Spotlight on Year 1
In July 2015, the Centers for Disease Control and Prevention (CDC) provided $23 million in funding to 30 state, university, and tribal grantees to carry out the Colorectal Cancer Control Program (CRCCP) overa 5-year period. CRCCP grantees partner with health systems and clinics serving high-need populations to implement evidence-based interventions (EBIs) and other supporting activities to increase colorectal cancer (CRC) screening rates.
What is the burden of colorectal cancer?
CRC is a leading cause of cancer-related death in the United States. Although screening reduces CRC incidence and mortality, only 67% of adults aged 50 to 75 years are currently up-to-date with screening.
What are EBIs?
Evidence-based interventions (EBIs) are services, programs, or policies proven to be effective in improving CRC screening rates. The U.S. Preventive Services Task Force recommendations on evidence-based practice are available on the Guide to Community Preventive Services website: www.thecommunityguide.org.External
What did CRCCP achieve in Year 1?
In Year 1, CRCCP grantees recruited more than 400 clinics that serve more than 700,000 patients aged 50 to 75 years to implement EBIs. On average, partner clinic CRC screening rates increased 4.4 percentage points in Year 1, from 42.9% at baseline to 47.3%. In contrast, screening rates among federally qualified health centers nationally increased just 1.6 percentage points from 2015 to 2016.
A closer look at CRCCP partner clinics—
- 72% are federally qualified health centers.
- 31% serve high percentages of uninsured patients (20% or more).
- 53% use fecal occult blood tests (FOBT) or fecal immunochemical tests (FIT) as the primary CRC screening test type.
How did CRCCP increase screening rates in Year 1?
To increase CRC screening, CRCCP grantees work with clinics to start or enhance up to four priority EBIs identified on the Guide to Community Preventive Services website.
In Year 1, grantees most often used CRCCP resources towards patient reminder systems followed by provider assessment and feedback, reducing structural barriers, and provider reminders.
Partners conducted a variety of activities in Year 1. The five most frequently reported activities were—
- Provider education and professional development.
- Quality improvement.
- Health information technology to improve electronic health record systems.
- Patient reminders.
- Small media.
In addition to clinics, CRCCP grantees work with other organizations to implement their programs. The most common partners and the number of grantees who partnered with each in Year 1 are shown below.
- American Cancer Society: 25
- State primary care associations: 16
- Local health departments: 12
- Universities: 10
- Nonprofit organizations: 10
What have we learned?
- Grantees successfully launched this evidence-based, public health model for increasing CRC screening rates in clinics serving high-need populations.
- The CRCCP has the potential for significant impact as grantees continue to recruit new clinics.
- Partnerships are important to successful CRCCP implementation.
- Grantees must work closely with clinics to improve electronic health records and reliability of screening rate data.