About the Playbook

The American Society for Gastrointestinal Endoscopy (ASGE) created the CRC Screening Playbook to increase the colorectal cancer (CRC) screening and completion colonoscopy rate for underserved patients in the US. CRC is one of the leading causes of cancer death in the US and the completion colonoscopy rate for underserved patients in the US who have had an abnormal CRC screening test result is just 50 to 70 percent.

This Playbook is a free resource that Federally Qualified Health Centers (FQHCs), policymakers, advocacy organizations, gastroenterologists and allied stakeholders can use to increase CRC screening and completion colonoscopy rates for underserved patients.

ASGE developed the Playbook using the outcomes of ASGE’s CRC Screening Project, which helped hundreds of uninsured patients get screened for CRC and, when applicable, have a completion colonoscopy – which represents the gold standard in CRC screening.

ASGE worked with an FQHC, Community Health Care Systems, and MedChi Network Services, a subsidiary of the Maryland State Medical Society, to administer developmental projects in a rural part of Georgia and an urban community in Maryland.

CHCS and MedChi supported these patients with navigation professionals who guided them through the full continuum of care, and the patients who participated in the project received the care at no cost. 
 
In addition to serving as a roadmap, the Playbook will serve as an evergreen clearinghouse for best practices, models and resources that can be used at the local, state and regional levels. This includes CRC screening, patient navigation, advocacy and community outreach and education.
 
The Playbook has sections that address:
 
  • The screening, patient navigation and advocacy outcomes of ASGE’s developmental projects in Georgia and Maryland   
  • The ASGE CRC Screening Project model, including funding, roles and workflows 
  • Abbreviated how-to guides for patient screening – and suggestions for overcoming common barriers like cost, the lack of insurance, access to care or fear – and advocacy   
  • The best patient navigation practices, including the protocols that ASGE developed for its project
  • Educational and outreach resources that leading gastroenterologists developed for clinicians and their patients (e.g., brochures, practice infographics, talking points, sample letters)  
  • Vital information regarding Colorectal Cancer and CRC 
  • Other successful CRC screening and advocacy models 
 
The Playbook is the culmination of a collaborative, four-year effort that tapped into the expertise of an array of allied stakeholders, including gastroenterologists and other physicians and health care professionals, FQHCs and medical practices, patient navigators, legislators and regulators, state and local advocacy organizations and community leaders.  
 
This matters because CRC is the leading cause of cancer death in men under 50 and the second leading cause of cancer death in women who are under 50, and there is clear evidence that it is a disease that is increasingly affecting people of younger ages. And it is worth noting that the people who are on the lower end of the socioeconomic scale are more likely to get CRC regardless of other risk factors. 
 
With this in mind, it is crucial for everyone to get screened for CRC and for those who have an abnormal test result to get a completion colonoscopy in less than 10 months (given the higher risk of CRC and advanced stage disease).
 
CRC has a 90 percent survival rate when it is detected early enough, which is why ASGE and its members are appealing to every average-risk patient who is 45 or older to get screened for this disease. What’s more, ensuring that uninsured and underinsured patients receive this care can help eradicate racial and ethnic disparities.
 
Our hope and vision is that you will take advantage of what we learned during the  ASGE CRC Screening Project and use this Playbook to increase CRC screening and completion colonoscopy rates in your community. Improved CRC screening will save lives.  
 
Finally, as members of the ASGE CRC Screening Project Advisory Council we would like to thank and applaud our allies for making the ASGE CRC Screening Project possible, including Exact Sciences, Ironwood Pharmaceuticals and Sebela Pharmaceuticals and its Braintree Laboratories affiliate.

The ASGE CRC Screening Project Advisory Council

Jennifer Christie, MD, MASGE
University of Colorado, Anschutz Medical Campus
Aurora, CO
Chair

Tonya Adams, MD
Gastro Health-Virginia Division
Fairfax, VA

Iman Boston, MD, MBA
Beth Israel Deaconess Medical Center
Boston, MA 

Juan Carlos Bucobo, MD, FASGE 
Northwell Health
Manhasset, NY

Lukejohn Day, MD, FASGE
University of California San Francisco
San Francisco, CA

Jason Dominitz, MD, MHS, FASGE
University of Washington & Veterans Health Administration
Seattle, WA

Pegah Hosseini-Carroll, MD, FASGE 
University of Mississippi Medical Center & Baptist GI
Jackson, MS

Rachel Issaka, MD, MAS 
Fred Hutchinson Cancer Research Center,
University of Washington
Seattle, WA

Brian Jacobson, MD, MPH, FASGE
Massachusetts General Hospital
Boston, MA

Inessa Khaykis, MD, FASGE
Vanguard Gastroenterology
New York, NY

Mark Marino, MD
GI Alliance
(Metropolitan Gastroenterology Associates)
Metairie, LA

Folasade May, MD, PhD, MPhil
David Geffen School of Medicine/UCLA, 
VA Greater LA Healthcare System
Los Angeles, CA

Doug Rex, MD, MASGE
Indiana University School of Medicine
Indianapolis, IN

Colleen Schmitt, MD, MHS, MASGE
Gastroenterologist
Chattanooga, TN

Edward Sun, MD, MBA, FASGE
Peconic Bay Medical Center,
Northwell Health
Riverhead, NY

Javelle Wynter, MD
Ad Meliora Gastroenterology
Dartmouth, MA