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Colorectal Cancer Screening

Clinical Basis

The USPSTF found convincing evidence that screening for colorectal cancer in adults aged 50 to 75 years reduces colorectal cancer mortality. Physician recommendation for screening has been shown to be the greatest influencing factor in achieving patient compliance.

Exclusions

Diagnosis of colorectal cancer or total colectomy any time during the patients’ history through Dec. 31 of the measurement year.

Clinical Guidelines

  • Recommend appropriate colorectal cancer screening to all eligible patients.
  • Institute an office policy of colorectal cancer screening.
  • Use visual depiction of policy to train office staff.
  • If patients have had a colonoscopy within the last 10 years, document the date in the medical records and request historical records.
  • Although there are a variety of recommended screening methods, colonoscopy is the only method that will satisfy the measure for 10 years.

Coding and Documentation Guidance

Include documentation of the type of screening test (listed below), date of screening and results:

  • Colonoscopy
  • Flexible sigmoidoscopy
  • CT colonography
  • FIT-DNA Test
  • FOBT

Additional Guidance

  • See the Agency for Healthcare Research and Quality (AHRQ) study Targeted Patient Outreach Can Increase Colon Cancer Screening at https://archive.ahrq.gov/news/newsletters/e-newsletter/428.html.
  • An intensive colorectal cancer screening outreach program targeting vulnerable patients dramatically improved screening rates for colorectal cancer, according to an AHRQ-funded study published in the June 2016 issue of Journal of the American Medical Association (JAMA) Internal Medicine.1 The study found that community health center patients who received outreach via mail, automated phone and text messages and calls by a health center staff member were more than twice as likely to complete an at- home colon cancer screening test. This was the case even though most patients in the Chicago-based study were poor and uninsured and had limited English proficiency and low understanding of health information.
  • A FLU-FOBT program allows you to increase access to colorectal cancer screening by offering home tests to patients at the time of their annual influenza shots. You can download these programs from the AHRQ Health Care Innovation Exchange by  visiting https://innovations.ahrq.gov/narrow-by-subjects?ter-m=&key=FLU-FIT%20program. Download materials you can use to customize these programs for your clinical setting from the FluFIT website at http://flufit.org/programmaterials.html.

 

1 Screening for Colorectal Cancer - US Preventive Services Task Force Recommendation Statement, June 21, 2016. Visit the JAMA Network at http://jamanetwork.com/journals/jama/fullarticle/2529486?result- Click=1.

 

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