NAPRC accreditation is the American College of Surgeons (ACS) National Accreditation Program for Rectal Cancer, which accredits rectal cancer programs inside Commission on Cancer (CoC) accredited programs against the Optimal Resources for Rectal Cancer Care standards. This page is for rectal cancer program leaders preparing a first application or a renewal. Integral Healthcare Solutions (IHS) builds your rectal cancer program's review workflow and accreditation evidence; your surgeons own the clinical work.
Last reviewed: October 2026.
What is NAPRC accreditation?
ACS describes NAPRC as a program that "was developed" to address variable rectal cancer outcomes by setting up multidisciplinary teams and research-supported care protocols (ACS, NAPRC). Its standards are published as Optimal Resources for Rectal Cancer Care. The ACS standards page lists the 2026 Standards and the prior edition, Optimal Resources for Rectal Cancer Care (2020 Standards), effective January 1, 2021 (ACS, NAPRC Standards and Resources). Check the 2026 edition's effective date on that page, and which edition governs your site visit, before your team starts work.
The program attaches to a cancer program that already holds CoC accreditation. ACS's first instruction is: "Verify your rectal cancer program is part of a Commission on Cancer (CoC)-accredited program" (ACS, NAPRC Accreditation).
Who needs it and what triggers it
The buyer is the leader of a rectal cancer program within a CoC-accredited cancer program. The triggers:
- Meeting the eligibility floor. ACS requires a program to show "12 months of compliance with the standards" and at least "10 rectal cancer surgical resections during the most recent calendar year" (accreditation page).
- The June 30 deadline. "Applications must be submitted by June 30 to have an initial site visit scheduled in the same year" (ACS, NAPRC FAQ).
- A network structure. "If the affiliated CoC program has an Integrated Network Cancer Program (INCP) category, then the NAPRC program attaches at the individual hospital level" (same FAQ).
- Renewal. Accreditation lasts "3 years from the date of the initial site visit" (accreditation page).
The NAPRC process and timeline
ACS sets these points in the process (ACS, NAPRC Accreditation):
- Initial visits occur "within 6–9 months after the application is approved."
- The Pre-Review Questionnaire is due "at least 60 calendar days" before the visit.
- Initial reviews examine "pre-selected charts from a 12-month timeframe" (FAQ).
- The Accreditation Report arrives "within 45 days of the site visit, or as soon as practical."
- Seven or more non-compliant standards produce a "Not Accredited" rating, with reapplication after one year.
The accreditation page also states that a program with too few cases at the time of the site visit has the visit canceled without a fee refund. That point is summarized here from the page, not quoted; read the page for the exact terms.
How IHS helps
IHS works on the review workflow and evidence side of accreditation. The process:
- Gap assessment. IHS reads your program against the Optimal Resources for Rectal Cancer Care standards your program obtains from ACS.
- Questionnaires. IHS sends questionnaires on multidisciplinary review, referral and data.
- Document and evidence mapping. IHS builds a crosswalk from each standard to its evidence and sets up the evidence structure for the Pre-Review Questionnaire.
- Drafting. IHS drafts the multidisciplinary review workflow, coordination responsibilities and a data ownership map for your program director and surgeons to approve.
- Mock review. IHS reviews the file against the standards as a reviewer would, including a sample of the records a chart review would draw on, and lists what is missing.
- Readiness support. IHS drafts responses to findings for your program to submit.
What you supply: the standards, tumor-board records, program data and your surgeons' clinical decisions.
The limit: clinical pathways and outcome data are physician and registrar work. IHS does not abstract cases or judge clinical care. Your program submits the application and the Pre-Review Questionnaire and handles every exchange with ACS.
What to have ready
Each item ties to the ACS NAPRC pages read on 2 October 2026.
- Confirmation that your rectal cancer program "is part of a Commission on Cancer (CoC)-accredited program" (accreditation page).
- The current Optimal Resources for Rectal Cancer Care standards, with the governing edition confirmed on the standards page.
- A count showing at least "10 rectal cancer surgical resections during the most recent calendar year" (accreditation page).
- Records showing "12 months of compliance with the standards" (accreditation page).
- A multidisciplinary team with physicians from surgery, pathology, radiology, medical oncology and radiation oncology, plus a named Program Director and Program Coordinator (accreditation page, summarized).
- Multidisciplinary review records for the 12-month period that charts will be "pre-selected" from (FAQ).
- A named owner and a calendar for the Pre-Review Questionnaire, due "at least 60 calendar days" before the visit (accreditation page).
- An application date that meets the June 30 deadline if you want a visit "in the same year" (FAQ).
- If your CoC program is an INCP, a decision on which hospital the NAPRC program attaches to (FAQ).
The introductory call is the place to go through this list against your program today.
How it compares
| Option | What it involves | Basis |
|---|---|---|
| NAPRC accreditation | Rectal-cancer-specific standards, case-volume floor, chart review, 3-year term | ACS NAPRC pages |
| Commission on Cancer accreditation alone | The prerequisite for NAPRC; not specific to rectal cancer | ACS NAPRC accreditation page |
| No NAPRC accreditation | IHS's reading (October 2026): the program continues under its CoC accreditation only | Structure of the ACS prerequisite |
Other site-specific ACS cancer programs, such as the National Accreditation Program for Breast Centers, do not cover rectal cancer. Related ACS surgical programs: ACS Quality Verification Program readiness. See all Accreditation Consulting services.
What it costs
The cost has two parts: the ACS accreditation fees and your own staff and physician time. ACS does not publish a fee schedule on the pages we reviewed. The NAPRC FAQ says: "No, there is no application fee to apply for accreditation," and "Current fees may be requested by emailing naprc@facs.org with 'Accreditation fees' in the subject line" (ACS, NAPRC FAQ). ACS also states that "the 2026 fee chart is available in the resources section of QPort" for Commission on Cancer, breast and rectal cancer programs (ACS Cancer Programs News). Verify current fees with ACS. IHS prices its own work after a free introductory call.
What this is not
- IHS is not part of ACS. It does not grant, influence or predict an accreditation decision.
- IHS does not submit to ACS or act for your program before it. Your program applies, submits and corresponds.
- IHS does not make clinical decisions or abstract registry data, and this page is not clinical advice.
Frequently asked questions
What is NAPRC accreditation?
It is the ACS National Accreditation Program for Rectal Cancer. ACS says the program "was developed" to address variable rectal cancer outcomes through multidisciplinary teams and research-supported protocols (ACS). Its standards are Optimal Resources for Rectal Cancer Care.
Does a rectal cancer program need Commission on Cancer accreditation first?
Yes. ACS's instruction is: "Verify your rectal cancer program is part of a Commission on Cancer (CoC)-accredited program" (ACS, NAPRC Accreditation).
How many rectal cancer resections does a hospital need to qualify?
ACS requires a minimum of "10 rectal cancer surgical resections during the most recent calendar year," along with "12 months of compliance with the standards." The accreditation page also states that insufficient cases at the site visit lead to cancellation without a fee refund.
Which specialties must sit on the NAPRC multidisciplinary team?
The accreditation page describes a team with physicians from surgery, pathology, radiology, medical oncology and radiation oncology, plus a Program Director and a Program Coordinator. Check the standards document for the exact roles and qualifications.
How long does NAPRC accreditation take, and when must we apply?
Initial visits occur "within 6–9 months after the application is approved." "Applications must be submitted by June 30 to have an initial site visit scheduled in the same year" (ACS FAQ).
What does the NAPRC site visit review?
Initial reviews examine "pre-selected charts from a 12-month timeframe." The Pre-Review Questionnaire is due "at least 60 calendar days" before the visit, and the Accreditation Report arrives "within 45 days of the site visit, or as soon as practical."
How many non-compliant standards lead to Not Accredited?
Seven or more non-compliant standards produce a "Not Accredited" rating, and the program may reapply after one year. A successful program is accredited for "3 years from the date of the initial site visit."
How much does NAPRC accreditation cost?
"No, there is no application fee to apply for accreditation" (ACS FAQ). Accreditation fees are not published on the pages we reviewed; ACS says current fees may be requested from naprc@facs.org and that the 2026 fee chart is in QPort's resources section.
Can a hospital in an integrated cancer network get NAPRC accreditation at the network level?
ACS states: "If the affiliated CoC program has an Integrated Network Cancer Program (INCP) category, then the NAPRC program attaches at the individual hospital level."