cancer screening

A proposed law in Colorado seeks to slow the rise of colorectal cancer by lowering the minimum age for preventative screening from 50 to 45. Rural counties such as Las Animas tend to have lower screening rates and higher per capita diagnosis of late stage disease.

The Colorado Cancer Coalition is working to raise awareness of the disease, and says colorectal cancer is the fastest growing young female cancer in Colorado and the most deadly cancer among men under 50 in the U.S.

Early treatment and diagnosis “can make the difference between, frankly, death and survival,” said Scott Wilson, a survivor advocate with the Colorado Cancer Coalition. “The survival rate (defined as living five years beyond diagnosis) at early stage diagnosis is 90 percent. The survival rate at late stage, or Stage 4, is 10 percent. This is a slow growing disease, if it’s caught early your survival chances are dramatically improved.”

The proposed law, HB20-1103, has bipartisan sponsorship and would ensure that Coloradans are eligible for preventative screening starting at age 45, following American Cancer Society guidelines. The prospects for passage look positive, according to one of the bill sponsors, House Speaker Pro Tempore Janet Buckner (D-Aurora). “We are so pleased because right now, we are working with the insurance providers on wording, and we’re really close to where we want to be,” she said. “We are close to the wording that will get us to the point where we will not have opposition to this bill.”

State Rep. Richard Holfort, (R-Akron) of House District 64, which includes Las Animas County, is well aware of the issue and supports the bill. His stepfather passed away from colorectal cancer at age 72. “Southeastern Colorado has the highest rate of colorectal cancer in Colorado, so it is a problem in House District 64,” he said. “I believe that we need to educate, inform and get more people in my district involved in screening. It makes no sense not to begin these at age 45.”

But it will take more than a change in the preventative screening age to increase the testing rate. Screening most commonly consists of a colonoscopy, an invasive procedure performed under anesthesia. According to Wilson of the Colorado Cancer Coalition, “the reality is that not everybody is open to an invasive test, and so fear, stigma, all sorts of reasons point people towards a non-invasive test. If that turns out to be positive, then the requirement still is to follow up with a colonoscopy. That can still turn out to be negative. We want to make sure that follow up colonoscopy is fully covered by insurers as if it was the first step.”

Non-invasive testing includes the FIT (Fecal Immunochemical Test), which detects blood in the stool, a possible early sign of cancer. A positive FIT requires a follow up colonoscopy to remove any pre-cancerous polyps. Such follow up colonoscopies would also be covered by insurance under the proposed law.

“The advantage of a colonoscopy is that if polyps are found, then removing them is the completion of that preventative process. You can prevent cancer by removing polyps. That’s all covered in one colonoscopy process,” Wilson said.

Las Animas County is part of what’s known by the Colorado Department of Health as Health Statistics Region 6, which includes the southeast counties. “56 percent of diagnoses in southeast counties are late stage, and that just makes treatment and survival that much harder,” said Wilson.

Raising awareness of screening for colorectal cancer involves not only changes to insurance requirements, but also getting the word out to the community. “I think education is critically important here, so there’s a program called the Colorado Cancer Screening Program, and they’re charged with reaching underserved areas so they have a very active program across Colorado in terms of reaching rural and underserved areas, which we know are the lowest screened,” Wilson said.

Changing insurance requirements can be costly in some cases but not in this circumstance, according to the bill’s backers. “We’re not adding new screens into the market. Currently it’s 50, then 60, then move on to Medicare,” said Wilson. “The new bill in Colorado is no different. You would get screened at 45, then 55, and by the time you would need any further procedures you are on Medicare. So we’re not actually adding a burden of cost to the insurer market.”

The Chronicle-News reached out to two of Colorado’s largest health insurers for comment, Anthem Blue Cross and Blue Shield as well as United Health Care, but did not receive any response by publication deadline.

It appears however that the insurance companies are on board. “So far I’ve had very good response from my fellow legislators. It’s a bipartisan bill,” said Rep. Buckner. “I’m just really pleased with the collaboration with the insurance companies, I’m pleased with how far we’ve already come and I’m really confident that this bill is going to pass.”

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