Brief Description of Measure:

CMS130: Colorectal Cancer Screening:
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

Description of Issue:

​Several organizations have updated guidelines that recommend starting colorectal cancer screening at age 45, including the United States Preventive Services Task Force (USPSTF).​
​To incorporate the updated USPSTF guideline, we propose to update the age criteria for this measure from ages 50-75 to age 45-75.
To maintain trending for ages 50-75, as well as to track performance of the newly recommended age group 45-49, we propose to add age stratifications for ages 46-49 by the end of the measurement period, and ages 50-75 by the end of the measurement period.

Proposed Solution:

​Current:
//Header: Description
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

//Header: Clinical recommendation statement
The U.S. Preventive Services Task Force (2016) recommends screening for colorectal cancer starting at age 50 years and continuing until age 75 years. This is a Grade A recommendation (U.S. Preventive Services Task Force, 2016).  

//Header: References
'US Preventive Services Task Force, Bibbins-Domingo, K., Grossman, D. C., Curry, S. J., Davidson, K. W., Epling, J. W., … Siu, A. L. (2016). Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. JAMA, 315(23), 2564–2575. https://doi.org/10.1001/jama.2016.5989'

//Header: Initial Population Description
Patients 50-75 years of age with a visit during the measurement period

//Logic
define "Initial Population":
  exists ( ["Patient Characteristic Birthdate": "Birth date"] BirthDate
      where Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime,
      start of "Measurement Period" ) in Interval[50, 75 )
        and exists AdultOutpatientEncounters."Qualifying Encounters"
  )

Proposed:
//Header: Description
Percentage of adults 45-75 years of age who had appropriate screening for colorectal cancer

//Header: Stratification
Stratum 1: Patients age 46-49 by the end of the measurement period
Stratum 2: Patients age 50-75 by the end of the measurement period

//Header: Clinical recommendation statement
The U.S. Preventive Services Task Force (2021) recommends screening for colorectal cancer starting at age 50 years and continuing until age 75 years. This is a Grade A recommendation (U.S. Preventive Services Task Force, 2021).

The U.S. Preventive Services Task Force (2021) recommends screening for colorectal cancer starting at age 45 years and continuing until age 49 years. This is a Grade B recommendation (U.S. Preventive Services Task Force, 2021).   

//Header: References
US Preventive Services Task Force. Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2021;325(19):1965–1977. doi:10.1001/jama.2021.6238

//Header: Initial Population Description
Patients 46-75 years of age by the end of the measurement period with a visit during the measurement period

//Logic
define "Initial Population":
AgeInYearsAt(date from
  end of "Measurement Period"
)in Interval[46, 75]
  and exists AdultOutpatientEncounters."Qualifying Encounters"

define "Stratification 1":
AgeInYearsAt(date from
  end of "Measurement Period"
)in Interval[46, 49]

define "Stratification 2":
AgeInYearsAt(date from
  end of "Measurement Period"
)in Interval[50, 75]

Rationale for Change:

We propose to update the age criteria for this measure from ages 50-75 to age 45-75 to align with new clinical recommendations from the United States Preventive Services Task Force (USPSTF).