By Dianne M. Cleveland, RHIA, CTR

The United States spends almost twice the money on cancer care costs than countries in Europe.  However, over the past 20 years, patients with rectal cancer have a wide variety of outcomes in the US compared to European countries which have improved the quality of rectal cancer care at a national level. 

As a result, the OSTRiCh Consortium was formed in 2011.  OSTRiCh (Optimizing the Surgical Treatment of Rectal Cancer) is a group of healthcare institutions with a mission to improve the quality of rectal cancer care in the United States.  The Consortium has five core principles of evidence-based rectal care:

  1. Total Mesorectal Excision (TME) in which a significant length of bowel around the tumor is removed
  2. Measurement of quality of surgery by specific techniques of pathology assessment
  3. Specialist imaging techniques identifying patients at high risk for local recurrence
  4. The use of newer more effective neo-adjuvant and adjuvant therapies including radiotherapy and chemotherapy
  5. A multi-disciplinary team approach that identifies, coordinates, delivers, and monitors the “ideal” treatment on an individual patient-by-patient basis

OSTRiCh has two registries, Transanal Total Mesorectal Excision (taTME) Registry and Rectal Cancer Registry.  This Consortium worked with the American College of Surgeons and the Commission on Cancer to create the National Accreditation Program for Rectal Cancer.  Initially, there was a pilot program.  now there is a total of eleven (11) facilities accredited by NAPRC.

The NAPRC Program Standards Manual has three chapters, Program Management, Clinical Services and Quality Improvement.  Unlike the National Accreditation Program for Breast Centers, NAPRC requires CoC Accreditation.  Other Program Management requirements include Multidisciplinary Care, Team Meetings and Attendance, Program Director and Coordinator, and Education.

Under Clinical Services, standards apply to Surgery, Staging, Pathology, Prognostic Indicators and Treatment Planning and Outcomes.

Chapter 3 provides standards on Accountability and Quality Improvement Measures including Rapid Quality Reporting System.

In order to apply for accreditation, a facility must assess and demonstrate compliance with all program standards.  It is important to know that the “initial” NAPRC survey cannot take place at the same time as the initial CoC survey.

In addition to the Standards Manual provided for download from the NAPRC website, resources have been made available through the CAnswer Forum, the interactive, virtual bulletin board for questions and answers regarding standard requirements.

In summary, as awareness of the best practices of rectal cancer care and management increases, outcomes in the United States may be more similar to that of European countries.

MedPartners has qualified and experienced Cancer Registrars to help your facility prepare for accreditation. Contact MedPartners today and let us help you with your staffing needs.


The National Accreditation Program for Rectal Cancer Standards Manual,

2017 Edition (Revised October 2017)

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