NAPRC Standards and Resources

The NAPRC Optimal Resources for Rectal Cancer Care (2020 Standards) are available for download. The change log documents edits made to 2020 Standards since its original release.

A crosswalk and notable changes resource comparing the 2017 standards to the 2020 Standards is available for download. Unless otherwise noted, programs are expected to implement changes in the 2020 standards by January 2021.

Interested in using content from Optimal Resources for Rectal Cancer Care (2020 Standards)? Please review the ACS Cancer Programs Accreditation Content Use Permission Requirements.

Download Standards Changelog

2020 Standards Implementation Updates

Beginning January 1, 2025, the required compliance percentages for the following Optimal Resources for Rectal Cancer Care (2020 Standards) accreditation standards will be lowered to ninety percent (90%):

Standard 5.1 – Review of Diagnostic Pathology
Standard 5.2 – Staging before Definitive Treatment
Standard 5.3 – Standardized Staging Reporting for Magnetic Resonance Imaging Results
Standard 5.5 – Rectal Cancer Multidisciplinary Team Treatment Planning Discussion
Standard 5.8 – Surgical Resection and Standardized Operative Reporting
Standard 5.11 – Multidisciplinary Team Post-Surgical Treatment Outcome Discussion

Each of these standards previously required compliance for one hundred percent (100%) or ninety-five percent (95%) of patients. The lower compliance thresholds are effective for any site visits during calendar year 2025 and beyond.

The National Accreditation Program for Rectal Cancer (NAPRC) Standards evaluate the following elements of a rectal cancer program:

Program Management: Ensures the program and multidisciplinary team is overseen by a qualified Rectal Cancer Program Director
Clinical Services: Confirms rectal cancer patients receive appropriate care based on diagnosis and within specified time targets
Quality Improvement: Utilizes data to improve efficiency, standardize care, and improve outcomes

Compliance Resources

Frequently Asked Questions for Radiology and Pathology Standards

A Frequently Asked Questions resource has been developed based on questions received from programs on pathology and radiology-related standards.

Standard 2.2: Rectal Cancer Program Director

Because the NAPRC rectal cancer measures in the National Cancer Database (NCDB) are in development, the four reports on NCDB data required in Standard 2.2 are not currently being rated. However, it is encouraged that the Rectal Cancer Program Director begin to report on data that is relevant to the rectal cancer program from the program's own registry or through other NCDB tools, such as the CQIP report.

Standard 5.3: Standardized Staging Reporting for MRI Results

The required elements for rectal cancer MRI results are defined in the Society of Abdominal Radiology template.

Standard 5.13: Adjuvant Therapy after Surgical Resection

Beginning January 1, 2023, Standard 5.13 is retired. It will not be rated at site visits occurring after its retirement.

Standard 7.1: Accountability and Quality Improvement Measures

Compliance with Standard 7.1 is not required at this time. This standard is still in development.

Standard 8.1: Rectal Cancer Program Education

For compliance with Standard 8.1, all surgeons, pathologists, and radiologists on the facility’s Rectal Cancer Multidisciplinary Team must complete the NAPRC-endorsed education module related to their respective specialties at least once.

Programs that underwent a NAPRC site visit in 2021 or earlier will need to comply with Standard 8.1 before the first re-accreditation visit. For any program undergoing its initial site visit in 2022 or later, Standard 8.1 must be complied with before the initial site visit.

Surgery

The American Society of Colon and Rectal Surgeons (ASCRS) web-based Fundamentals of Rectal Cancer Surgery Course is now available. More information, including cost, may be found on the course’s website.

Radiology

The American College of Radiology (ACR) has released the education module that RC-MDT radiologist members must complete for compliance with Standard 8.1. For full course description please visit ACR’s Rectal Cancer Staging module webpage. NAPRC applicant programs have two options to purchase the course:

Individual Purchase
Direct your radiologist to individually purchase the module directly from the ACR website for immediate access. The cost is $120 for ACR members and $220 for ACR non-members. Make an individual purchase.
Facility Group Purchase
For institutions that would like to purchase access for multiple radiologists, group pricing is available for $600. Group pricing allows institutions to enroll radiologists as needed for up to one calendar year from the date of payment. Please email Melissa Parker at mparker@acr.org for more information and/or to coordinate a group purchase. Please put RC-MDT Group Pricing in the subject line of your email.

Pathology

The College of American Pathologists' (CAP) “Protocol for the Examination of Resection Specimens from Patients with Primary Carcinoma of the Colon and Rectum” must be reviewed as a self-study by all pathologist members of the accredited program’s RC-MDT. This protocol can be found on the CAP's Cancer Protocol Templates website.

The NAPRC Pathology Education Module webinar is now available.

NAPRC Optimal Resources for Rectal Cancer Care Gap Analysis Tool

To assist your accreditation journey, the NAPRC has developed a tool to help assess your site’s readiness to apply for NAPRC accreditation. This resource includes:

Standard Elements – A basic description of the elements within each standard.
Required Documentation – Information on what is needed to demonstrate compliance.
Site Status – A space to document your site’s current standard compliance status.
Action Plan – A space to document an action plan to address compliance gaps.
Resources – Links to available resources that can assist with compliance, including access to templates and an example of the Pre-Review Questionnaire (PRQ).

For more information on this tool, please visit the ACS Store .

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