Date of Degree


Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)




Holly DiLeo


Alicia Valdez


Within the United States, colorectal cancer is the fourth most common cancer diagnosed in both women and men. The American Cancer Society approximated that 97,220 new colon cancer cases and 43,030 rectal cancer cases would occur within 2018. Overall, it was estimated there were approximately 50,630 colorectal cancer deaths in 2018. Despite recommended guidelines, reported screening rates are only 31% to 55%, well below the goal of 75% set by the American Cancer Society. The purpose of this project was to increase preventative colorectal cancer screening referrals and completion of colonoscopies for qualified individuals age 50–75 years within a family practice setting. Anticipated outcomes were (a) 100% of qualified patients would be assessed for preventative colonoscopy status, (b) 85% of patients would be provided a referral for a preventative colonoscopy on the same day as their visit, and (c) 95% of those patients would complete a screening colonoscopy. Guidelines recommend that women and men begin routine screening starting at age 50 and every 10 years thereafter. This process improvement project resulted in 100% of qualified patients being identified when the primary medical assistant was present, 51% of identified patients being referred, and 45% of those referred for screening completed a colonoscopy. Preventative screenings can provide early identification and removal of colorectal polyps before cancer develops or provide for early cancer diagnosis that allows initiation of treatment in the early stages to reduce morbidity and mortality.