Description:  The percentage of members 50–75 years of age who had appropriate screening for colorectal cancer.


Denominator:  

Product lines
Commercial, Medicare (report each product line separately).
Ages
51–75 years as of December 31 of the measurement year.
Continuous enrollment
The measurement year and the year prior to the measurement year.
Allowable gap
No more than one gap in continuous enrollment of up to 45 days during each year of continuous enrollment.
Anchor date
December 31 of the measurement year.
Benefit
Medical.
Event/diagnosis
None.


Denominator Exclusions (when applicable)    Note: Members in hospice are excluded from the eligible population. If an organization reports this measure using the Hybrid method, and a member is found to be in hospice or using hospice services during medical record review, the member is removed from the sample and replaced by a member from the oversample. Refer to General Guideline 20: Members in Hospice.


Either of the following any time during the member’s history through December 31 of the measurement year:

  • Colorectal cancer (Colorectal Cancer Value Set).
  • Total colectomy (Total Colectomy Value Set).



Numerator:  


One or more screenings for colorectal cancer. Any of the following meet criteria:
  • Fecal occult blood test (FOBT Value Set) during the measurement year. For administrative data, assume the required number of samples were returned, regardless of FOBT type.
  • Flexible sigmoidoscopy (Flexible Sigmoidoscopy Value Set) during the measurement year or the four years prior to the measurement year.
  • Colonoscopy (Colonoscopy Value Set) during the measurement year or the nine years prior to the measurement year.