DC Colorectal Cancer Health Systems Change Program to Increase Screening - Colorectal cancer (CRC) is the fourth leading cause of cancer-related mortality in the District of Columbia, disproportionately affecting high-risk populations . The 2020 CRC screening rate for District residents was approximately 79%, a 5% increase from 2018 (74%) and higher than the 2020 national rate (73%) . However, among Federally Qualified Health Centers (FQHCs) in the District serving populations with lower income and increased patient needs (89% below 200% Federal Poverty Guideline), the CRC screening rate was 41% in 2020 . The purpose of the DC Colorectal Cancer Control Program (DC3C) is to reduce colorectal cancer (CRC) incidence and mortality in the District of Columbia by increasing screening rates, improving early detection, and ensuring timely follow-up care and linkage to treatment. The program prioritizes high-risk populations, including Medicaid, Medicare, and low-income individuals aged 45-75 years, to improve colorectal cancer outcomes. Through strategic partnerships with Federally Qualified Health Centers (FQHCs) or look alike primary care clinics, health systems, Technical Assistance (TA) support organizations, and local governmental agencies, DC3C will implement evidence-based interventions (EBIs) to improve screening and follow-up testing uptake ultimately increasing early-stage diagnosis and reducing mortality. The key strategies include: 1. Establishing and enhancing partnerships with primary care clinics and supporting organizations to improve access to CRC screening. 2. Implementing EBIs such as patient and provider reminders, patient navigation, provider assessment and feedback, and structural barrier reductions to increase CRC screening and follow-up testing. 3. Conducting robust monitoring and evaluation to ensure data quality and effectiveness of interventions. 4. Supporting the completion of stool-based tests and colonoscopies and alleviate the cost burden on patients for diagnostic colonoscopy as follow-up procedures to ensure timely diagnosis and treatment. Throughout implementation, DC3C will leverage data-driven strategies, including Electronic Health Record (EHR) enhancements and health information exchange integration, to track monitor program impact (e.g. screening and follow-up test completion rates), and drive continuous quality improvement. Enhancements that support sustainability (such as EHR enhancements/automation, integration of enhanced workflows through clinic-wide training, and written policies) of EBIs long-term will be prioritized and promoted. The outcomes will include an increase in partner clinic CRC screening rates, early detection of CRC, and a reduction in CRC-related mortality in DC’s high-risk communities. This initiative aligns with the District’s Healthy People 2030 goal to achieve a 74% CRC screening rate through targeted interventions.
