Developing a Quality Program to Track Colorectal Cancer Screening

Colorectal cancer screening is a multistep process. Problems at any stage diminish its clinical effectiveness. Common issues include suboptimal return rates for stool-based tests, lack of timely colonoscopy after abnormal stool-based tests, and surveillance recommendations inconsistent with current guidelines. High-quality colonoscopy is also essential. Tracking of screening activities has the potential to enhance program performance, support equitable screening delivery, and strengthen preventive impact at the population level. In this article, we propose features for the ideal tracking system and outline practical considerations concerning design and implementation such as the need for institutional alignment, technical expertise, and multidisciplinary collaboration.