Implementation Science Success Stories: Colorectal Cancer Screenings 

All cancers are unfair, but colorectal cancer feels like a sucker punch. A small polyp forms on the colon or rectum’s inner lining and, if undetected, spreads to lymph nodes and beyond. Within the body, cells are growing out of control while outside, a life is shattered. 

Among the deadliest cancers, colorectal cancer is expected to take the lives of about 52,900 Americans in 2025. But here’s the upside: Death rates are dropping, especially among older adults. This decrease can be largely attributed to improved screening methods that are catching cancers earlier.  

Today, we look at implementation science — a field focused on helping medical professionals integrate the latest evidence-based practices into everyday care — and its effect on colorectal cancer screenings. Without it, screenings would be far less effective, and many more lives would be lost to this cancer.  

Why Do Colorectal Cancer Screenings Matter? 

Hearing that you have colorectal cancer can feel like the world is tilting off its axis, but it’s not an automatic death sentence. Screenings often detect this cancer early, when it’s small and hasn’t spread, making it highly treatable and often curable. 

The Evolution of Colorectal Cancer Screenings 

Back in the day (pre-1980), a proctosigmoidoscopy was the go-to screening method recommended to adults 40 and over. Now, the American Cancer Society recommends that healthy adults between 45 and 75 receive a:  

• Yearly fecal immunochemical test (FIT).  
• Yearly Guaiac-based fecal occult blood test (gFOBT). 
• Stool DNA test every three years. 
• Colonoscopy every 10 years. 
• CT colonography (virtual colonoscopy) every five years. 
• Flexible sigmoidoscopy every five years.  

Thanks to these developments, colorectal cancer rates have dropped every year since the mid-1980s. More than ever, people are getting screened and making lifestyle changes to lower their cancer risk.  

Reducing Risk Factors 

If you’re worried about colorectal cancer, you may want to: 

• Move toward or maintain a healthy weight. 
• Avoid processed meats and sugary drinks. 
• Quit smoking. (Seriously, it’s gross.)  
• Cut back on alcohol. 

Unfortunately, some risk factors that can’t be mitigated, particularly those that are inherited. 

When Genetics Play a Role 

One of the more recent breakthroughs in colorectal cancer screening is the discovery of the link between the disease and gene changes (mutations).  

In the early 1960s, Henry Lynch, M.D., theorized that some cancers have a genetic cause that can be passed down through generations. To prove his theory, he bought a camper and, every weekend for two years, toured rural Nebraska, Kansas and Missouri, collecting medical records from cancer-prone families. He discovered an unusually high number of people died of colon cancer before the age of 50.  

Lynch’s contemporaries didn’t buy it. Cancer, they believed, was caused by environmental factors, or bad luck. It wasn’t until the mid-1980s that molecular genetics techniques identified and linked the first genes to familial cancers. Turns out, cancer can run in the family.  

Genetic Testing for Lynch Syndrome 

We now know that inherited mutations cause between 5% and 10% of colorectal cancer. The most common of these is hereditary nonpolyposis colorectal cancer, known today as Lynch Syndrome and named after Henry Lynch, who would come to be known as “the father of cancer genetics.”  

Decades after Lynch’s tour across the Midwest, genetic testing can diagnose Lynch Syndrome, giving families with this inherited cancer syndrome peace of mind. With regular, lifelong screenings, they can live fully, knowing cancer doesn’t get the final say.  

New Treatments on the Horizon 

Screening techniques are only becoming more sophisticated. Take Shield, the first blood test used as a primary screening for people at average risk of colon cancer. Shield works by detecting changes to cell-free DNA: small fragments of DNA that float freely in the blood and can indicate the presence of tumors in the colon.  

Screening tests like Shield have the potential to lower the barrier to testing. (We imagine more people would get tested if they didn’t have to suffer through a colonoscopy.) But, as history shows, disseminating scientific breakthroughs throughout the medical field isn’t easy. That’s where implementation science comes in.  

Bridge the Gap Between Research and Practice With Implementation Science 

Want to ensure that cutting-edge research saves lives? Consider our online Graduate Certificate in Implementation Science.  

Promoting the adoption of evidence-based practices takes a unique skillset. You’ll need a deep understanding of implementation frameworks, project management, research and analytics, not to mention human behavior. How do I convince everyone — practitioners, policy makers and community members — to buy in to these new practices? You’ll find the answer in our online program.  

Interested? Check out our online Graduate Certificate in Implementation Science, or contact us to learn more about program benefits, admission requirements or tuition options.  

When you’re ready to explore this growing career field, apply to UF. There’s a future where screenings are noninvasive and families don’t have to worry about hereditary cancer, and we can’t wait to see it with you.   

Sources: 
https://www.cancer.org/cancer/types/colon-rectal-cancer/about/what-is-colorectal-cancer.html
https://www.cancer.org/cancer/types/colon-rectal-cancer/causes-risks-prevention/risk-factors.html
https://www.cancer.org/cancer/types/colon-rectal-cancer/about/key-statistics.html
https://www.cancer.org/cancer/understanding-cancer/history-of-cancer/screening-early-detection.html
https://www.cdc.gov/colorectal-cancer-hereditary/testing/index.html