Earlier this month, the U.S. Food and Drug Administration (FDA) authorized Medtronic and Cosmo Pharmaceuticals to start marketing its novel artificial intelligence (AI) device, the GI Genius, that improves the quality of colonoscopies by detecting precancerous polyps that clinicians may otherwise overlook if they are flat or are located in areas of the colon that are difficult to see with an endoscope.

 

According to a systematic review and meta-analysis of 43 international publications, 13 of which were conducted in the United States, many cases of colorectal cancer can be attributed to polyps and adenomas that are not detected during routine screenings. The study found that 26%  (95% CI: 23%-30%) of adenomas are missed during colonoscopies as well as 27% of serrated polyps (95% CI: 16%-40%). GI Genius is one of a few devices cleared by the FDA to aid in colonoscopies and is the first computer-aided detection (CADe) system that uses AI to recognize polyps. The tool was reviewed through the FDA’s De Novo premarket review pathway for low-to-moderate risk novel devices.

 

The GI Genius works by emitting a sound and displaying green markers that are superimposed over the endoscope video when it recognizes a potential lesion; it is compatible with many video endoscopy systems. GI Genius utilizes an algorithm to recognize polyps that was developed by reviewing over 13 million colonoscopy videos. Gastroenterologists labeled tissues as being either healthy or unhealthy to help “teach” the GI Genius how to distinguish the two. While the GI Genius can recognize unhealthy tissue, it does not characterize lesions and is not a substitute for lab sampling to diagnose the tissue in question.

 

The safety and effectiveness of the GI Genius were assessed through a large randomized controlled trial in Italy. Out of a subpopulation of 263 subjects who required screening or surveillance at least every three years, 136 patients had a colonoscopy with the assistance of the GI Genius, while 127 patients served as controls and underwent a standard colonoscopy. In the experimental group, adenomas or carcinomas were detected in 55.1% of patients, while they were only identified in 42% of patients in the control group. No adverse events related to the use of GI Genius were reported, although its use led to a small increase in the amount of healthy tissue that was biopsied.

 

Overall, GI Genius shows great promise as a way to enhance the quality and reliability of colonoscopies by aiding physicians who may otherwise miss polyps that are hard to see.

Updated phase III results from the BEACON study have found that encorafenib with cetuximab can lead to promising survival outcomes among patients with advanced colorectal cancer (CRC) who had received previous lines of treatment.

The third most common cancer and the third most common cause of cancer-related deaths in the U.S., CRC occurs when there is development of mutations in oncogenes, tumor suppressor genes, and genes that aid in DNA repair. Depending on the site of the mutation, CRC can be classified as familial, inherited, or sporadic. Chromosomal instability (CIN), microsatellite instability (MSI), and CpG island methylator phenotype (CIMP) are pathogenic mechanisms through which CRC can develop. These mutations, changes in the chromosomes, and translocations can affect various signaling pathways (Wnt, TP53, TGF-β, and MAPK/PI3K) and genes such as c-MYC, KRAS, BRAF, SMAD2, and SMAD4. Oftentimes, mutations in these genes can serve as important predictive markers in the context of patient outcomes.

In addition to CRC, mutations in BRAF have been found to be responsible for various other cancers such as melanoma, thyroid, small-cell lung, and hairy cell leukemia. BRAF encodes for  the B-RAF serine/threonine kinase protein, which is a part of the RAS/RAF/MEK/ERK pathway. Most of the mutations that take place in the BRAF gene lead to a V600E substitution, which often leads to a poor prognosis in patients. The BRAFV600E mutation initiates activation of the mitogen-activated protein kinase (MAPK) signaling pathway, which causes the tumor cells to rapidly divide. It has been estimated that approximately 10% of patients with metastatic CRC have a mutation in BRAF.

In the past, treating metastatic CRC with BRAFV600E mutations has led to low response rates, partly due to incomplete inhibition of the MAPK signaling. Recently, the combination of a BRAF (encorafenib) and EGFR (cetuximab) inhibitor has shown promising results compared to BRAF inhibitor monotherapy. The BEACON CRC study is a randomized, open-label, phase III trial that enrolled 665 patients and compared triple combination therapy; encorafenib (300 mg x1 a day) plus binimetinib (45 mg 2x a day) plus cetuximab (400 mg/m2 x1 a week) versus double combination therapy; encorafenib plus cetuximab versus cetuximab plus irinotecan or FOLFIRI. Of the total 665 patients, 224 received triple therapy, 220 received double therapy, and 221 received the control therapy.

The objective of the BEACON trial was to detect the overall survival in relation to the triple combination therapy/double combination therapy as compared to the control. It was determined that triple/double therapy led to a median overall survival of 9.3 months, while the control group showed an overall survival of 5.9 months. This indicates that both triple/double therapy improved the overall survival rate and can therefore be used as the new standard of care in patients with metastatic CRC with BRFV600E mutations.

 

 

In February 2021, Brett Walker, M.D., became the 10th awardee of the Thomas K. Weber Colorectal Cancer Research Scholar Award, awarded by the Colon Cancer Foundation in partnership with the Society of Surgical Oncology.

The award was renamed in 2020 after Thomas K. Weber, M.D. (1954-2019), founder and former president of the Colon Cancer Foundation. Dr. Weber devoted his life to increasing colorectal cancer awareness, detection, and prevention, and his dedication to “a world without colon cancer” lies at the heart of the Colon Cancer Foundation. Thus, the award was renamed to keep his legacy alive while celebrating members of the community that display excellence in translational research pertaining to the molecular biology of colorectal cancer.

This year, Dr. Walker received the award for his abstract submission on circulating hybrid cells (CHCs) as a potential biomarker for treatment response in gastrointestinal cancers. CHCs are a type of hybrid cell created by the fusion of an immune cell and a tumor cell. Research pertaining to CHCs is novel as the primary focus of previous studies on cancer cell biomarkers has been on circulating tumor cells (CTCs), cells that bud off from a primary tumor and circulate in the bloodstream. 

Though CHCs also disseminate outward from a primary tumor and circulate in the peripheral blood, the difference between the two lies in their names. Whereas CTCs only express cytokeratin, a tumor protein, CHCs express both cytokeratin and CD45, an immune cell marker. It is postulated that CHCs have both immune and tumor cell markers in order to successfully evade the immune system to form new tumors. 

“CHCs have this opportunity to escape out of the primary tumor and migrate to different areas and potentially seed new metastatic tumors,” said Dr. Walker in an email correspondence with the Colon Cancer Foundation. 

According to Dr. Walker, CHCs have the potential to be a better evaluative marker of treatment response and disease progression compared to CTCs because there are more of them circulating in the bloodstream. 

Dr. Walker’s research itself indicates the effectiveness of CHCs as biomarkers. According to The ASCO’s Post description of his research, CHCs “successfully discriminated pathologic complete response from non–pathologic complete response in both rectal and esophageal cancers.”

Additionally, Dr. Walker mentioned that CHCs can provide information on the actual tumor itself. 

“By collecting CHCs, we can actually gain information on the tumor, specifically what proteins they express and their genetic makeup including mutations, which could potentially help guide targetable treatments for patients,” said Dr. Walker.  

Though more studies need to be conducted into CHCs, the implications of the research conducted by Dr. Walker’s laboratory are immense. If indeed CHC levels can be used as an effective biomarker, then patients with colorectal cancer can opt for non-invasive blood tests to track disease and treatment progression, as opposed to undergoing traditionally invasive imaging techniques and endoscopies. This in turn improves patients’ quality of life by avoiding intensive procedures that can cause stress and fear. 

 

Dr. Walker expressed excitement over CHCs as a biomarker and hopes that his research will inspire others in the field to conduct their own studies. 

 

“I think that there’s a huge opportunity here for us to really affect how we both detect and manage colon cancer. And so I really think this is an awesome opportunity to bring attention to hybrid cells and hopefully expand the number of researchers in this field.”

 

In 1999, the Prevent Cancer Foundation designated March as the National Colorectal Cancer Awareness Month. The foundation partnered with the American Digestive Health Foundation and the National Colorectal Cancer Roundtable to raise awareness and advocate for policy change for the third most common type of cancer in the United States. On November 19, 1999, an official declaration came through from the United States Senate and the House of Representatives. 

With approximately 100,000 new cases of colorectal cancer (CRC) every year, March is an important month to cast a spotlight on the value of preventative measures such as screening. The American Cancer Society estimates there will be 149,500 new cases of CRC and 52,980 deaths in 2021. In December 1995, the United States Preventive Services Task Force (USPSTF) recommended that adults with an average risk of CRC should be screened between the ages of 50-75 years. Due to increasing evidence over the last few decades, in December 2020 the USPSTF released draft recommendations saying screening should start at the age of 45 years.

The COVID-19 pandemic led to a drastic reduction in the number of colonoscopies in 2020: about a 90% drop compared to previous years. Approximately 1.7 million Americans missed their annual screening test in 2020, and 18,800 CRC diagnoses were either delayed or missed altogether. 

In recognition of the month of March, the Colon Cancer Foundation (CCF) had several activities planned, including the #GiveACrap Challenge. The Challenge encouraged individuals to sign up to receive a free Fecal Immunochemical Test (FIT), and the chance to receive a special limited-edition beer. People also had the option of making a donation to the foundation to receive the test kit and the beer. Other activities included the CCF Challenge which is a 45-mile walk-run and a concert celebrating the culmination of a week full of activities.

In his proclamation for National Colorectal Cancer Awareness Month, President Joseph Biden urged Americans to call attention to CRC risk factors and increase annual screening practices. He emphasized that March is the perfect opportunity to improve public understanding of CRC and to educate individuals about the age for proper screening. He reiterated that if caught early, CRC is highly treatable and curable. “Because of the Affordable Care Act, most health insurance plans must cover a set of preventive services with no out-of-pocket cost. This includes colorectal cancer screening in adults aged 50 and older,” President Biden said.

Fight Colorectal Cancer and the Colon Cancer Coalition urged business leaders and landmarks to go blue to spread CRC awareness. As of March 9, 2021, businesses, healthcare systems, and landmarks in 21 states had confirmed their status to “Go Blue” in honor of CRC Awareness Month. Moreover, the Colon Cancer Coalition hosted a ‘Get Your Rear in Gear’ event on March 21, 2021, in-person and virtually, as a 5K untimed run/walk-in Charlotte, North Carolina. 

Every year in March, various events take place all throughout the U.S. with the hope of spreading awareness and advocating for CRC. It is essential to spread the word about CRC and emphasize the importance of regular screening to prevent, manage, and treat CRC.

 

March 2021 brought 21 updated recommendations and guidelines from the American College of Gastroenterology (ACG) regarding colorectal cancer (CRC) screening.

While the American Cancer Society recommends CRC screening for those aged 45 and up, the ACG recommends regular CRC screening for those aged 50-75, which follows the current recommendations set by the U.S. Preventive Services Task Force and the Multi-Speciality Task Force. For those aged 76 and beyond, the ACG recommends that the decision to screen for CRC be dependent on the health status and lifestyle of each individual, as the risks of CRC screening can outweigh the benefits depending on the individual’s situation. 

The recommendation to start screening at age 50 is only for those at average risk for CRC. For those who have a family history of CRC or advanced polyps and are therefore at a two-fold increased CRC risk, the ACG recommends screening starting at the age of 40 or 10 years before the youngest affected relative—whichever comes first. 

The various CRC screening options include:

  • Stool-based tests like fecal immunochemical test (FIT) and multitarget stool DNA (mtsDNA)
  • Blood-based tests like Septin 9
  • Direct visualization like colonoscopy, flexible sigmoidoscopy, CT colonography, and colon capsule

The ACG recommends that colonoscopy and FIT should be the primary CRC screening methods. While advising against the Septin 9 blood test due to its low CRC detection sensitivity, the ACG does recommend the other screening methods outlined above for individuals who do not want to undergo a colonoscopy or FIT. It is important to note that all non-colonoscopy screening methods require a follow-up colonoscopy in the case of a positive result.  

In terms of chemopreventive methods, multiple long term studies have indicated that aspirin can reduce CRC incidence and mortality. However, these studies showed mixed results and did not break down the results by individual CRC screening history, so the ACG recommends against the usage of aspirin as a substitute for traditional CRC screening methods. 

Recommendations for Improving the Quality of Colonoscopy Screening 

Of all the screening methods, a direct visualization test like the colonoscopy is the most commonly performed procedure in the U.S. However, the colonoscopy does come with a main drawback: the results of the test are dependent upon the colonoscopist. The Adenoma Detection Rate (ADR), defined by “the fraction of persons aged 50+ who have one or more adenomas detected and removed,” is a good indicator of colonoscopy performance quality. Several studies have identified a link between colonoscopists with higher ADR rates and a reduction in CRC in their patients. Therefore, the ACG recommends remedial training for colonoscopists with an ADR of <25%.

The ACG further recommends that colonoscopists spend at least six minutes inspecting the mucosa before the scope is withdrawn from the anus, as a withdrawal time of six minutes or more increased the detection of neoplastic lesions and reduced the risk of post-colonoscopy CRC (PCCRC). An additional indicator of colonoscopy quality is the cecal intubation rate (CIR), which is defined as “the passage of the colonoscope tip into the cecal caput.” It is recommended that colonoscopists achieve a CIR of at least 95%, as studies have shown that a low CIR is associated with an increased risk of PCCRC.

Recommendations for Increasing Awareness About CRC Screening

As CRC remains the third leading cause of cancer in the U.S. among men and women, screening outreach is essential to increase participation in CRC screening. Studies have found that various screening outreach methods like brochures, invitations, reminders, patient navigation, patient reminders, clinical interventions, and clinical reminders were associated with increased CRC screening rates. Additionally, having primary care providers involved in screening outreach methods increased patient participation in CRC screenings. Therefore, the ACG recommends all the above to increase screening participation. 

To improve adherence to follow-up colonoscopies after positive non-colonoscopy results, the ACG recommends mail and phone reminders, patient navigation, and provider interventions.

The Colon Cancer Foundation implemented various campaigns this March to increase CRC screening participation in honor of National Colon Cancer Awareness Month. One of the most notable was the #GiveaCrapChallenge, where CCF partnered with Squatty Potty and DuClaw Brewing Company to screen 100 people for colon cancer. Participants traded a stool sample via a FIT kit for a limited edition, six-pack brew sample from DuClaw. These types of innovative screening outreach methods can increase participation in CRC screening, allowing for earlier detection of CRC.

Early detection can significantly reduce the incidence and mortality of CRC. Though there are currently no randomized clinical trials that compare the various CRC screening intervals in terms of the number of life-years gained, the Cancer Intervention and Surveillance Modeling Network, through various studies, recommends the following:

  • Annual FIT
  • Colonoscopy every 10 years
  • mtsDNA test every 3 years
  • Flexible sigmoidoscopy every 5-10 years
  • CT colonography every 5 years
  • Colon capsule every 5 years

 

With activities in full swing across the U.S. during National Colorectal Awareness month in March, the Colon Cancer Foundation (CCF) spoke to Whitney Jones, MD, founder of the Colon Cancer Prevention Project (CCPP, Louisville, Kentucky), about the foundation’s history, their success with flipping colorectal cancer (CRC) screening rates in the state, and their vision for the future.

Back in 2003, Dr. Jones, a gastrointestinal specialist, was shocked when he encountered several individuals who should have been screened for CRC, presenting with advanced colon cancer in his clinic. Intrigued by this, he found out that Kentucky ranked 49th for CRC screening rates and led the nation in incidence and mortality. It was then that he decided to make changes in the space and started the foundation the same year.

Partnerships to Help Move the Needle on Preventive Screening

While early years were focused on developing informational flyers and attending health fairs, by 2008 CCPP’s attention shifted to influencing policy changes, such as making sure CRC screening received preventive care coverage. They simultaneously developed a screening program for the state’s uninsured populations under the oversight of an advisory committee (healthcare providers, policy experts, and legislators) that continues to meet on a monthly basis even today.

In 2015, CCPP began promoting lead-time messaging and on-time screening, with a particular emphasis on high-risk and younger populations. “We called out, not the guidelines, but in fact our strategy for implementing our guidelines,” he said, which culminated in a paper on establishing a standard process for timely messaging for CRC screening for both average-risk and high-risk individuals, with an overall goal of changing mindsets. “If we have to reach disparate populations, we have to start earlier, message more frequently, and offer more choices,” Dr. Jones said.

CRC screening compliance is mainly driven by primary care providers (PCPs) and health care systems. “Gastroenterologists are the catchers, and the PCPs and health systems are the pitchers,” he said. “We can no longer trust opportunistic screening as in the past. We need to aim for a more systematic, longitudinal, benchmarked system for evidence-based and guideline-driven screening.”

This, he added, will require participation from payers, Medicaid, and the Department of Insurance to instill policies such as coverage for a colonoscopy following a positive FIT test, or genetic testing for those who meet criteria. Additionally, partnering with organizations that understand the local landscape—such as the Cancer Prevention Programs at a safety-net university-based hospital—provides vital on-the-grounds insight. Dr. Jones’ recommendation is for each state to create a statute for an advisory committee or a technical advisory committee that includes lawmakers and insurance companies, to help develop, clarify, and implement CRC policy.

To spread the success of their state-based screening programs, CCPP is partnering with FightCRC to replicate Kentucky’s success in other states—especially in the context of stakeholder engagement. “The key was really in engaging all of our partners that we have now and asking them, ‘What power can you bring from your organization to really advance something?’” He strongly believes that having a CRC-focused organization lead the charge can have a huge impact on moving the needle and getting things done for the community.

Family Health History for On-Time Screening

We all know that disparate platforms make it difficult for sharing information across electronic health records (EHRs). Add to that the time constraints faced by practitioners and gathering accurate information about a person’s family health history (FHH) could be really challenging. Dr. Jones’ vision rises a step above that—using an AI-based system that will gather FHH, critical to Hereditary Cancer Risk Assessment, prior to a patient’s appointment and integrate it within their EHR, compare it to existing guidelines, and provide the physician with a recommendation that can guide the conversation during the patient visit. “Logistics and informatics will play a significant role in improving our struggles with on-time screening,” Dr. Jones added.

45 IS The New 50: Now What?

While the debate over when to start screening average-risk adults is over (see USPSTF draft recommendation), onboarding 20-21 million people across the country in the 45-49 age group is going to be a challenge, especially during the COVID-19 pandemic. Catching-up will require a dramatic increase in the utilization of stool-based testing. “While we cannot conduct colonoscopy in all the new population, we can definitely send them stool-based testing kits. That’s what health systems should focus on,” Dr. Jones said.

In Kentucky, CCPP has been preparing hospitals, health systems, insurance companies, and large group payers since mid-2020 to adopt these guidelines as soon as they are finalized. The focus is on communicating with folks in their late 30s to inform them about symptoms, screening the high-risk population at age 40 or sooner with colonoscopy, identifying candidates for whom genetic testing is appropriate and for average risk individuals, and screening with either stool-based tests or colonoscopy in a shared decision-making model.

“Forty-five should be the finish line for starting risk-based CRC screening communication, not the starting point,” Dr. Jones said.

 

Colon Cancer Foundation To Host Virtual Challenge in Support of Colorectal Cancer Awareness Month in March

  • The CCF Virtual Fitness and Fundraising Challenge will take place the week of March 14th
  • Event week to conclude with a Virtual Concert and Online Celebration on Sunday, March 21st
  • Participants to Support the Foundation’s goal of screening 10,000 people in 2021; Online registration is open at coloncancerfoundation.org

NEW YORK – March 10, 2021 – March is National Colorectal Cancer Awareness Month and this year the Colon Cancer Foundation (CCF) is helping promote the importance of early detection in successfully beating the disease. CCF is honoring awareness month with a range of activities aimed at the Foundation’s ambitious goal of providing 10,000 colorectal cancer screenings to the nation’s most underserved and vulnerable communities in 2021.

Highlighting the events will be the CCF Fitness and Fundraising Challenge, which takes participants on a fun-filled, 45-mile virtual experience through the past, present and future of the Foundation. The unique aspect of the virtual challenge allows each participant to safely walk or run solo or in teams of five to complete the 45-mile distance and the best part is, there are over 70 fitness activities that convert into “mileage.”  Each entry will pay for a life-saving cancer screening kit for one person and help CCF reach their goal of screening 10,000 people in 2021.

“We are excited to host the CCF Fitness and Fundraising Challenge, which not only provides a great incentive for fitness, but an opportunity for the community to support our foundation’s goal of screening 10,000 people in 2021,” said Cindy Borassi, President of the Foundation. “Despite the ongoing pandemic, it is important now more than ever that we stay connected as a community. Join us and help save lives from colon cancer.”

With each mile logged, participants will unlock amazing stories and photos from CCF’s past and present and hear all about how CCF is helping to shape the future of colon cancer prevention, treatment, and care. Participants will be treated to special live-streamed events during the week to help them stay motivated and engaged. With live-streamed cooking demonstrations by noted Chef Claes Petersson and Chef Chintan Pandya, a 2020 James Beard Award finalist, excitement levels are sure to be high.

Funds raised through the Challenge will benefit the Colon Cancer Foundation’s outreach efforts and all athletes will get a special invite to the “Virtual Concert for a Cause” to celebrate their accomplishment.

The “Virtual Concert for a Cause” is set for Sunday, March 21st at 5pm EST and will feature performances by N.E.D (No Evidence of Disease); renowned classical pianists Francois Xavier Poizat and Slava Gryaznov; Mark MK, Niren Chaudhary, along with Rachelle Babler and Mark Huls. Stand alone virtual concert tickets are available for $10 (suggested donation $35), with all proceeds benefiting CCF’s mission.

For more information about the #CCFChallenge or to register, please visit at coloncancerfoundation.org.

 

About the Colon Cancer Foundation

The Colon Cancer Foundation (CCF) is a 501(c)3 non-profit organization with a mission to fight against colorectal cancer (CRC) by supporting research, leading advocacy, and promoting prevention through education and awareness. For over 15 years, CCF has led the charge against this disease by hosting innovative events such as our Annual Early Age-Onset CRC Summit and the Colon Cancer Challenge; providing grants to young investigators; and forming strategic partnerships to raise awareness about CRC and the importance of on-time screening through ground-breaking multimedia campaigns. Together with our partners and supporters, we work towards our vision of A World Without Colorectal Cancer™. For more information, please visit coloncancerfoundation.org or connect with us on Instagram, facebook or twitter.

 

More about Colorectal Cancer & affected populations:

  • 2nd leading cause of cancer death among men and women in the U.S.
  • Regular testing is recommended for adults 45+.
  • 75M people should be regularly tested, half being underserved and uninsured.
  • African Americans are at high risk, with incidence rates +20%, and death rates +40%.
  • Anyone > 45 with symptoms should see their primary care provider as soon as possible.
  • The recent and tragic deaths of actors Chadwick Boseman, 43, and Natalie Desselle-Reid, 53, as a result of colorectal cancer illustrate the younger trend:
    • The fastest growing incidence among those 20-29.
    • The most cases under 50 among those 40-49.

 

Media Contact

Dan Cruz, 619.925.7671

dan@socialendurance.com

 

# # #

Under advice from the Citywide Colorectal Cancer Control Coalition (C5), the NYC Department of Health has updated its screening guidance to recommend that adults with an average risk of colorectal cancer (CRC) should begin screening at age 45. This announcement, which coincides with the National Colorectal Cancer Awareness Month in March, comes prior to the anticipated final recommendation from the U.S. Preventive Services Task Force (USPSTF), which currently remains in a draft form.

NYC’s screening recommendation advices the use of:

  • Colonoscopy every 10 years OR
  • Stool-based testing at required intervals, to be followed up with a colonoscopy in case of a positive stool test

Average risk adults are stratified based on the following characteristics:

  • No personal or family history of CRC
  • No personal or family history of adenomas or sessile serrated polyps
  • No personal history of inflammatory bowel disease
  • No personal history of genetic syndromes (e.g., familial adenomatous polyposis, other polyposis syndrome, Lynch syndrome)
  • No other source of increased risk (e.g., cystic fibrosis, history of abdominopelvic radiation)

The guidance also points out that those at an increased risk—either due to personal or family history of polyps CRC—may need to be screened before age 45. A colonoscopy is recommended for those at a higher risk of developing CRC.

Adults with an increased risk are stratified based on the following characteristics:

  • History of CRC
  • History of adenoma, sessile serrated polyp (SSP), or certain hyperplastic polyps
  • Inflammatory bowel disease
  • Known or suspected genetic syndrome (e.g., familial adenomatous polyposis, other polyposis syndrome, Lynch syndrome)
  • CRC, advanced adenoma, or advanced SSP in one first degree relative before 60 years of age
  • CRC, advanced adenoma, or advanced SSP in two or more first degree relatives at any age
  • CRC, advanced adenoma, or advanced SSP in one first degree relative 60 years of age or older

 Useful Resources for Providers and Patients

The department has developed several downloadable, and easy-to-follow resources for both health care providers and patients:

For the public/patients:

Information on screening tests:

All the information sheets are available in multiple languages.

Aspirin is a non-steroidal anti-inflammatory drug (NSAIDs) that is commonly used as a pain reliever, antipyretic (fever reducer), and preventative medication for cardiovascular illnesses. It is cost-effective, generic, and available over the counter. Aspirin has also been recommended as being beneficial in preventing the development of colorectal cancer (CRC). 

Aspirin has the ability to inhibit proliferation and allow apoptosis (cell-programmed death) of CRC cell lines. Approximately 10-20 billion aspirin tablets are consumed annually in the United States, making it one of the most commonly used medications in the world. The U.S. Preventive Services Task Force (USPSTF) has recommended that the use of aspirin can be of benefit in reducing the risk of CRC. Andrew Chan, M.D. wrote in Nature Reviews Cancer that the USPSTF recommendation is a ‘crucial step’ for cancer prevention.

The CAPP2 trial tested the effect of high-dose aspirin in carriers of the Lynch Syndrome. Also known as hereditary nonpolyposis CRC, Lynch syndrome is a hereditary condition that increases the risk of CRC and endometrial cancers. The trial concluded that 63% of patients who were given high-dose aspirin (600 mg/day) for a mean period of about 2 years saw a reduction in CRC development compared to the placebo group, over a period of about 5 years.  Comparably, the Cancer Prevention Program trial (CAPP3 trial) is a randomized trial that began recruitment in 2014 also targeted individuals with Lynch Syndrome but used varying doses of aspirin (100 mg, 300 mg, or 600 mg/day) for a duration of 2 years. Their follow-up period was 5-10 years later. Similarly, two large prospective cohort studies led by Dr. Chan at Harvard University established that the use of aspirin for 6 years or longer led to a 19% decreased risk of CRC. 

The data currently available on the benefits of aspirin were reviewed by Cuzick et al. who reiterated that the use of aspirin (75-325 mg/day) for greater than 5 years when started between the ages of 55-65 years, has shown benefit.

Although aspirin is chemopreventive for CRC, it is not without its adverse effects. Aspirin is an antiplatelet medication, which makes bleeding one of its most serious risk factors and therefore increases the risk for a hemorrhagic stroke by 32-36% and gastrointestinal bleeds by 30-70%. However, once the chemopreventive effects of aspirin are taken into consideration, the benefits outweigh the risk which is confirmed by an overall 4% reduction in CRC mortality. 

While there is an abundance of evidence as to the benefits of aspirin in the prevention of CRC, questions remain around the adequate dosage and duration of administration. 

 

Colon Cancer Foundation, Squatty Potty & DuClaw Brewing Company are coming together to offer ‘unicorn farts’ beer for getting tested during National Colorectal Cancer Awareness Month

 

March 1, 2021 (New York, NY) – Colorectal cancer is crappy. As the nation’s second-deadliest form of cancer, it kills thousands every year. This March, adults can enjoy a limited-edition glittery beer that can’t be purchased with money, but can only be accessed with their own poop during National Colorectal Cancer Awareness Month.

The unusual ask is part of the clever ‘Give a Crap Challenge’ hatched by the Colon Cancer Foundation, Squatty Potty and DuClaw Brewing Company with help from Everlywell, CraftShack and Diablo Doughnuts to help the Colon Cancer Foundation reach their goal of providing 10,000 colorectal cancer screenings to underserved communities in 2021.

As a result of signing up, participants will also help to raise awareness for the 75 million people in the U.S. who are 45+ and should be regularly tested for colorectal cancer (and their loved ones who can help to encourage “the talk”).

For 400 eligible participants, it’s as easy as: Click. Squat. Sip. –

  1. Click – Sign up at www.GiveACrapChallenge.com between March 3 – 7 for a chance to participate and receive the screening, Squatty Potty and beer.

(One hundred lucky entrants will be randomly selected from signups to participate at no cost. Another 300 can instantly participate by making an $85 donation.)

  1. Squat – Take your noninvasive colorectal cancer screening test in the privacy of your own home and mail to the lab in the prepaid envelope.
  2. Sip – Enjoy your 6-pack of DuClaw’s ‘Thanks for Giving a Crap’ edition of Sour Me Unicorn Farts glittered sour ale on your doorstep from CraftShack & relish in the fact that you gave a crap today! (You’ll receive secure, personalized results of your screening from to your device.)

“This is us, arms in the air shouting from the rooftops that colorectal cancers are no longer simply an old person’s disease,” said Cindy Borassi, president of the Colon Cancer Foundation. “The fight against the second-leading cause of cancer death among U.S. men and women is serious…and sometimes, the best way to engage people is with a little humor!”

Participants will get exclusive access to the limited-edition pilot batch of this year’s much anticipated Sour Me Unicorn Farts glittered sour ale made with fruity cereal, a trio of fruits, edible glitter plus the addition of graham cracker. The beer will be gifted in 12oz 6-packs. The label will say, ‘Thanks for Giving a [rainbow poop emoji]’ with a blue star for colorectal cancer awareness.

The promotion will run during National Colorectal Cancer Awareness Month in March, with signups opening up on Wednesday, March 3, on National Colorectal Cancer Screening Day, closing on Sunday, March 7.

Marketing will include a series of short, humorous videos produced by Squatty Potty and feature the brand’s famous rainbow ice cream-pooping unicorn ‘Dookie’ as an employee at DuClaw Brewing Company, getting into all sorts of trouble.

[Squatty Potty is notorious for the 2015 viral video featuring the Prince of Poop and Dookie educating people on the benefits of squatting to eliminate more effectively.]

Additionally, with the help of celebrities and influencers, the campaign will activate a social #GiveACrapChallenge on TikTok and other platforms, where participants can ask a parent or loved one, “When was the last time you pooped?” as a way to encourage “the talk” about getting tested because you “give a crap” about them. Participants can donate any amount by texting CRAP to 512-920-5521. For every $35 contribution, one colorectal cancer screening will be donated to someone in need.

For more on the promotion including restrictions, visit www.GiveACrapChallenge.com. To apply to receive a donation of testing kits to distribute to underserved communities, or to learn more about Colorectal Cancer Awareness Month, visit www.coloncancerfoundation.org.

More about Colorectal Cancer & affected populations:

  • 2nd leading cause of cancer death among men and women in the U.S.
  • Regular testing is recommended for adults 45+.
  • 75M people should be regularly tested, half being underserved and uninsured.
  • African Americans are at high risk, with incidence rates +20%, and death rates +40%.
  • Anyone >45 with symptoms should see their primary care provider as soon as possible.
  • The recent and tragic deaths of actors Chadwick Boseman, 43, and Natalie Desselle-Reid, 53, as a result of colorectal cancer illustrate the younger trend:
    • The fastest growing incidence among those 20-29.
    • The most cases under 50 among those 40-49.

About the Campaign Collaborators:

Colon Cancer Foundation

The Colon Cancer Foundation is a 501(c)3 non-profit organization registered in the state of New York and is listed by the IRS as a public charity. The organization is dedicated to supporting colorectal cancer research; educating the public about the importance of early detection, and forming strategic partnerships in the fight against colorectal cancer. The foundation offers those affected by colorectal cancer a platform to increase public awareness of colorectal cancer, while also working to lower incidence and death rates through public education, collaborations, and early-screening education. The Colon Cancer Foundation hosts annual events and challenges that seeks to raise money to support the foundation’s mission.

For more information please visit (www.coloncancerfoundation.org/) or connect with us on InstagramFacebook or Twitter.

Squatty Potty, LLC

Founded in 2011, Squatty Potty, LLC is a consumer products company whose product lines consist of toilet stools, sprays and other bathroom accessories. Its flagship product, the Squatty Potty stool, is designed to help users assume the squatting position while using the bathroom, delivering fast, complete elimination with comfort and ease. In 2014, the Company was featured on ABC’s hit TV show Shark Tank, and became the second most successful company in the history of the show. In 2015, the Company launched a wildly successful marketing campaign featuring a viral YouTube video that has garnered over 140 million views to date and won the 2016 Webby Award. Currently Squatty Potty products are sold in over 6,000 retail locations globally including Bed, Bath & Beyond, Walmart and Target.

DuClaw Brewing Company

Baltimore-based and fearlessly innovating in craft beer since 1996: Craft Be Cherished. Rules Be Damned. DuClaw beer is available in 19 U.S. states and DC plus Canada and France, with additional U.S. distribution through Brew Pipeline. www.duclaw.com.

CraftShack

The premier online marketplace and platform for specialty craft beers delivered to your door. www.craftshack.com.

Diablo Doughnuts

Baltimore doughnut shop that’s ‘Local as F*ck.’ Home of the original Unicorn Farts doughnut and original collaborator on the Sour Me Unicorn Farts beer. www.410dough.com.

Agencies who worked on the campaign include Elevation Advertising, 212 Communications and Social Endurance.  

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