The National Accreditation Program for Rectal Cancer (NAPRC) was formed to address the differences between patient outcomes in the United States as compared to Europe. According to the American College of Surgeons, outcomes for rectal cancer patients in Europe have for years been significantly better than for those in the U.S. Characterized by the use of multidisciplinary teams to make treatment decisions, the NAPRC standards aim to decrease the average circumferential resection margins, decrease the overall colostomy rate, and increase quality of life as reported by recovering patients. Two statistics illustrate the difference in treatment. A decade ago, the colostomy rate in Europe ranged from 25 percent to 35 percent, while today’s colostomy rate in the U.S. is about 50 percent, meaning that many more patients in the U.S. have colostomies as compared to Europeans. Rectal cancer cases in the U.S. have an average circumferential resection margins (CRMs) rate of 17 percent, significantly higher than the 3 percent to 11 percent range for European countries. Background Collaboration between numerous professional organizations serves as the driving force behind the creation of the NAPRC and its standards. To create the new standards and address the disparities between treatment in Europe and the U.S., the OSTRiCh (Optimizing Surgical Treatment of Rectal Cancer) Consortium was created by the American College of Surgeons and its Commission on Cancer (CoC) working with the American Society of Colon and Rectal Surgeons (ASCRS), the College of American Pathologists, the American College of Radiology, the Society of Gastrointestinal and Endoscopic Surgeons (SAGES), the Society for the Surgery of the Alimentary Tract and Society of Surgical Oncology. Lead members of the steering committee include Steven D. Wexner, MD, FACS, past president of the ASCRS, and Frederick L. Greene, MD, FACS, past chair of the CoC. The NAPRC is the fourth accreditation program approved by the CoC. Prior to the CoC's creation of the NAPRC, a study was conducted on the current state of treatment in the US. The study was published in the Journal of the American College of Surgeons. The results showed that the full set of proposed quality standards were only met in 28.1% of patients, who were all diagnosed between 2011 and 2014 with non-metastatic rectal cancer. The completion of these measures varied based on location of the facility, type of facility, insurance, race, stage of disease, and operative volume. </ref> The study's authors plan to review