NAPRC Standards and Resources

The National Accreditation Program for Rectal Cancer (NAPRC) is pleased to announce the release of its new accreditation standards, Optimal Resources for Rectal Cancer Care (2026 Standards). The new standards are available for download.

The standards have been updated to incorporate non-operative management and local excision treatment options for rectal cancer while providing comprehensive, multidisciplinary care.

Interested in using content from Optimal Resources for Rectal Cancer Care (2026 Standards)? Please review the ACS Cancer Programs Accreditation Content Use Permission Requirements.

Download Standards

Implementation Date

All NAPRC-accredited programs are required to come into compliance with the new standards no later than January 1, 2026. The NAPRC will continue providing guidance and education regarding the new standards and future site visits throughout the 2025 calendar year.

Site Visits

Compliance requirements for NAPRC site visits will follow the information provided in the tables below. The tables reference the year of a scheduled or anticipated site visit, the year(s) of compliance data that will be reviewed during that site visit, and the standards version against which compliance will be measured.

Please reference the correct table for Renewal Sites undergoing a reaccreditation site visit, and Initial Sites undergoing their first NAPRC site visit.

Renewal Sites

Year of Site Visit	Years to be Reviewed	2020 or 2026 Standards
2025	2022, 2023, 2024	2020 Standards
2026	2023, 2024, 2025	2020 Standards
2027	2026	2026 Standards
2028	2026, 2027	2026 Standards

Initial Sites

Year of Site Visit	Review Period	2020 or 2026 Standards
2025	Initial site visits for NAPRC accreditation review a rolling 12 months	2020 Standards
2026		2020 or 2026 Standards*
2027		2026 Standards
2028		2026 Standards

Renewal Sites must follow the compliance requirements outlined in the table above.

*Initial Sites undergoing their first accreditation site visit in 2026 have the option of choosing which version of the standards they will be measured against to confirm compliance. This choice is at the discretion of the individual program. It is recommended that Initial Sites choose to demonstrate compliance with the 2026 Standards. However, if the Initial Site has been preparing for their initial site visit using the 2020 Standards, they will be allowed to demonstrate compliance at their initial site visit under the 2020 standards. All Initial Sites must begin implementing the 2026 Standards by January 1, 2026.

Upcoming Educational Events

ACS Cancer Conference
March 12–14, 2025
Phoenix, AZ

With changes to rectal cancer care, the NAPRC has completed a new edition of its accreditation standards that reflect current practice in rectal cancer care and introduced new standards that address quality improvement and measures of performance. The workshop will address the evidence for the changes, outline the content of the new standards, describe the needed changes to current cancer program structure and processes, and review the available tools that will assist with implementing the changes.

2020 NAPRC Standards and Resources

The National Accreditation Program for Rectal Cancer (NAPRC) accreditation standards, Optimal Resources for Rectal Cancer Care (2020 Standards) are available for download. The change log documents edits made to the 2020 Standards since its original release. Optimal Resources for Rectal Cancer Care (2020 Standards) are effective as of January 1, 2021, unless otherwise noted.

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.

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

The requirement for the RCP Director to present reports on National Cancer Database (NCDB) data to the Rectal Cancer Multidisciplinary Team (RC-MDT) has been retired and is not rated for compliance.

NAPRC-accredited programs must meet all other requirements for Standard 2.2 as outlined in Optimal Resources for Rectal Cancer Care (2020 Standards).

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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