What COL is
COL stands for Colorectal Cancer Screening. It is the HEDIS measure, maintained by NCQA, that reports the percentage of adults 45 to 75 who had appropriate screening for colorectal cancer. NCQA lowered the starting age from 50 to 45 to align with updated screening guidance.
Unlike a single-test measure, COL accepts several screening methods, each with its own qualifying interval. The interval is the heart of the measure: the same member can be compliant or open depending only on which test they had and how long ago. The ECDS version of the measure is identified as COL-E.
Why COL matters
COL is a clinical quality measure in Medicare Star Ratings, so its rate flows into the quality bonus and rebate dollars CMS pays Medicare Advantage plans. Colorectal cancer is also one of the most preventable cancers when caught early, so the measure tracks care that genuinely changes outcomes.
COL is reported through ECDS, so a gap closes only when the screening and its date are captured as structured supplemental data. A colonoscopy done years ago still satisfies the ten-year interval, but only if the plan can source the date.
How COL is scored
The numerator is members with any one of the accepted screenings inside its interval: a fecal occult blood test (FOBT or FIT) during the measurement year, a stool DNA test (such as FIT-DNA) within three years, a flexible sigmoidoscopy or CT colonography within five years, or a colonoscopy within ten years.
Exclusions include a diagnosis of colorectal cancer or a total colectomy, hospice enrollment or services, and, for members 66 and older, frailty with advanced illness or long-term institutional residence.
Because the intervals differ by method, the operational task is matching each member to the right test and date, then sourcing that record into an accepted ECDS data feed so the gap reflects reality.
Common mistakes teams make with COL
- Applying one interval to every method. A stool test only counts for the measurement year, while a colonoscopy counts for ten. Treating them the same misclassifies who is actually open.
- Missing the lowered age floor. The measure now starts at 45. Members 45 to 49 who are eligible can be overlooked by panels still built around age 50.
- Not sourcing prior colonoscopies. Many members were screened years ago at facilities the plan never billed. Without the historical record, a compliant member reads as a gap.
- Sending stool kits without follow-through. A mailed FIT kit only counts when it is completed and returned. Distribution without return tracking produces no measure movement.
How Pelica handles COL
Pelica's Quality and Stars Copilot tracks COL by method and interval on one canonical record, reconciles claims with supplemental data so a colonoscopy from years ago closes the gap when its date can be sourced, and routes the right intervention, a stool kit with return tracking or a colonoscopy referral, to the members who are genuinely open. Across Pelica deployments, quality gap closure improves by 41%.
Related terms
COL sits inside the HEDIS and Stars framework. See BCS for the parallel breast cancer screening measure, ECDS for the reporting standard COL uses, and cut points for how a screening rate becomes a star.