Cancer screening is entering a new chapter, and healthcare leaders face a critical question: How do we move from offering individual screening tests to building a coordinated strategy that reaches more patients, detects cancer earlier, and connects screening to appropriate follow-up care?
The challenge extends beyond adopting new technologies. Health systems must balance established evidence-based screening programs with emerging innovations while addressing workforce constraints, fragmented workflows, patient access, and rising operational demands. Advances in colorectal cancer (CRC) screening, including stool-based and blood-based options, are creating additional opportunities to engage patients.
Multi-cancer early detection (MCED) technologies are also emerging, with the potential to identify signals associated with cancers that lack established screening pathways. However, these innovations bring new considerations regarding clinical evidence, appropriate utilization, diagnostic follow-up, and integration into existing care models.
For healthcare executives, the opportunity is not simply to expand the screening menu. It is to build an integrated, patient-centered strategy that connects population health, clinical operations, technology, and accountability.
Lead with Population Strategy, Not Technology
Effective screening strategies begin with understanding the population, rather than selecting a test. Who remains unscreened or overdue? Which populations experience the greatest barriers? Where are opportunities to improve screening participation, and what resources are needed to ensure patients complete the recommended care pathway?
Answering these questions requires health systems to leverage population health data, identify screening gaps, and segment patients according to clinical risk, screening history, and barriers to care. Established, guideline-recommended screening modalities should remain the foundation. Within those recommendations, offering appropriate options can help accommodate patient preferences, improve accessibility, and address persistent screening gaps.
For colorectal cancer, for example, patients may face barriers involving procedure preparation, transportation, time away from work, or access to specialty services. Offering appropriate noninvasive screening options, supported by patient education and navigation, may help engage individuals who otherwise delay screening.
Equity must also be intentional. Differences in language, health literacy, digital access, transportation, and trust can significantly influence participation. A successful strategy recognizes these differences and tailors outreach accordingly. Importantly, health systems should involve patients and communities in designing interventions. What appears operationally efficient may not always be accessible or acceptable to the intended population.
The objective is not simply to offer more tests, but to reach more of the right patients with the right screening options at the right time.
Close the Gap Between Screening Orders and Completion
One of the greatest opportunities in cancer screening lies in improving execution of programs already in place. Identifying a care gap is only the beginning. The true measure of success is whether a patient completes the recommended screening and, when necessary, receives timely diagnostic evaluation.
This emphasis on completing the screening continuum is increasingly reflected in national quality standards. Beginning with HEDIS Measurement Year 2027, the National Committee for Quality Assurance (NCQA) is introducing a separate measure, Follow-Up After Positive Colorectal Cancer Non-Invasive Screening Test (COF-E), evaluating colonoscopy completion following a positive noninvasive screening result among adults ages 45–75. While the existing colorectal cancer screening measure (COL-E) continues to recognize qualifying completed screening, the new measure adds accountability for diagnostic follow-up. For health system
leaders, this reinforces the importance of tracking patients beyond the initial test and establishing reliable pathways to timely diagnostic resolution.¹
Effective care-gap programs combine accurate patient identification, targeted outreach, simplified ordering, and reliable follow-up. Electronic health record (EHR) data can help identify patients who are overdue, while population-based outreach programs can engage them through patient portals, text messaging, telephone calls, mailed communications, or community partnerships.
However, outreach alone may not be enough. Health systems must consider whether patients understand their screening options, can access the recommended test, and know what happens next. Clear clinical ownership and navigation become particularly important when patients encounter barriers or receive abnormal results.
For home-based screening, coordination among ordering clinicians, laboratories, population health teams, and patient support services can help reduce unnecessary friction. Reliable data is equally important. Incomplete contact information, inconsistent documentation, or delays in recording results can lead to duplicate outreach, missed opportunities, and inaccurate quality reporting.
Successful programs therefore measure more than orders placed. They track patient engagement, test completion, abnormal results, diagnostic follow-up, and unresolved concerns. These measures allow leaders to identify where patients disengage and where workflow improvements or additional resources are needed.
The future of screening quality is not simply measuring whether patients complete a test, but ensuring that those with abnormal results receive the timely diagnostic follow-up needed to complete the screening continuum.
Integrate Screening into the Clinical Operating Model
As screening portfolios evolve, operational integration becomes increasingly important. Healthcare professionals already manage complex clinical workflows, competing priorities, and significant documentation demands. Introducing additional screening options without a clear implementation strategy risks increasing administrative burden rather than improving care.
Health systems should evaluate how screening modalities fit within existing EHR ordering, clinical decision support, results management, and patient communication processes. This includes defining who can order a test, how eligibility is determined, where results appear, and which team is responsible for follow-up.
For established screening modalities, these processes may already be well developed. Emerging technologies, including MCED testing, introduce additional considerations. Unlike screening programs with established diagnostic algorithms, MCED approaches may require evaluation across multiple organ systems. Health systems considering these technologies should establish clinical governance, patient selection criteria, diagnostic pathways, and clear accountability before implementation.
They must also assess the evolving evidence regarding clinical utility, benefits, potential harms, and the resources required to evaluate positive findings. MCED testing should not replace guideline-recommended cancer screening. Rather, its potential role should be evaluated within a broader strategy that preserves established screening standards.
For executives, this creates an important intersection between clinical innovation and operational readiness. A new technology may offer promising capabilities, but its value to the organization depends in part on whether the health system can implement it responsibly, support clinicians, and manage the downstream care pathway.
Recognize Screening as a Shared Responsibility
No single department can independently deliver a comprehensive cancer screening strategy. Clinical leadership, population health, primary care, specialty services, information technology, quality improvement, and patient navigation all contribute to successful execution.
Health systems may also consider optimizing or implementing resources to support certain aspects of a screening strategy. Depending on the screening program, these may include HER connectivity, patient outreach, multilingual education, laboratory logistics, care navigation and provider education. While these activities can be supported in different ways, clinical governance, appropriate test utilization, management of abnormal results, and coordination of diagnostic care remain the responsibility of the health system and should be clearly defined.
Comprehensive cancer screening strategies work best when responsibilities, performance expectations, data exchange, and escalation processes are established at the outset. Collaboration across internal stakeholders can also support quality performance, continuity of care, and patient resources.
Ultimately, the goal is a connected operating model in which patients receive consistent guidance, clinicians have actionable information, and organizational teams understand their respective responsibilities.
Start Deliberately, Measure Results, and Scale
Building an integrated screening strategy does not require transforming every workflow simultaneously. A practical approach begins with a defined population, measurable objectives, and an implementation model that can be evaluated and refined.
For CRC screening, a health system might prioritize patients overdue for rescreening, individuals who have not responded to previous outreach, or populations with persistently low screening participation. A targeted pilot can evaluate patient engagement, completion rates, operational workload, and diagnostic follow-up before expanding across additional clinics or markets.
Similarly, organizations evaluating emerging MCED technologies may begin with carefully defined populations and structured clinical oversight, while considering evidence, access, reimbursement, and diagnostic capacity.
Regardless of the starting point, leaders should establish clear success measures before implementation. These may include screening participation, completion, time to diagnostic resolution, patient experience, equity across populations, and operational resource utilization. Importantly, leaders should evaluate unintended consequences alongside intended benefits. Additional testing may generate diagnostic demand, and systems must be prepared to manage that demand without compromising existing services.
Continuous measurement creates opportunities to improve workflows, strengthen patient support, and make informed decisions about broader implementation. The most sustainable programs are not necessarily those that launch at the largest scale. They are those that establish accountability, demonstrate operational feasibility, and adapt based on measurable performance.
The Leadership Opportunity Ahead
Cancer screening will continue to evolve as technologies advance, evidence develops, and patient expectations change.
At Exact Sciences, now part of Abbott, our cancer screening portfolio includes the Cologuard ® and Cologuard Plus ® tests for stool-based colorectal cancer screening, the SimpleScreen™ CRC test for blood-based colorectal cancer screening, and the Cancerguard ® test for multi-cancer early detection. Our experience supporting health systems reinforces the importance of connecting screening innovation with practical implementation through EHR integration, patient engagement, provider education, and navigation. Together, these capabilities can support a more coordinated approach to cancer screening while helping health systems address patient access and operational challenges.
For health system leaders, the priority is to build an infrastructure that can accommodate innovation without losing sight of clinical evidence, patient needs, or operational accountability. The next chapter of cancer screening will not be defined by how many tests a health system offers, but by how effectively it connects patients to appropriate screening, timely follow-up, and the care they need.
Reference
1. National Committee for Quality Assurance (NCQA). (2026, August 3; updated
September 30, 2026). HEDIS MY 2027: What's New, What's Changed, What's
Retired. https://www.ncqa.org/blog/hedis-my-2027-whats-new-whats-changed-whats-
retired/
Authors:
David Harding
David Harding is a healthcare executive with more than two decades of experience driving growth and innovation across precision medicine, women’s health, and cancer diagnostics. As Senior Director, Screening Product Management at Abbott Cancer Diagnostics, he leads strategy and development for the company’s next-generation screening and diagnostic solutions, advancing the mission to detect cancer earlier and improve patient outcomes at scale. Since joining Exact Sciences now Abbott in 2017, David has held multiple senior leadership roles spanning business development, market access, health outcomes, and the launch of groundbreaking products — including the Cancerguard test, Exact Science’s multi-cancer early detection (MCED) test. Prior to Exact Sciences, David served as Chief Commercial Officer at both T2 Biosystems and OvaScience, as Senior Vice President of Women’s Health at Hologic, Inc., and as Partner at McKinsey & Company. David holds a bachelor’s degree from the University of Southern California and an MBA from the Wharton School at the University of Pennsylvania. He also serves on nonprofit boards including the Wellesley Free Library and Rising Star Outreach.
Travelle Ellis, MD, PhD
Dr. Travelle Ellis is a visionary leader at the intersection of evidence-based medicine, biomedical engineering, and ensuring innovation gets to those that need it most. She
currently serves as Screening Medical Officer at Exact Sciences now Abbott. She has spearheaded sustainable partnerships with communities, providers, and executives
to dismantle systemic barriers and advance innovative, outcomes driven care. Prior to Abbott, she served as the inaugural Health Equity director at Exact Sciences focused on
implementing evidence-based interventions to facilitate systems change and improve outcomes. Dr. Ellis holds both an MD and a PhD in Biomedical Engineering, from the
University of University of Wisconsin Madison & School of Medicine and Public Health. She gives back to her community through mentorship and service in civic organizations and non-profit boards. Dr. Ellis resides in Houston, TX with her family and their spirited dog, Davy.
