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Colorectal Cancer Screening

Part 1: Introduction

Part 2: Characteristics for Success: Colorectal Cancer Screening

Part 3: Implementation of Clinical Quality Measure: Colorectal Cancer Screening

Part 4: Improvement Strategies: Colorectal Cancer Screening

Part 5: Holding the Gains and Spreading Improvement

Part 6: Supporting Information


Part 6: Supporting Information 

Case Study

To gain insight into how a fictional QI team approached this measure, review a hypothetical case study highlighting Southeast Health Center's approach to improving Colorectal Cancer Screening performance.

References
  1. U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999-2005 Incidence and Mortality Web-based Report. Atlanta (GA): Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute; 2009.
  2. Shike M, Winawer SJ, Greenwald PH, et al.: Primary prevention of colorectal cancer. The WHO Collaborating Centre for the Prevention of Colorectal Cancer. Bull World Health Organ 68 (3): 377-85, 1990.
  3. Ries LAG, Eisner MP, Kosary CL, et al., eds.: SEER Cancer Statistics Review, 1975-2002. Bethesda, MD: National Cancer Institute, 2005.
  4. Moertel CG, Fleming TR, Macdonald JS, et al.: Levamisole and fluorouracil for adjuvant therapy of resected colon carcinoma. N Engl J Med 322 (6): 352-8, 1990.
  5. Krook JE, Moertel CG, Gunderson LL, et al.: Effective surgical adjuvant therapy for high-risk rectal carcinoma. N Engl J Med 324 (11): 709-15, 1991.
  6. Colorado Colorectal Cancer Screening program fact sheet. November 2009;
  7. Seifeldin R, Hantsch JJ. The economic burden associated with colon cancer in the United States. Clinical Therapeutics. 1999;21(8): 1370-1379.
  8. Selby JV, Friedman GD, Quesenberry CP Jr., Weiss NS. A case control study of screening sigmoidoscopy and mortality from colorectal cancer. New England Journal of Medicine 1992;326(10):653-657.
  9. Meyerhardt JA, Giovannucci EL, Holmes MD, et al. 2006. Physical activity and survival after colorectal cancer diagnosis. J Clin Oncol 24: 3527 - 3534.
  10. Seeff LC, Nadel MR, Klabunde CN, Thompson T, Shapiro JA, Vernon SW, et al. Patterns and predictors of colorectal cancer test use in the adult U.S. population. Cancer 2004;100: 2093-103.
  11. Patterns of colorectal cancer screening uptake among men and women in the United States. Mesissner HI; Breen N; Klabunde CN; Vernon SW, Cancer Epidemiol Biomarkers Prev. 2006 Feb; 15 (2): 389-94
  12. Best practices and lessons learned: status in HRSA HDC 2006; Ahmed Calvo, MD Exit Disclaimer.
  13. Healthy People 2010 progress report
  14. Colorectal Cancer Rates by Race and Ethnicity
  15. Hawk eT, levin b. Colorectal cancer prevention. J Clin oncol 2005 23: 378 - 388.
  16. Colon cancer survival rates with the new American Joint Committee on Cancer sixth edition staging. Meissner HI; Breen N; Klabunde CN; Vernon SW; Cancer Epidemiol Biomarkers Prev. 2006 Feb;15(2):389-94
  17. Institute of Medicine. Breakthrough Series College Aim Statement Checklist Boston: Institute for Healthcare Improvement. Exit Disclaimer. February 2004.
  18. Adapted from pre-work manual used in HRSA sponsored Health Disparities Collaborative
  19. NQC "A Guide to Consumer Involvement" Exit Disclaimer.
  20. Timmermans S, Mauck A (2005). The promises and pitfalls of evidence-based medicine. Health Aff (Millwood) 24 (1): 18-28. doi:10.1377/hlthaff.24.1.18. PMID 15647212.
  21. Rex, DK, Johnson, DA, Anderson, JC, et al. American College of Gastroenterology guidelines for colorectal cancer screening 2008. Am J Gastroenterol 2009; 104: 739
  22. Levin, B, Lieberman, DA, McFarland, B, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA Cancer J Clin 2008; 58: 130.
  23. Screening for colorectal cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2008; 149:627
  24. Low rates of colorectal, cervical, and breast cancer screening in Asian Americans compared with non-Hispanic whites: Cultural influences or access to care? Kandula NR; Wen M; Jacobs EA; Lauderdale DS Cancer. 2006 Jul 1;107(1):184-92.
  25. Adapted from Chronic Care Model...
  26. Langley G., Nolan K., Nolan T., Norman C., Provost L. The Improvement Guide: A Practical Approach to Enhancing Organizational Performance. San Francisco. Jossey-Bass, 1996.
Additional Resources
  1. American Cancer Society. What are the risk factors for colorectal cancer? Exit Disclaimer.
  2. Cancer Intervention Surveillance Network (CISNET), Colorectal Cancer Mortality Projections
  3. Colorectal Cancer (PDQ®): Screening - Health Professionals
  4. Colorectal Cancer Testing in the Medicare Population: 1998-2004
  5. Healthy People 2010, Volume 1, Chapter 3 - Cancer
  6. National Cancer Institute, Colorectal Cancer Screening: Questions and Answers
  7. National Health Interview Survey (NHIS) (NCHS)
  8. State Cancer Profiles, Latest Rates, Percents, and Counts
  9. U.S. Preventive Services Task Force Recommendations (ARHQ)
  10. Rex, DK, Johnson, DA, Anderson, JC, et al. American College of Gastroenterology guidelines for colorectal cancer screening 2008. Am J Gastroenterol 2009; 104: 739
  11. Levin, B, Lieberman, DA, McFarland, B, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA Cancer J Clin 2008; 58: 130.
  12. Screening for colorectal cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2008; 149:627



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