ACP Calls for Better Performance Measures Relevant to Internal Medicine for Colorectal Cancer Screening
PHILADELPHIA, October 21, 2025 – Colorectal cancer is the second leading cause of cancer-related deaths for males and females. Screening for colorectal cancer is an effective strategy to reduce morbidity and mortality. The evidence-based guidance statement from the American College of Physicians (ACP) supports colorectal cancer screening in asymptomatic average risk adults aged 50-75. ACP reviewed current performance measures for colorectal cancer screening and surveillance to identify those that are methodologically sound and evidence-based to inform physicians, payers, and policymakers in their selection and use of these measures for assessing quality of care. ACP supports the use of one – Facility 7-Day Risk-Standardized Hospital Visit Rate after Outpatient Colonoscopy out of the five measures relevant to internal medicine reviewed by ACP’s Performance Measures Committee (PMC). ACP's report, “Quality Indicators for Screening and Surveillance of Colorectal Cancer in Adults: A Review of Performance Measures by the American College of Physicians,” is published in Annals of Internal Medicine.
Colorectal cancer screening and surveillance measures are widely used in pay-for-performance, public reporting, and accountability programs. ACP stresses that using appropriate measures is essential to avoid unnecessary harms to patients, limit physician burden, and protect reputation and reimbursement.
The PMC supported one measure as it promotes patient safety by tracking unplanned hospital admissions resulting from colonoscopies. The other four performance measures reviewed were either not aligned with current scientific evidence, promoted unnecessary screening in patients beyond the appropriate age groups, or measures were not tested, valid, or reliable at the level where they were being applied and hence no proof they would improve quality of clinical outcomes -- perhaps leading to unintended consequences such as increased harms.
“Performance measures can be very useful in improving the care we provide to patients, but only when they are grounded in strong evidence and show that they can drive better outcomes,” said Jason M. Goldman, MD, MACP, President, ACP. “Otherwise, they simply add an unnecessary administrative burden which takes physicians’ time away from necessary patient care.”
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About the American College of Physicians
The American College of Physicians is the largest medical specialty organization in the United States with members in more than 172 countries worldwide. ACP membership includes 162,000 internal medicine physicians, related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on X, Facebook, Instagram, Threads, and LinkedIn, and subscribe to our new RSS feed.
Contact: Lori Bookbinder, 215-351-2431, Lbookbinder@acponline.org