Other Research Topics

Overview

Colorectal cancer screening can find abnormal growths in the colon or rectum (called polyps) so they can be removed before they turn into cancer. Screening also helps find colorectal cancer early, when treatment works best. If new cases of colorectal cancer can be prevented or found earlier, this can help improve long-term health outcomes and cancer survival.

In the first study listed below, researchers looked at the long-term health benefits and cost of screening through CDC's Colorectal Cancer Control Program (CRCCP). Other studies looked at ways to increase colorectal cancer screening.

Estimating long-term health benefits of screening

CRCCP works with clinics, hospitals, and other health care organizations to increase colorectal cancer screening for adults ages 45 to 75. The program provides services to people with low incomes who have trouble getting health care. People with health insurance are more than twice as likely to be screened for colorectal cancer as recommended than people without health insurance.

This study looked at the long-term health benefits and cost of providing colorectal cancer screening services to people with limited access to health care. Direct colorectal cancer screening services provided through CRCCP include one screening test and follow-up testing, if needed. The study used CDC's Colorectal Clinical Data Elements data. Study data include patients with low incomes, without health insurance or whose health insurance didn't cover screening, and who received at least one colorectal cancer screening through CRCCP between 2009 and 2020.

The findings of this study suggest that many long-term health gains are possible for people who are screened through CRCCP. The study estimated that:

• CRCCP screening prevented 806 cancer cases, avoided 392 deaths, and added 5,368 life-years per 100,000 people when compared to no intervention.
• The program cost per additional year up-to-date with colorectal cancer screening was $315 for colonoscopy screening and $789 for stool test screening.
• The program cost per life-year gained for those screened with colonoscopy ranged from $25,740 to $27,583, compared to a range of $70,410 to $75,979 for those screened with stool tests.

Citation

O'Leary MC, Koutouan PR, Mayorga ME, et al. Estimating the long-term health impact and program cost-effectiveness of providing direct screening services to low-income, medically underserved patients through the Colorectal Cancer Control Program (CRCCP). Cancer Causes Control 2025;36(10):1175–1195.

Supporting screening with program champions

CRCCP works to increase colorectal cancer screening by using evidence-based interventions (EBIs) in clinics that partner with the program. Program champions are an important part of the program. They are expected to manage how EBIs are set up, support changes that may be needed, and help clinics get resources. Currently, little is known about the role of program champions and the long-term sustainability in clinical systems.

This study looked at program champion types, roles, and sustainability within CRCCP health systems and clinics. The study included a survey of 205 health system and clinic staff from 303 clinics and 12 interviews of CRCCP award recipients and partnering clinics.

The study found:

• In health systems, program champions most often were quality improvement (QI) managers (49%), doctors (36%), or high-level administrators (27%).
• In clinics, program champions were most often doctors (37%), QI managers (26%), or medical assistants (24%).
• Program champions in both health systems and clinics were most often assigned the role. Program champions in clinics were more likely to take on the role naturally than those in health systems.
• Interview results show that champions promote screening, help set up EBIs, and set screening policies.

Results from the study show how program champions can help promote colorectal cancer screening in different clinical settings.

Citation

Escoffery C, Sun J, DeGroff A, et al. Characterizing screening champions in the Center for Disease Control and Prevention's Colorectal Cancer Control Program (CRCCP). Implement Sci Commun 2025;6(1):79.

Increasing screening through partnerships

The District of Columbia Department of Health (DC Health) has received funding from CRCCP since 2015. This study looked at the partnership model DC Health created to increase screening among people with low levels of colorectal cancer screening.

DC Health's colorectal cancer screening program focuses on the individual, social needs, organization, and community. DC Health works with partners to increase screening by setting up EBIs. The DC Health partnership supports nine health systems that serve patients with a high risk of getting colorectal cancer, and who are unlikely to be up to date on screening.

The study found:

• DC Health partnerships include six federally qualified health centers (FQHCs), three hospital systems, and 21 clinics. A federally qualified health center gets money from the federal government to provide health care to people even if they can't afford to pay for it.
• Working with organizations that provide social needs support can help patients overcome barriers to cancer screening.
• These partners help develop processes, support data tracking, and solve problems to make sure EBIs are set up correctly.
• The percentage of patients who were screened for colorectal cancer among these health system partners increased from 19% in 2015 to 53% by 2022.

Citation

Wasala S, Tangka FKL, Mekonnen T, Riverson S, Hoover S, Subramanian S. A multilevel partnership approach to increase colorectal cancer screening. Health Promot Pract 2025:15248399251362174.