Begin with a strong commitment to preventive services delivery.

Use any visit to recommend colorectal cancer screening.

Use paper or electronic health record to prompt screening recommendation.

Offer a brief personal recommendation bundled with other preventive health services.

Recommend colonoscopy or fecal occult blood testing (if colonoscopy is declined or not affordable).

Emphasize benefits of early detection and avoiding regret.

Determine barriers and use anecdotes to overcome.

If colorectal cancer screening is declined, demonstrate concern and repeat recommendation during the next visit.

Off-load explaining the details of the screening process to office staff.

Cultivate a relationship with endoscopist(s) who provide quality service and communication, and outsource responsibility for the details of endoscopy process.