March is National Colorectal Cancer Awareness Month and the perfect time for all of us to get involved in the fight against this deadly disease. The American Cancer Society estimates that in 2019, there will be 145,600 new cases of colorectal cancer and 51,020 deaths across the United States. Every hour, 17 families learn that a loved one has the disease, and six families lose a loved one to it. In South Carolina, 2,370 new cases and 870 deaths will occur this year, meaning that six people will be diagnosed and two will die each day in our state.
These sobering numbers make colorectal cancer the fourth-most diagnosed form of cancer and the second-leading cause of cancer mortality.
Research tells us that a number of lifestyle factors, including excess weight and obesity, physical inactivity, smoking, heavy alcohol use, and diets rich in red and processed meats, increase the risk of colorectal cancer. Changes in bowel habits, blood in the stool, rectal bleeding, cramping or abdominal pain, and chronic weakness and fatigue can be indicators of colorectal cancer and need to be checked out by a physician.
We know that screening for colorectal cancer is highly effective in the early detection and prevention of the disease. The United States Preventive Services Task Force recommends that screening begin at age 50 for the general population, while individuals at increased risk due to racial and ethnic backgrounds, genetic factors, family histories, or certain medical conditions should consider starting at an earlier age, following the recommendations of their physicians.
There are now several available methods for colorectal cancer screening, including colonoscopy, flexible sigmoidoscopy, CT-colonography and several stool-based tests. Colonoscopy and flexible sigmoidoscopy have the advantage that pre-cancerous polyps and early-stage cancers can be identified and removed during the procedure, thus adding prevention to the screening process. CT-colonography and stool-based tests must be followed up by a colonoscopy should the possibility of polyps or cancer be indicated.
Increasingly, insurance providers are covering the costs of colorectal cancer screening for their clients at average risk. Unfortunately, senior citizens covered by Medicare are at a disadvantage. Medicare pays for their screening colonoscopy, but if a polyp is found and removed during the procedure, the exam is reclassified as diagnostic and subjected to a co-insurance charge of several hundred dollars or more. This added expense inhibits many seniors from getting screened and puts them at an increased risk for colorectal cancer.
Companion congressional bills called the “Removing Barriers to Colorectal Cancer Screening Act of 2019” have been introduced in the Senate and the House of Representatives to address this barrier to screening for Medicare beneficiaries. These bills (S.668 in the Senate and H.R.1570 in the House) mandate that Medicare pay the full costs of colonoscopy screening tests, regardless of whether or not a therapeutic intervention, i.e., removal of a polyp, is required.
It is critical that these bills get passed. Already, 134 House members and 42 senators have signed on as co-sponsors, but all of us as citizens and constituents must play a role. Contact your congressional representatives today and ask them to co-sponsor and pass S.668 or H.R.1570.
We must also turn our attention to the younger population. Incidences of colorectal cancer in people in their 20s, 30s and 40s have increased significantly over the past 30 years. For adults of all ages, screening is the key to early detection and prevention of colorectal cancer. Let’s remove the barriers to screening and pay attention to our family histories, lifestyles and symptoms.
For more information, visit the American Cancer Society website at www.cancer.org or call the group’s helpline at 800-227-2345.
Franklin G. Berger, Ph.D., is research and outreach director for the Colorectal Cancer Prevention Network at the University of South Carolina.