Colorectal cancer screening represents a major health issue that can be improved at the primary care level by individualized, focused attention to screening. We describe a practice-based method to increase awareness of the potential barriers to effective screening and our attempts to overcome these barriers. A recent study indicating the prevalence of colorectal neoplasm in patients with documented coronary artery disease emphasizes the pivotal role that primary care providers play in screening procedures across the medical spectrum. While we are intuitively aware of increased screening success, we intend to document the change in our effectiveness since we initiated this effort in January 2004.