The Ohio Academy of Family Physicians (OAFP) is pleased to highlight the new Colorectal Cancer (CRC) Easy Performance Improvement (EasyPI) Track, developed to support family physicians in improving CRC screening delivery and follow-up care sponsored by Exact Sciences.
Why This Matters: The Epidemiology of Colorectal Cancer
Colorectal cancer remains a major public health concern. It is the second-leading cause of cancer-related death among men and women in the United States,1 and among adults younger than age 50, CRC is now the leading cause of cancer death in both men and women underscoring the importance of earlier and more accessible screening strategies.1
The Population-Level Screening Gap
Despite clear evidence supporting CRC screening, significant gaps remain. An estimated 60 million average-risk Americans are not up to date with CRC screening, while annual capacity for screening colonoscopy is limited.2 Current estimates suggest that the U.S. healthcare system can perform approximately 6–7 million screening colonoscopies annually, highlighting the need for multiple guideline-supported screening options, including non-invasive tests, to meet population-level demand.3
Coverage for Follow-Up Colonoscopy: A Critical Policy Update
Historically, patient cost-sharing for colonoscopy after a positive non-invasive screening test has been a barrier to completing the CRC screening process. As of January 1, 2023, federal policy now requires that any follow-up colonoscopy after a positive non-colonoscopy CRC screening test including FIT, multitarget stool DNA (mt-sDNA), flexible sigmoidoscopy, or CT colonography be covered by Medicare, Centers for Medicare and Medicaid Services (CMS)-regulated plans, and most commercial insurers with no patient cost-sharing.4,5 This policy change recognizes follow-up colonoscopy as an integral part of the screening continuum and removes a major financial barrier for patients. If you need information on how to code for the follow-up colonoscopy after a positive non-invasive screening test, the American Gastroenterological Association has a helpful coding FAQ online.
History of the Cologuard® Test:
David A. Ahlquist, MD, a gastroenterologist and physician-scientist at Mayo Clinic, recognized that colorectal cancers and advanced precancers shed tumor-associated methylated DNA biomarkers, in addition to globin. He envisioned a more sophisticated, noninvasive, at-home colorectal cancer screening test that could detect these molecular signals and expand screening access. This work led to the development of the Cologuard® test and now, the Cologuard Plus® test.
Topline data from the pivotal trial that brought the Cologuard Plus® test, a next-generation multitarget stool DNA test to market for average-risk adults aged 45-85:6
- 95% sensitivity for colorectal cancer (Stages I–IV)
- 43% sensitivity for advanced precancerous lesions
- 74% sensitivity for high-grade dysplasia
- 94% specificity is age-weighted to the U.S. population for the absence of colorectal neoplasia.
Learn More
The EasyPI: CRC track offers practical tools, evidence-based insights, and real-world context to help clinicians improve CRC screening rates, ensure appropriate follow-up, and reduce preventable cancer deaths.
- Siegel RL, Wagle NS, Jemal A. Leading Cancer Deaths in People Younger Than 50 Years. JAMA. Published online January 22, 2026. doi:10.1001/jama.2025.25467.
- Ebner DW, Kisiel JB, Fendrick AM, et al. Estimated Average-Risk Colorectal Cancer Screening-Eligible Population in the US. JAMA Netw Open. 2024;7(3):e245537.
- Fendrick AM, Ebner D, Kisiel JB, et al. Abstract Sa1144. Eliminating the colonoscopy backlog with stool-based colorectal cancer screening options. Gastroenterol. 2024;166(5)(suppl):S358-S359.
- FAQs About Affordable Care Act Implementation Part 51, Families First Coronavirus Response Act and Coronavirus Aid, Relief, and Economic Security Act Implementation. Published January 10, 2022. Accessed January 14, 2026.
- Centers for Medicare & Medicaid Services. HHS Finalizes Physician Payment Rule Strengthening Access to Behavioral Health Services and Whole-Person Care. [Press Release]. Published November 1, 2022. Accessed January 14, 2026.
- Cologuard Plus Clinician Brochure. Exact Sciences Corporation. Madison, WI.