Cancer is the second leading cause of death in the United States (1), and colorectal cancer (CRC) is the second leading cause of cancer death among cancers that affect both men and women (2). There is strong evidence that screening for CRC reduces incidence and mortality rates from the disease either by detecting cancer early, when treatments are more effective, or by preventing CRC through removal of precancerous polyps (3). The US Preventive Services Task Force recommends CRC screening for people at average risk (aged 50–75 y), using either stool-based tests (ie, fecal immunochemical test [FIT], fecal occult blood test [FOBT], multi-targeted stool DNA test [FIT-DNA]) or tests that directly visualize the colon (ie, colonoscopy, sigmoidoscopy, or computed tomographic colonography [CTC]) (3). Despite availability of these tests, a significant proportion of Americans remain unscreened; in 2016, only 67.3% of age-appropriate men and women were up to date with screening (4).

BACKGROUND: The Colorectal Cancer Control Program (CRCCP) of the Centers for Disease Control and Prevention (CDC) funded 30 grantees to partner with health systems with the goal of increasing screening for colorectal cancer (CRC). METHODS: Evaluators applied CDC's Framework for Program Evaluation to design a national level outcome evaluation for measuring changes in CRC screening rates in partner health systems. RESULTS: The resulting evaluation design involves the collection and reporting of clinic-level CRC screening rates supplemented by various tools to support the reporting of high quality, reliable data. CONCLUSIONS: The CRCCP evaluation represents a strong design to measure the primary outcome of interest, CRC screening rates, and public health practitioners can benefit from lessons learned about stakeholder involvement, data quality, and the role of evaluators in data dissemination.