How UAB’s national accreditation for rectal cancer improves care
Most people hear “colorectal cancer” and think of it as a single condition. But in practice, colon cancer and rectal cancer are treated differently. Rectal cancer tends to be more complex and usually requires advanced imaging and surgery, as well as chemotherapy and radiation.
In June 2025, the UAB O’Neal Cancer Center earned accreditation from the National Accreditation Program for Rectal Cancer (NAPRC), making UAB one of only two centers in Alabama to hold this designation. This nearly three-year process helps ensure that patients are receiving the highest standards of multispecialty care available, which often depends on timing and coordination.
About the designation
Established by the American College of Surgeons (ACS) and launched in 2017, the NAPRC aims to bring consistency, coordination, and better outcomes to rectal cancer care. Most cancer centers have expert providers, but not all have consistent systems. The NAPRC created a national framework for rectal cancer care, with more than 20 quality standards that hospitals must meet, from diagnosis and treatment to follow-up care.
“There was too much variation in how rectal cancer was being treated across the country,” said Robert Hollis, M.D., colorectal surgeon and clinical lead for UAB’s colorectal cancer program.
One of the most important requirements is that every case must be evaluated by a multispecialty team before treatment begins. This means that surgeons, oncologists, radiologists, radiation oncologists, and pathologists review the same case at the same time.
“Before accreditation, you might have all the specialists in the same building but not necessarily talking about every patient together,” Hollis said. “Bringing providers together as a team each week with a formal system creates more consistency in care.”
Even with the structure in place, the UAB O’Neal Cancer Center’s accreditation process took nearly three years and involved detailed self-assessments, system changes, and a formal site visit by national reviewers. Accreditation must be maintained through regular performance audits and continued compliance. According to the ACS, there are only 119 accredited centers in the country.
Clarity and confidence
Patients should understand that the NAPRC’s detailed criteria reflects high marks for clarity, coordination, and detailed care plans among the centers that earn the designation.
“Our team meets weekly via Zoom to review new cases together, looking at scans, pathology, and treatment history in real time,” Hollis said. “We’re not just sending messages through the chart – we’re literally in the same room, at the same time, looking at the same images and making real-time decisions.”
These discussions may shape important treatment decisions, such as how radiation and surgery are used to target tumor tissue while preserving healthy tissue.
Another important NAPRC requirement is having a dedicated nurse navigator, who serves as a single source of information for patients during their treatment journey. Ridley Brown, RN, the rectal cancer nurse navigator, helps patients schedule tests, access records, get answers, and keep treatment on track.
“UAB can feel big, and we don’t want patients to feel lost here,” Brown said. “I’m with them from diagnosis through treatment. They have my direct number. When they need answers, I know exactly what’s going on and what needs to happen next. That’s a big advantage of my being dedicated to this one patient group.”
She also helps coordinate care for patients who live outside Birmingham and therefore may receive some treatments closer to home. “Some of my patients are getting scans in one city, chemo in another, and surgery here,” Brown said. “I keep it all connected, so they can focus on getting through it.”
In addition to early planning, the NAPRC requires teams to review cases after each major phase – such as after chemotherapy or radiation – to determine whether surgery or further treatment should be the next step.
“We don’t just discuss the case once,” Hollis said. “We bring patients back to the tumor board after chemo or radiation to re-review the imaging and talk about the next step. That’s what this program requires, and it’s what we believe patients deserve.”
Also, accredited programs must determine whether patients are eligible for any clinical research trials. In addition, they must track outcomes and follow the latest national treatment guidelines.
An asset to Alabama
For patients who do receive some treatment outside of Birmingham, UAB’s colorectal cancer team regularly coordinates with local providers, sends treatment summaries and recommendations, and continues to review cases internally.
“We consider ourselves as leading a statewide effort to improve rectal cancer care,” Hollis said. “While we usually lead on the planning, over half of our patients receive some part of their care outside of UAB, so we are always collaborating with other providers.”
Rectal cancer care doesn’t always follow a straight line. A scan might reveal a new concern, or a patient’s condition might change during treatment. When that happens, accredited centers like UAB’s are required to re-review the case – bringing the entire team back together to evaluate next steps. With seven colorectal surgeons, specialized oncologists and radiologists, and a full-time nurse navigator, the team has the depth and coordination to adjust the plan without delay.
“This isn’t about having one good doctor,” Hollis said. “It’s about building a process that patients can trust. That’s what this accreditation represents.”
Learn more about rectal cancer care at the UAB O’Neal Cancer Center.