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Why Colorectal Cancer Awareness Month Celebrate This Year




(Conversations are an independent, non-profit source of news, analysis, and commentary from academic experts.)

University of South Carolina Franklin G. Burger

(Conversation) March is National Colorectal Cancer Awareness Month. Most of us are reluctant to talk about hips and bowel habits, so we recognize that you are unlikely to have a party to celebrate. But there is really a reason to talk about the disease, which kills more than 50,000 people each year in the United States.

As a research scientist and advocate of colorectal cancer, I am particularly excited about two important recent developments. These can save lives.

First, to stop the increase in young adults diagnosed with the disease, the National Committee recommends lowering the age at which screening should begin to 45 years.

Second, federal law has changed Medicare’s reimbursement to ensure that the cost of screening colonoscopy is fully covered.

Fatal illness

Colorectal cancer continues to be a major cause of cancer incidence and mortality worldwide. The American Cancer Society recently estimated that there would be 149,500 new cases of colorectal cancer and 52,980 deaths in the United States alone in 2021. This makes the disease the fourth highest cancer incidence and the second highest mortality rate. In the United States, only lung cancer kills cancer. In addition, African Americans are more likely to be diagnosed with the disease and die.

Still, colorectal cancer is one of the most preventable cancers. Over the last three decades, timely screening and removal of precancerous lesions called polyps before they progress to cancer has led to a sustained reduction in the incidence and mortality of colorectal cancer. So while progress is progressing, we have a way.

In 2000, President Bill Clinton dedicated March as National Colorectal Cancer Awareness Month, stating that “early detection and treatment are the most effective weapons to defeat colorectal cancer.” Each year, survivors, patients, healthcare providers, researchers, and supporters are conscious of collectively disseminating knowledge about colorectal cancer and its prevention to the general public and reducing the number of victims of this highly preventable disease. Promote action.

Worrying trends in young adults

For quite some time, national guidelines have recommended that screening for colorectal cancer begin at age 50, when the risk of the disease begins to increase significantly. However, in recent years, researchers and doctors have observed an increase in colorectal cancer in people under the age of 50. Screening is generally not recommended for people under the age of 50 unless major symptoms occur.

Our people studying the disease do not fully understand the reasons behind this increase, but there is growing concern among doctors, researchers, and of course patients and their families. .. This concern has led to a review of screening guidelines by the federal committee that recommends them.

In October 2020, its panel, the US Preventive Medicine Expert Committee, conducted a comprehensive and detailed assessment. Adults aged 45-49 years were recommended to be screened for colorectal cancer. This ensures that the Task Force is consistent with what the American Cancer Society recommended in 2018.

The revised recommendations are now officially in draft format, but will be finalized in the coming months. The Affordable Care Act requires that screening for colorectal cancer follow these guidelines and that private insurance companies and Medicare cover approved screening tests at no cost.

With the new guidelines in place, young adults aged 45-49, who are increasingly vulnerable to colorectal cancer, will be covered by insurance that covers full screening.

Get rid of surprise payments

The second development concerns the scope of Medicare for colonoscopy screening. Medicare should cover colorectal cancer screening at no cost, but will be charged if polyps or other tissue are found and removed during colonoscopy. The rationale for this was that tissue removal was considered a diagnostic procedure rather than a screening.

This distinction surprised patients with unexpected out-of-pocket costs. Therefore, Medicare patients undergoing colonoscopy believe they are fully covered, but are only confused by being charged a co-payment after the procedure has been performed.

It has been considered unacceptable by healthcare providers and public health advocates who consider removal of precancerous lesions to be an integral part of the screening process. Overall, this situation, known as a loophole in Medicare, is a barrier to prophylactic colonoscopy in the elderly at high risk for colorectal cancer.

After years of support and lobbying on the issue by organizations such as the Fight Colorectal Cancer and the American Cancer Society Cancer Action Network, the loophole was finally closed in December 2020, when Congress passed and President Trump signed. Screening method for 2020. The law, which is part of the COVID-19 Economic Relief Bill, requires the exemption of joint insurance premiums associated with colorectal cancer screening tests, regardless of whether tissue was removed during the test. It will be phased in over the eight years starting in 2022.

The future of colorectal cancer screening

In a proclamation on March 1, President Biden encouraged “all citizens, government agencies, private businesses, nonprofits and other groups to participate in activities to raise awareness and prevention of colorectal cancer.” New screening guidelines will help make that happen in the future.

Many effective options for colorectal cancer screening have been approved under new guidelines. These include tests that look for the presence of blood or specific DNA biomarkers in fecal samples, and visualization tests that directly examine the lining of the colon to allow removal of tumors or precancerous lesions.

New technologies are emerging that make screening easier and more effective. For example, liquid biopsy involves the analysis of readily available body fluids such as blood and urine. Doctors may soon be able to isolate and analyze cells or DNA that originate from the tumor and are present in the bloodstream.

In addition, molecules in urine may be potentially important as biomarkers for detecting colorectal lesions.

The usefulness of such techniques is still under investigation, but it is clear that in the near future we need to witness the emergence of simpler, more accessible, and more sensitive tests for colorectal cancer. However, it is important to note that colonoscopy should be performed after these non-invasive tests if concerns are raised.

As the National Colorectal Cancer Awareness Month reminds us, it is important that people of all ages are aware of the risk factors for colorectal cancer, the symptoms that may indicate the disease, and strategies and guidelines for screening and prevention. .. Talk to your doctor and insurance company about colorectal cancer and its prevention. The more you know, the better.

This article has been republished by The Conversation under a Creative Commons license. Read the original article here:

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