Moving forward: using the experience of the CDCs' Colorectal Cancer Screening Demonstration Program to guide future colorectal cancer programming efforts.

BACKGROUND The Centers for Disease Control and Prevention (CDC) established and supported a 4-year Colorectal Cancer Screening Demonstration Program (CRCSDP) from 2005 to 2009 for low-income, under- or uninsured men and women aged 50-64 at 5 sites in the United States. METHODS A multiple methods evaluation was conducted including 1) a longitudinal, comparative case study of program implementation, 2) the collection and analysis of client-level screening and diagnostic services outcome data, and 3) the collection and analysis of program- and patient-level cost data. RESULTS Several themes emerged from the results reported in the series of articles in this Supplement. These included the benefit of building on an existing infrastructure, strengths and weakness of both the 2 most frequently used screening tests (colonoscopy and fecal occult blood tests), variability in costs of maintaining this screening program, and the importance of measuring the quality of screening tests. Population-level evaluation questions could not be answered because of the small size of the participating population and the limited time frame of the evaluation. The comprehensive evaluation of the program determined overall feasibility of this effort. CONCLUSIONS Critical lessons learned through the implementation and evaluation of the CDC's CRCSDP led to the development of a larger population-based program, the CDC's Colorectal Cancer Control Program (CRCCP). Cancer 2013;119(15 suppl):2940-6. (c) 2013 American Cancer Society. The Centers for Disease Control and Prevention (CDC) supported a 4-year Colorectal Cancer Screening Demonstration Program (CRCSDP) from 2005 to 2009 for low-income, under- or uninsured men and women aged 50-64 at 5 participating US sites. A multiple methods evaluation was conducted in conjunction with program implementation including 1) a longitudinal, multiple case study of program implementation; 2) analysis of client-level screening and diagnostic services outcome data; and 3) a cost study. Several themes emerged from the series of articles in this supplement including the benefit of building on an existing infrastructure, strengths and weaknesses the 2 most frequently used screening tests (colonoscopy and fecal occult blood tests), costs of the screening tests used in this program, and the continued importance of measuring the quality of screening tests. Critical lessons were learned through the implementation and evaluation of the CDC's CRCSDP, which informed the development of a larger follow-up population-based program.