete the activity.
  2. Complete the evaluation at www.cdc.gov/TCEOnline.
  3. Pass the post-test at www.cdc.gov/TCEOnline with a score of 80% or better.

Fees: No fees are charged for CDC’s CE activities.

Disclosures for Both Versions

In compliance with continuing education requirements, all presenters must disclose any financial or other associations with the manufacturers of commercial products, suppliers of commercial services, or commercial supporters, as well as any use of unlabeled product(s) or product(s) under investigational use.

CDC, our planners, content experts, and their spouses/partners wish to disclose they have no financial interests or other relationships with the manufacturers of commercial products, suppliers of commercial services, or commercial supporters with the exception of Dr. Lieberman. He wishes to disclose he served on the Scientific Advisory Board of Exact Sciences Corporation.

Content experts reviewed content to ensure there is no bias. Content will not include any discussion of the unlabeled use of a product or a product under investigational use. CDC does not accept commercial support.

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