This has not been a great year in the fight against colorectal cancer. After decades of declining colorectal cancer death rates and improvement in five-year survival rates – both of which are the direct result of increases in preventive screening – we have encountered a new challenge that has the potential to set us back significantly. COVID-19 has caused a massive drop in colorectal cancer screening, and even though procedures have now resumed in most parts of the country, there are still significant backlogs and many of those appointments that were delayed or missed during the height of the pandemic will never be recovered.
 
Our research earlier this year with Komodo Health found that the total number of colonoscopies and biopsies performed in March and April of this year declined by nearly 90% versus the same period last year. Moreover, we found that nearly 40% of colorectal cancer patients and caregivers reported disruptions in their care and 78% said they were nervous, anxious, or on edge about receiving treatment during the pandemic. Now, as the US healthcare system tries to play catch-up, we’ve been hearing reports of colonoscopy backlogs of over 3,000 patients in some cases.
 
Flex Your Vote
 
Meanwhile, potential strategies that could help alleviate this issue have been caught in a quagmire of complicated federal policies regarding patient cost-sharing. Critical funding for the Centers for Disease Control, which affects state-level screening efforts, has been called into question. And the death of Chadwick Boseman – an actor known as much for his Hollywood superhero image of strength as his gifted character development – reminded us how vulnerable we all are and put a spotlight on the need for colorectal cancer awareness among African American men.
 
The fact that all of these issues – the pandemic, Medicare policies, federal funding for screening, and sociodemographic disparities in care – have come to a head during an election year only underscores the importance of raising our voices about the issues that are important to the colorectal cancer community. That’s why we’ve launched the Flex Your Vote campaign at Fight CRC to encourage those who’ve been affected by colorectal cancer to get out and vote for the policies, research, education, and awareness we need. 
 
Eliminating Barriers to Early Diagnosis
 
For our part at Fight CRC, we’ve been tackling all of these issues head-on. When it comes to the pandemic’s impact on preventive screening, for example, we have been engaging the Centers for Medicare and Medicaid Services (CMS) to change cost-sharing policies for colonoscopies following noninvasive, at-home screening tests. Under current CMS guidelines, patients who receive a positive result on a noninvasive colorectal cancer screening test still face significant cost-sharing for the colonoscopy that is needed as a next step toward diagnosis. This financial burden causes many patients to delay their colonoscopy.
 
This type of roadblock needs to be removed from the fight against colorectal cancer.
 
Federal Funding for State Screening Programs
 
Another key area of focus for us is CDC funding for the Colorectal Cancer Control Program (CRCCP), which provides grants to states to develop colorectal cancer screening programs. With virtually every state in the country straining under the weight of COVID-19 relief programs and budget shortfalls, this funding will be crucial to keeping screening initiatives on pace.
 
Addressing Social Determinants
 
We are also addressing social determinants of health, making sure that structural, societal, and cultural barriers to care are eliminated for good. Chadwick Boseman’s death was a tragic reminder that Black men are almost two times more likely to die from colorectal cancer than white men.
 
Dr. Rachel Issaka, a gastroenterologist and assistant professor at the Fred Hutchinson Cancer Research Center at the University of Washington and a member of our Health Equity Committee, recently published an important essay addressing this issue in JAMA. Sharing her own experiences as a Black female physician and discussing the larger cultural and societal factors that influence the healthcare experiences of minority groups, Issaka’s essay is an eye-opener for just how big a role race has played in healthcare.
 
For all of us, 2020 has come with its fair share of setbacks. For me personally, along with the pandemic this year brought my own battle with cancer, too. But these challenges also give us an opportunity to refocus our priorities. For both political parties – whoever wins the election – the repercussions of COVID-19 on cancer are very real and addressing those issues will need to be a priority. Regardless of partisan divisions, I hope we can all agree that lives impacted by cancer are worth fighting for.
 
 
About the Author:
Anjelica (“Anjee”) Davis serves as president of Fight Colorectal Cancer (Fight CRC), a national patient-empowerment organization founded in 2005. Fight CRC promotes better policies and supports research, education, and awareness for all those touched by colorectal cancer. All employees, board members, and volunteer representatives at Fight CRC are required to maintain nonpartisanship while acting in an official capacity on behalf of the organization.