Colorectal cancer is the second most common cancer-related death in the United States, making it a crucial screening for people ages 45 and up.¹ But oftentimes, patients feel uncomfortable discussing the topic with their health care providers.
At Chota Community Health Services in Tennessee, Tammy Madison, former Director of Nursing, recognized this as an obstacle and began brainstorming a creative solution.
And so, the "Poop Can Save Your Life" campaign was born.
“It seems like if you can get someone to laugh at something uncomfortable, it makes it a little easier to talk about,” Tammy explains. “I just started saying, ‘You know, poop can save your life,’ and [patients] would laugh at it and seem to be a little more receptive to hearing about the colorectal screenings.”
The idea began building, with other members of the team—like Pamela Sartin, the Quality Improvement/Risk Management Coordinator, joining the charge. They made "Poop Can Save Your Life" buttons for staff to wear and even purchased a hat shaped like a poop emoji.
“The care coordinators became the ‘poop queens’,” Tammy jokes. “They were the ones following up with patients about the screening.”
Beyond the pins and messaging, Chota took practical steps to increase their colorectal screenings, such as patient outreach, care coordination, and a partnership with Cologuard—a noninvasive colon cancer screening test that patients can do at home.2
The Cologuard test is covered by Medicare and Medicare Advantage for eligible patients, and at Chota, uninsured patients under 200% of the federal poverty level can receive the test at no cost.
Chota’s current process for the screenings is incredibly streamlined. When a patient comes in with a gap in care for a colorectal cancer screening, the clinical team will recommend the Cologuard test. They can order the kit and send it centrally to the care coordination team to ensure the patient is eligible, answer any coverage questions, and provide guidance as needed. The staff even have their own demo kit so they can walk through the process with the patient step by step.
“We make sure screenings are a priority with not just our providers, but also our clinical support staff, nurses, and medical assistants,” Pamela says.
In 2025, Chota was able to grow their compliance rate for colorectal cancer screening from 28% to 45% for patients ages 45-74 due to their efforts and commitment as a team.
“Even if you only screen one additional person, that matters,” Pamela shares. “We have patients who had multiple cancerous polyps removed after screening, and they likely would’ve had full-blown colon cancer in three to five years if it wasn’t detected in time.”
While the growth in their compliance rate is meaningful, Pamela emphasizes that their focus is not just on the percentage. “These are people we’re actually impacting, not just numbers.”
This interview was edited for brevity and clarity.
1 Siegel RL, Wagle NS, Star J, Kratzer TB, Smith RA, Jemal A. Colorectal cancer statistics, 2026. CA Cancer J Clin. 2026 Mar-Apr;76(2):e70067. doi: 10.3322/caac.70067. PMID: 41769777; PMCID: PMC12951547.
2 What is the Cologuard® Test? https://www.cologuard.com/what-is-cologuard.
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