Improving Colorectal Cancer Screening Rates

May Fola

The UCLA Vatche & Tamar Manoukian Division of Digestive Diseases and the Department of Medicine at the David Geffen School of Medicine at UCLA are spearheading an ambitious initiative throughout the UCLA Health system to improve the rates of colorectal cancer screening. The two-pronged effort includes a public-facing campaign to raise awareness among UCLA Health patients and employees of the importance of being screened, as well as a system-level quality improvement initiative aimed at providers and staff. It has already yielded positive results — UCLA Health saw a 6.1% increase in screening rates between July 2018 and July 2019 — along with national acclaim from the American College of Gastroenterology, which recently honored the UCLA Health team with four 2019 SCOPY awards in recognition of its community engagement, education and awareness efforts for colorectal cancer prevention. The UCLA Health Colorectal Cancer Screening Campaign also received a Gold Award for Best Integrated Campaign from the eHealthcare Leadership Awards, which recognizes the best websites and digital communications of health care organizations.

The U.S. Centers for Disease Control and Prevention estimates that nearly one-third of adults ages 50-75 are not up to date on their screening. To address this concern, the National Colorectal Cancer Roundtable has set a goal of reaching 80% colorectal cancer screening rates. “At UCLA, we recognized that we were below the benchmark and that our rates could be improved,” says Folasade May, MD, PhD, MPhil, an assistant professor in the division who has led the effort in conjunction with Maria Han, MD, chief quality officer for the Department of Medicine.

Last March, coinciding with national Colon Cancer Awareness Month, UCLA Health launched its first-ever month-long public awareness campaign targeting UCLA Health patients, providers and employees. Activities included community lectures on colon health, community health fairs, and events on the UCLA campus, including an inflatable colon walk-through tunnel. “The idea was to make people feel more comfortable talking about a subject that is typically uncomfortable,” Dr. May explains.

A critical part of the campaign involved social media engagement. In addition to daily postings on the colorectal cancer campaign activities and materials throughout the month, UCLA patients shared their experiences with screening or treatment for colorectal cancer via UCLA Health social media platforms. The effort drew more than 23 million Twitter chat impressions and more than 300,000 Facebook/Twitter/Instagram impressions; it also featured partnerships with celebrities including Kareem Abdul-Jabbar, Tyra Banks, and Maria Menounos.

The ongoing system-level efforts to improve colorectal cancer screening uptake at UCLA Health came out of a workgroup consisting of experts in clinical medicine, quality improvement, population health, medical informatics, and health services research. The group identified a number of interventions designed to engage providers and front-line staff in both primary care and gastroenterology clinics. One of the key areas of focus has been designing standard workflows to ensure that patients who are due for screening don’t leave their appointments without ordering or scheduling their test. The process for ordering screening tests on the electronic health record has been streamlined, and the group launched an evaluation and improvement project around a program to mail the fecal immunochemical test (FIT) to patients who opt for that screening form.

“This is a national public health concern,” Dr. Han says. “We know that colon cancer is the second-leading cause of cancer death in the U.S., and that more than half of those deaths are likely preventable through appropriate screening. Our goal is to generate awareness around colorectal cancer screening among the general public as well as to engage and activate providers and frontline staff to improve screening rates in their clinics.”

UCLA colon cancer screening website >