The Colorectal Cancer Detection Act of 2023: Benefits and Concerns from a Health Policy Perspective

Main Article Content

Michael J. Farber Sreejan Saha Karthik Madhira Steven W. Tseng Jonathan Kim Sonika Rathi Arthur A. Klein Joerg R. Leheste

Abstract

Colorectal cancer (CRC) is a major public health concern in the United States, accounting for the second highest number of cancer-related deaths after lung and bronchus cancer. Individuals with CRC having spread to other parts of the body face a dismal prognosis, with a 5-year survival rate of only 15%. However, early detection at a localized stage significantly improves the survival rate to 91%. Notably, African Americans are disproportionately affected by CRC, owing to lower compliance with screening measures. The COVID-19 pandemic exacerbated the situation further, resulting in approximately 9.4 million missed cancer screenings and an additional 4,500 annual deaths in the United States. The aim of this work is to bring attention to this health discrepancy with the explicit goal of introducing the Epi proColon blood-based CRC screening test as a feasible alternative to the current standard of care to close the existing racial gap through increased compliance. For this reason, the United States Congress has already suggested Medicare coverage for the Epi proColon blood-based CRC screening test in several bills and resolutions.

Keywords: colorectal cancer (CRC), cancer-related deaths, health disparities, screening compliance, Epi proColon, public health, legislative action, COVID-19 impact, missed cancer screenings, health policy, Medicare coverage, gastroenterology, Public health

Article Details

How to Cite
FARBER, Michael J. et al. The Colorectal Cancer Detection Act of 2023: Benefits and Concerns from a Health Policy Perspective. Medical Research Archives, [S.l.], v. 12, n. 10, oct. 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/5754>. Date accessed: 03 dec. 2024. doi: https://doi.org/10.18103/mra.v12i10.5754.
Section
Review Articles

References

1. Centers for Medicare & Medicaid Services. National Coverage Analysis (NCA) for Colorectal Cancer Screening - Blood-Based Biomarker Tests (CAG-00454N). (2021). Accessed: 7-25-2024: https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx.
2. Grützmann R., Molnar B., Pilarsky C., et al.: Sensitive detection of colorectal cancer in peripheral blood. PLOS ONE. 2008, 3:1-8. 10.1371/journal.pone.0003759
3. American Cancer Society. Survival Rates for Colorectal Cancer. (2024). Accessed: 7-25-2024: https://www.cancer.org/cancer/types/colon-rectal-cancer/detection-diagnosis-staging/survival-rates.html.
4. CDC. National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). Health and Economic Benefits of Colorectal Cancer Interventions.. (2024). Accessed: 7-25-2024: https://www.cdc.gov/nccdphp/priorities/colorectal-cancer.html.
5. Carethers, J.M.: Racial and ethnic disparities in colorectal cancer incidence and mortality. Advances in Cancer Research, 151. 2021, 151:197-229. 10.1016/bs.acr.2021.02.007
6. Gangireddy V. G. R., & Swathi M. D.: Gender disparities in the incidence of colorectal cancer in the era of screening colonoscopy. American Journal of Gastroenterology. 2018, 176:99-101.
7. Laiyemo A. O., Thompson N., Williams C. D., et al.: Race and colorectal cancer screening compliance among persons with a family history of cancer. World Journal of Gastrointestinal Endoscopy. 2015, 7:1300-1305. 10.4253/wjge.v7.i18.1300
8. Siegel R., DeSantis C., & Jemal A.: Colorectal cancer statistics. CA: A Cancer Journal for Clinicians. 2014, 64:104-117.
9. Medicare.gov. Preventive & screening services. Colorectal cancer screenings. (2024). Accessed: 7-26-2024: https://www.medicare.gov/coverage/preventive-screening-services.
10. KFF. Health Coverage by Race and Ethnicity, 2010-2022. Latoya Hill, Samantha Artiga, and Anthony Damico. (2024). Accessed: 7-26-2024: https://www.kff.org/racial-equity-and-health-policy/issue-brief/health-coverage-by-race-and-ethnicity/.
11. Grego S., Welling C. M., Miller G. H., et al.: A hands-free stool sampling system for monitoring intestinal health and disease. Scientific Reports. 2022, 12:14803-14809. 10.1038/s41598-022-14803-9
12. Adler A., Geiger S., Keil A., et al.: Improving compliance to colorectal cancer screening using blood and stool based tests in patients refusing screening colonoscopy in Germany. BMC Gastroenterology. 2014, 14:1-8. 10.1186/1471-230X-14-183
13. Chen R. C., Haynes K., Du S., et al.: Association of cancer screening deficit in the United States with the COVID-19 pandemic. JAMA Oncology. 2021, 7:878-884. 10.1001/jamaoncol.2021.0884
14. Mazidimoradi A., Hadavandsiri F., Momenimovahed Z., et al.: Impact of the COVID-19 pandemic on colorectal cancer diagnosis and treatment: A systematic review. Journal of Gastrointestinal Cancer. 2023, 54:1-11. 10.1007/s12029-021-00752-5
15. CONGRESS.GOV. H.R.6275 - Donald Payne Sr. Colorectal Cancer Detection Act of 2016 114th Congress (2015-2016). (2016). Accessed: 7-25-2024: https://www.congress.gov/bill/114th-congress/house-bill/6275.
16. CONGRESS.GOV. H.R.1765 - Donald Payne Sr. Colorectal Cancer Detection Act of 2019. 116th Congress (2019-2020). (2019). Accessed: 7-25-2024: https://www.congress.gov/bill/116th-congress/house-bill/1765.
17. CONGRESS.GOV. S.2149 - Donald Payne, Sr., Colorectal Cancer Detection Act of 2021. 117th Congress (2021-2022). (2021). Accessed: 7-26-2024: https://www.congress.gov/bill/116th-congress/house-bill/1765.
18. CONGRESS.GOV. S.892 - Colorectal Cancer Detection Act. 118th Congress (2023-2024). (2023). Accessed: 7-26-2024: https://www.congress.gov/bill/116th-congress/house-bill/1765.
19. Biographical Directory of the United States Congress 1774 - Present. PAYNE, Donald Milford (1934-2012). (2012). Accessed: 7-26-2024: https://bioguideretro.congress.gov/Home/MemberDetails?memIndex=P000149.
20. CLERK. United States House of Representatives. Office of the Tenth Congressional District of New Jersey. (2024). Accessed: 7-26-2024: https://payne.house.gov/.
21. CONGRESS.GOV. S.1894 - Colorectal Cancer Payment Fairness Act. 118th Congress (2023-2024). (2023). Accessed: 7-26-2024: https://www.congress.gov/bill/118th-congress/senate-bill/1894.
22. CONGRESS.GOV. H.R.7714 - Colorectal Cancer Early Detection Act 118th Congress (2023-2024). (2024). Accessed: 7-26-2024: https://www.congress.gov/bill/118th-congress/house-bill/7714.
23. CONGRESS.GOV. H.R.2407 - Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act. 118th Congress (2023-2024) . (2024). Accessed: 7-26-2024: https://www.congress.gov/bill/118th-congress/house-bill/2407.
24. CONGRESS.GOV. S.2085 - Medicare Multi-Cancer Early Detection Screening Coverage Act 118th Congress (2023-2024). (2023). Accessed: 7-26-2024: https://www.congress.gov/bill/118th-congress/senate-bill/2085.
25. CONGRESS.GOV. https://www.congress.gov/bill/117th-congress/house-bill/1655. (2023). Accessed: 7-26-2024: https://www.congress.gov/bill/117th-congress/house-bill/1655.
26. Song L. L., & Li Y.: Current noninvasive tests for colorectal cancer screening: An overview of colorectal cancer screening tests. World Journal of Gastrointestinal Oncology. 2016, 8:793-800. 10.4251/wjgo.v8.i11.793
27. D'Andrea E., Ahnen D. J., Sussman D. A., et al.: Quantifying the impact of adherence to screening strategies on colorectal cancer incidence and mortality. Cancer Medicine. 2020, 9:2735-2743. 10.1002/cam4.2735
28. Peterse E. F. P., Meester R. G. S., de Jonge L.: Comparing the cost-effectiveness of innovative colorectal cancer screening tests. JNCI: Journal of the National Cancer Institute. 221, 113:154-162. 10.1093/jnci/djaa103
29. THE WHITE HOUSE. FACT SHEET: President Biden Details Cancer Moonshot Progress and New Initiatives on 60th Anniversary of President Kennedy’s Moonshot Address. (2022). Accessed: 7-26-2024: https://www.whitehouse.gov/briefing-room/statements-releases/2022/09/12/fact-sheet-president-biden-details-cancer-moo....
30. Lin KW. :mSEPT9 (Epi proColon) Blood Test for Colorectal Cancer Screening. American Family Physician. 2019, 100:10-11