'Put our people's health first': Why Colorado legislators are pushing to lower CRC screening age to 45

Colorado could soon require insurers to cover colorectal cancer screening costs beginning at age 45 instead of 50 if the Colorado Cancer Coalition and the American Cancer Society's Cancer Action Network are successful in their lobbying. 

Colorado would become the first state to pass such legislation that wasn't aligned with the American Cancer Society's guidelines, which recommend beginning screening at 45. 

Here, Colorado Cancer Coalition representative and CRC survivor Scott Wilson elaborated on the coalition's efforts:

Note: Responses were edited for style and content.

Question: Why did the CCC push to introduce this legislation?

Scott Wilson: The Colorado Cancer Coalition exists to reduce the burden of cancer in Colorado. CRC is the second-biggest cancer killer of men and women in the state — 1,940 new CRC cases and 660 deaths in 2019 — and the fastest-growing cancer among our young people who have no preventive screening coverage before 50.

Two-thirds of colorectal cancer diagnoses among 45-49-year-old Coloradans are late-stage with staggering impacts on mortality and healthcare costs. The American Cancer Society believes [starting] screening at 45 will cut 45-49-year-old CRC deaths in half.

Early-stage survival rates are 90 percent, versus 10 percent at stage 4, which costs in excess of $600,000 per patient to treat, so the human and economic benefits of earlier preventive screening are inarguable.

Q: How receptive were legislators to the legislation?

SW: Our sponsors — Reps. Janet Buckner, D, and Perry Will, R, and Sens. Rhonda Fields, D, and Kevin Priola, R, who are from both sides of the aisle and various regions of Colorado — fully understand the human cost of late-stage cancer — of any cancer — and the social and economic benefit of earlier screening. Colorado has a genuine leadership opportunity to begin to turn the tide on the rise of young-onset CRC. This is good healthcare and economic governance.

Q: Some guidelines released after ACS reaffirmed the previous recommendation of starting screening at 50. Has there been any more movement toward one set of guidelines over the other?

SW: The American Cancer Society guidelines were thoroughly substantiated by [the] latest research; two of the researchers from [Boulder-based] University of Colorado and lawmakers in states such as Maine and Kentucky have already acted on their recommendations.

It is only a matter of time before institutions such as the U.S. Preventive Services Task Force, which is currently reviewing its own guidelines, catch up and follow the ACS leadership, but this could potentially take up to five years. Any delay affects lives and healthcare costs.

Q: What would this change mean to the people of Colorado?

SW: Currently, those Coloradans most exposed to a late-stage CRC diagnosis are denied the coverage that would prevent their lives from being turned upside down, or worse. This bill promises to put our people's health first and tackle the rise in young-onset CRC without adding new screens into the system.

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