The need for cancer screening

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My father, former Rep. Donald M. Payne (D-N.J.), like all too many Americans, didn’t realize the importance of screening for colorectal cancer until it was too late.

By the time he was screened, the cancer was so advanced that he died just a few weeks later. Had my father undergone a colonoscopy at an earlier age, I truly believe he would still be with us today. That’s why it has become my mission to raise awareness about these life-saving cancer screenings.

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My father’s death was a wake-up call for me. I went in for my first screening at age 54 – four years after the recommended time to get a screening. At my initial examination, my gastroenterologist found and removed 13 polyps, and just a year later found and removed three more. They all turned out to be benign, but had I avoided the screening, the polyps could have turned cancerous, and I could have suffered the same fate as my father.

The good news, reported this month by the American Cancer Society, is that colorectal cancer diagnoses in the U.S. have dropped 30 percent in just the last decade for those aged 50 years and older. Much of this success is attributable to more people getting colonoscopy screenings within recommended age guidelines.

The sad news, though, is that this highly preventable disease is still the second-leading cause of cancer-related deaths in men and women in the U.S., and according to the group, an estimated 50,000 people will die from this disease in 2014.

But there is hope. About half of these people could be saved by a timely colonoscopy. But when roughly 1 out of every 3 older Americans still is not up–to-date with this potentially life-saving procedure, we have a lot of work to do to raise awareness.

Because of my family history and previous examinations, I’ll be having regular colonoscopies until advised otherwise by my doctor. Testing is particularly important for African-American families because their rate is 20 percent above average. When people tell me they don’t want to undergo the procedure, I tell them, “Be a man. Get tested. You might just save your own life.”   I push because no family should have to experience what we did.

It’s also why I am joining voices with Dr. Carla Ginsburg of Harvard Medical School, who serves on the leadership Cabinet of the American Gastroenterological Association. She has seen this needless suffering from the other side.

From the physician’s perspective, what happened to the Payne family is all too common. About 1 out of every 4 people will have polyps by age 50. But because colorectal cancer may have vague or no signs or symptoms, many patients don’t think they need testing. Many may also think they cannot afford it, or put it off because they are fearful, squeamish or embarrassed by the nature of a colonoscopy. For all these reasons, only approximately 65 percent of older Americans have had timely screenings. We are working hard to make that at least 80 percent by 2018. We have also come together with the American College of Gastroenterology and the American Society for Gastrointestinal Endoscopy on an important initiative to highlight the value of colonoscopy and the gastroenterologists that perform this life-saving procedure.

But raising awareness is only part of the battle. Passage of the Patient Protection and Affordable Care Act was a major victory in the fight against cancer. The law waives the co-insurance and deductible for many cancer-screening tests. For colonoscopies, however, if the screening leads to removal of a polyp, Medicare then automatically counts it as a therapeutic treatment for which patients then have to pay co-insurance. 

This highly illogical loophole means that about half of the Medicare beneficiaries who choose to have a colonoscopy will pay for a screening that they thought was free. We applaud the Obama administration for issuing a correction to make sure that consumers who are commercially insured should not carry this financial burden. But now, is also the time for the administration to fix a loophole that exists by waiving co-insurance for Medicare patients who have a screening colonoscopy with polyp removal in the same encounter. Removing any financial barriers will not only save lives but also save huge amounts of money when compared to treating cancer.

As we enter the last week of National Colorectal Cancer Awareness Month, we encourage each of you to get screened. Become part of that 80 percent and encourage your loved ones to become part of it as well. 

Payne has served New Jersey’s 10th Congressional District since 2012. He sits on the Homeland Security and the Small Business committees.  Ginsburg, M.D., M.P.H., AGA fellow, is an assistant clinical professor of Medicine at Harvard Medical School and a gastroenterologist in private practice at Newton-Wellesley Hospital in Newton, Mass.