Process-oriented approach and project management tools in improving the quality and effectiveness of colorectal cancer screening as a part of medical examinations

Colorectal cancer (CRC) ranks among the leading causes of cancer mortality in Russia. Despite established screening protocols as part of routine medical check-ups for specific adult demographics (RMCSAD), the detection rates, especially for early-stage disease, remain inadequate. In the Kabardino-Balkarian Republic, an incident management approach grounded in incident management principles has been implemented to enhance the quality and effectiveness of CRC screening. Objective. To optimize the organization and enhance the effectiveness of colorectal cancer screening by integrating incident management tools into the medical check-up framework for specific adult demographics. Materials and methods. This study was conducted as a pilot project at a medical organization in the Kabardino-Balkarian Republic. An interdisciplinary working group comprising endoscopists, coloproctologists, and oncologists was established. The analysis used process charts, a risk register, and stepwise screening decomposition. Management interventions included centralizing laboratory testing, shifting to quantitative methods for occult blood detection, and consolidating colonoscopy services within specialized medical institutions. Results. Between 2022 and 2025, coverage with RMCSAD increased from 43.3% to 72.9%, while the proportion of fecal occult blood tests rose from 36.3% to 81.3%. The identification of abnormalities through stool tests increased fivefold, and colonoscopy coverage more than doubled. The detection of early CRC increased from 42.9% to 86.4%. Conclusion. The application of incident management principles within the healthcare system has demonstrated efficacy in optimizing colorectal cancer screening. A comprehensive approach that encompasses process analysis, risk management, and interdisciplinary collaboration has proven instrumental in enhancing the quality, effectiveness, and continuity of preventive healthcare measures.