When it comes to colon cancer screenings, it pays to be informed. The more information you have on it, the more well prepared you will be. You’ll also have less stress because you will know more about what to expect. Here are some helpful colon cancer screening guidelines to help familiarize yourself with the details so that you can make decisions in confidence.

Understanding Colon Cancer

When considering colon cancer screening guidelines, it’s important to understand how colon cancer works. This disease can develop along any of the 5 sections of the colon which include the transverse colon, ascending colon, descending colon, sigmoid colon, and rectum. That’s a lot of ground to cover, which is why colonoscopies are so popular as a screening method for colon cancer. Colonoscopies are arguably one of the most thorough and effective types of colon cancer screenings available.

What are the Risks?

The risk of forgoing colon cancer screenings goes up over time. By going to your screenings without fail, the risks will be much lower and you will not have to worry as much. It’s important to note that colon cancer screenings should not be looked at as a bad thing. Although it is perfectly natural to be nervous about being screened and hearing the results it’s important to remember that

Early Warning Signs to Watch Out For

In addition to going to your regular screenings, there are some early warning signs to watch out for that can help you detect colon cancer before it has a chance to dig in. One of the most visually apparent of these early warning signs is sudden and unexplained weight loss. This doesn’t mean that you have to worry about colon cancer every time you lose a pound or two. Generally, a loss of 10 pounds over a period of 6 months would warrant a thorough screening like a colonoscopy.

Alternatively, if you know that someone in your family has contracted colon cancer before, you need to tell your Doctor so that they can set up an appropriately aggressive screening schedule. Having a family member with colon cancer is one of the earliest warning signs of all and it’s one that you should take especially seriously. Don’t panic or fret, just be mindful that you’ll have to undergo colon cancer screenings much earlier and more frequently than others.

Typically it is recommended that anyone that has a family member with colon cancer should be screened before the age of 45 rather than after reaching the age of 45. This will give you a much higher chance of catching any signs of colon cancer early and nipping it in the bud before it can do any damage.

Regardless of whether your family has a history of colon cancer or not, if you are diagnosed with having a large polyp or several polyps, you should have a colonoscopy. If adenomatous polyps with a low-grade abnormality are discovered over the course of your colonoscopy it is highly recommended that you have another colonoscopy in 5 years’ time.

Additional Screening Guidelines and Things to Watch Out for

For those of you who have had colorectal surgery, you will need to have a colonoscopy 3 years from the date of your surgery and then another colonoscopy 5 years after that. This will help ensure that you won’t be in for any unwelcome surprises and will catch it early enough to defeat with ease should it ever return.

Generally the very young are not require to be screened for colon cancer unless they have something concerning in their family medical history such as familial adenomatous polyposis. It is recommended that individuals with a family history of familial adenomatous polyposis should have either an annual flexible sigmoidoscopy or a colonoscopy between the ages of 10 and 12. Given the young age of such patients, a full colonoscopy might be more risk than it’s worth in this case as sigmoidoscopies are considerably less invasive.

Finally, anyone with hereditary nonpolyposis colon cancer in their family should be screened for colon cancer by age 20-25 or 2 years before their immediate family member’s colon cancer diagnosis, whichever comes first.

When it Comes to Colon Cancer it Pays to be Aggressive

The single best weapon against colon cancer is to be aggressive about screenings and preventative medicine. Colon cancer has a bad habit of sneaking up on people which is why it’s so important to remain vigilant.

Remember, if you catch it early, you won’t have nearly as hard of a time getting rid of it and won’t have to worry about it as much. You have the power to stop colon cancer in its tracks, as long as you keep getting screened for it.

 

 

A recently published white paper by the American Gastroenterological Association (AGA) titled “Roadmap for the Future of Colorectal Cancer Screening in the United States” states that the development of structured organized screening programs is vital to achieving target colorectal cancer (CRC) screening rates and reductions in CRC morbidity and mortality. The paper includes information shared at the AGA’s Center for GI Innovation and Technology’s consensus conference in December 2018, which outlined the following priorities:

  • Identify barriers to screening uptake
  • Assess the efficacy of available screening diagnostic methods
  • Consider the potential integration of novel diagnostic approaches into screening and surveillance paradigms

 

The paper highlights the following strategies:

Modifications to CRC Screening to Improve Uptake and Outcomes

Although over 1,700 organizations across the 50 states signed onto the “80% by 2018” initiative announced by the National Colorectal Cancer Round Table (NCCRT) in 2014, one-quarter of eligible Americans are yet to undergo CRC screening. Organized screening offers an opportunity for screening improvements by the use of multiple strategies, such as defined target populations, timely access and follow-up, and systematic opportunities for shared decision-making between patients and clinicians. It can also improve efficiency by incorporating noninvasive testing such as annual mailed fecal immunochemical (FIT) tests and colonoscopy alternatives like stool testing. Multiple studies have shown that offering stool testing as an option, in addition to colonoscopy, increases screening uptake, however a diagnostic colonoscopy is still necessary to confirm positive noninvasive test results.

Racial, socioeconomic, and geographic health care disparities also limit screening efficacy. African American and Hispanic American communities and individuals in rural areas in particular face screening barriers, accounting for 42% of the disparity in CRC incidence and 19% of the disparity in CRC mortality between black and white individuals.

The following strategies were discussed to resolve these issues:

  • Incorporate adjunct noninvasive testing to improve screening rates
  • Minimize the ineffective practice of performing re-screening and surveillance colonoscopy sooner than recommended by guidelines
  • Reconsider surveillance strategies for individuals with a history of adenomatous polyps to prevent constraining colonoscopy resources

 

Continued Development of Noninvasive and Minimally Invasive screening Tests

The paper states than an ideal, noninvasive test would “identify lesions with high short-term potential to progress to CRC and should do so with high sensitivity and specificity in a convenient, low-risk, low-cost, and operator-independent manner” that is easy to complete and should achieve high uptake among individuals who are eligible for screening. While an ideal test is yet to be developed, the FIT test and a blood test currently face the least resistance from patients. The researchers propose the development of a noninvasive test that is capable of detecting advanced adenomas and advanced serrated lesions while also being minimally invasive and easy-to-use with a one-time sensitivity and specificity of a minimum of 90%.

 

Improved Personal Risk Assessment for Optimal Programmatic Screening

Current risk assessment guidelines focus on familial and personal colorectal neoplasia risk, but do not acknowledge additional factors such as sex, race, smoking, body mass index, and environmental factors. Family history can be challenging to obtain due to a lack of patient awareness and the health care provider’s limited ability to derive and record the information. The researchers have proposed using patient portals with integrated electronic health record to ensure updated and accurate family health history data and to allow health care providers the ability to accurately assess the patient’s risk by looking at the data in the portal, irrespective of their geographic location. Improved personal risk assessment would help health care professionals select the appropriate CRC screening test method. For example, individuals with a higher risk of advanced adenoma or CRC would be directed to a colonoscopy, while individuals with a lower risk would be directed to a less-invasive screening method.

 

Although initiatives like the 80% by 2018 proposed by the NCCRT are a good step towards increased screening rates, the development of organized screening programs is necessary to further these efforts even more. The desired goal of these screening efforts is testing that is available to at-risk individuals, noninvasive testing methods that are highly accurate and easy to use, increased screening uptake, and reduction in CRC incidence.

 

 

 

 

 

 

 

 

 

A large cohort study that evaluated Swedish family inpatient and outpatient cancer registries found that those who had diabetes had an increased risk of colorectal cancer (CRC)—the magnitude of risk was similar to having a family history of CRC.

The study had a long timeline and follow-up was conducted between 1964-2015. The 12,614,256 individuals included in the study were born after 1931; 559,375 of them had diabetes and 162,226 had CRC. The authors queried the risk of developing CRC among those who had diabetes and found that:

  • 9-fold greater risk of CRC before 50 years among those diagnosed with diabetes before 50 years (range, 1.6-2.3)
  • 9-fold higher risk of CRC before age 50 years among those diagnosed with diabetes before 50 years who also had a family history of CRC (range, 4.1-12)
  • Lifetime risk of CRC before age 50 years among diabetic patients (0.4%) was similar to those with just a family history of CRC (0.5%). It was double that of the average population (0.2%).

This study confirms the positive association between early-onset diabetes and early-onset CRC and makes a case for earlier CRC screening among young adults with diabetes.

Results from the South Australian Young Onset (SAYO) CRC study identified a similar correlation between personal and family history of diabetes and CRC risk. The study cohort included 50 unrelated young adults up to age 55 years diagnosed with CRC (23-54 years), and 253 controls without CRC (18-54 years). Personal and family history of diabetes was documented in this entire population. The study found:

  • 24% of CRC patients also suffered from type II diabetes compared with 5% of the control group
  • 51% of young adults with CRC had at least one first-degree relative with type II diabetes
  • All patients with a personal history of type II diabetes also had first-degree relatives with type II diabetes
  • 44% of CRC patients under 45 years and 60% of CRC patients 45-54 years had a first-degree relative with type II diabetes

These findings create a very strong case for raising awareness among young adults with diabetes of their increased risk of early-onset CRC, especially if there is a family history of diabetes, so they can initiate CRC screening earlier than the USPSTF recommendation of 50 years.

2020 has been a challenging year in so many ways, but especially for the cancer community. However, colon cancer does not stop for Covid-19 and neither do we! We were extremely excited to continue the legacy of the physical Colon Cancer Challenge by going virtual this year. 2020 also marked the 17th year of the Challenge, where teams of families, friends, co-workers, local and national corporations come together to raise awareness of colorectal cancer, support those battling the disease and raise funds for the Colon Cancer Challenge Foundation’s strategic initiatives of Public Awareness, Prevention, and Research. 

We were blown away by the support of our community during this unprecedented time, and are happy to recognize Maya Degnemark and Darryl Gross for their efforts and support during the Challenge. They ran over 1,200 miles collectively during our virtual event, each for their own reasons which you can learn more about below:

 

Maya Degnemark, top female winner of the Global Colon Cancer Challenge

My name is Maya Degnemark, I am 16 years old and I live in Brooklyn, New York. I have watched my uncle, Sanjay Bery, battle colon cancer for many years and now I proudly stand beside him fighting for this cause. Though I have been on my school’s running team since I began high school and have participated in many local races (including the physical race for colon cancer the last couple of years), I have never been so serious about running or about staying healthy. Things changed, however, in mid- March when my packed everyday life quickly changed (and ultimately became more relaxed), and I saw the opportunity to set both a weight loss and general health goal for myself (and compete in this virtual challenge, which I did not know was this great when I started!) Since then, I have been staying very active – even reaching my 100th day of running (between 3 and 6.5 miles) on July 26th. Now looking back on the past few months and this challenge, I am proud of myself for achieving my personal goals but for also using my own determination to fight for a much greater cause. I thank everyone who participated in this challenge, donated to this organization, or just helped raise awareness for this cause. I am dedicated to continue working with this organization in the years to come and continuing to commend them for their fantastic fight.

Darryl Gross, top male winner of the Global Colon Cancer Challenge

I became involved with CCF after my wife, Jessica, was diagnosed with colon cancer back in April. It’s been a whirlwind since then with surgeries and having to then start chemotherapy.  The experience has been very hard especially during these times. The positive is that her cancer was caught relatively early due to her proactivity.  She knew her body and she felt something was not right and pressed the issue of getting a colonoscopy with her gastroenterologist even as the world was shutting down in March due to Covid-19.   Knowing her body, her intuition was right as she had a cancerous polyp that was removed during her colonoscopy.  She then had to have an additional colorectal surgery before starting chemo.  Chemotherapy will be done in November just in time for the holiday season! She’s 36 and her prognosis is great because she was proactive in getting a colonoscopy even during these uncertain times. It’s been an extra challenging time with everything else going on but we are pushing through. I know both my wife and our world will be better soon! Through this whole situation we have realized how important friends and family are and the power of positive thinking! We are very grateful for everyone in our lives!

As far our involvement with the foundation, it’s new but will be a cause we will support for the rest of our lives.  I saw the notification of the activity challenge and as a family who supports physical activity (we are both runners), I thought it was something great to get involved with.  I plan on participating for many years to come!

 

A recent report by Blue Cross Blue Shield examined the rate of colorectal cancer diagnoses among people with chronic conditions and those over the age of 50, both of which are at an increased risk of colorectal cancer (CRC). Chronic conditions associated with an increased risk of CRC have risen significantly among millennials, or those aged 22-37 years, between 2014 and 2018:

  • Crohn’s disease and ulcerative colitis increased by 14%
  • Type I and type II diabetes increased by 35%
  • Diagnosed obesity increased by 100%

A study found that those who are obese are 30% more likely to develop CRC than those who are not.

There are several reasons for this: obese individuals tend to have inflammation caused by visceral fat, which can cause damage to the body and increase the risk of cancer. This inflammation can also cause insulin resistance, in which the body doesn’t respond properly to insulin and thus produces more to offset the loss from the resistance. Increased insulin in the body can also boost the availability of estrogen, which can lead to increased cell production and tumor growth.

Increased insulin production also affects individuals with type I & II diabetes. Hyperinsulinemia, a condition where the amount of insulin in the blood is higher than normal, can create an environment in the colon that promotes the development and growth of cancer. There are other theories that hyperglycemia, or having too much sugar in the blood, and chronic inflammation from diabetes raises the risk as well. Further research is needed to examine the link between type II diabetes and colon cancer, but it’s noted that injected insulin used to treat type II diabetes is not linked to colon cancer. The risk is from the type II diabetes itself.

Individuals who have inflammatory bowel disease (IBD), like Crohn’s disease or ulcerative colitis, are at a higher risk of CRC due to inflammation of the colon. Individuals who have had IBD for many years tend to develop dysplasia, especially if their IBD has been left untreated. Dysplasia is a condition where cells in the lining of an organ look abnormal but aren’t yet cancerous, but can develop into cancer over time. It’s important to note that IBD is different from irritable bowel syndrome (IBS), which is not linked to an increased risk of colon cancer.

When compared to those who do not have a diagnosed chronic condition, those who do had a significantly higher risk of CRC:

  • People aged 18-64 with Crohn’s disease and ulcerative colitis had an almost two-times greater risk of CRC.
  • People aged 18-64 with diabetes had a 1.7-times greater risk of CRC and tend to have a less favorable prognosis after diagnosis
  • People aged 18-64 with diagnosed obesity had a 1.3-times greater risk of CRC, with a stronger link among men

Only 31% of people under 50 with Crohn’s or ulcerative colitis have received colon cancer screenings. Data obtained from the Blue Cross Blue Shield Axis survey that examined attitudes toward colorectal screening found that 58% of 18-49 year olds with Crohn’s disease or ulcerative colitis cited knowledge barriers as the reason for not getting screened for CRC. Both age groups—over 50 years and 18-49 years—said they were unaware of the need to be screened because their primary care physician had not recommended it. 61% of study participants over the age of 50 admitted that attitudinal reasons were the main barrier to getting screened for CRC. These reasons range from being uncomfortable with the screening process to being fearful of the results. 48% of 18-49 year olds admitted that they do not believe they’re at risk for CRC, therefore they have not been screened. External barriers, such as testing costs and being too busy, accounted for 26% of reasoning for those over 50 and 25% of those aged 18-49.

Increased awareness of CRC risks and symptoms can lead to a decrease of the amount of late stage diagnoses—if diagnosed early, the 5-year survival rate for CRC is 90%. The American Cancer Society recommends that people with an increased risk of CRC should start screening before the age of 45 and be screened more often. Gastrointestinal specialists advise individuals diagnosed with Crohn’s disease to begin regular colonoscopies 15 years after diagnosis or when they reach the age of 50, whichever comes first, and should continue to get screened every one to three years. Individuals diagnosed with ulcerative colitis are advised to begin regular colonoscopies 8 years after diagnosis or at age 50, whichever comes first, and continue every one to two years.

Sources: https://www.mdanderson.org/publications/focused-on-health/how-does-obesity-cause-cancer.h27Z1591413.html

First introduced in February 2017, the Removing Barriers to Colorectal Cancer Screening Act of 2019 (H.R. 1570/S. 668) aims to waive Medicare coinsurance for colorectal cancer (CRC) screening tests, regardless of the code billed for a resulting diagnosis or procedure. The bill sponsors are: Representatives Donald Payne, Jr. (D-NJ), Rodney Davis (R-IL), Donald McEachin (D-VA), and David McKinley (R-WV) in the House and Senators Sherrod Brown (D-OH), Roger Wicker (R-MS), Ben Cardin (D-MD) and Susan Collins (R-ME) in the Senate.

The bill acknowledges that CRC is largely preventable if polyps are detected early and removed before they become cancerous. But there is a large gap in CRC screening rates in the country, with 60% of CRC cases and 70% of deaths occurring in those 65 and over. In order to improve colonoscopy rates, the bill, if passed, will eliminate any unexpected costs, and remove financial barriers that prevent seniors from being screened.

In a statement supporting H.R. 1570 and S. 668, the American Cancer Society Cancer Action Network (ACS CAN) explains that seniors who set up a screening colonoscopy visit do so assuming there is no cost sharing since it’s a screening procedure. However, detection and removal of a polyp during the screening can result in the enrollee facing a surprise medical bill because removing the polyp changes the colonoscopy to a diagnostic process. Medicare enrollees are responsible for a 20% copay on diagnostic procedures, and this amount may vary based on the procedure and the facility where it was conducted. ACS CAN says that Medicare beneficiaries may be sensitive to such out-of-pocket (OOP) costs, and it may deter them from undergoing screening colonoscopy.

ACS CAN is hopeful that removal of this OOP cost loophole can not only save lives by catching CRC at an earlier stage, but it will also result in savings for Medicare, which is expected to spend $20 billion on CRC treatment in 2020 alone.

Jamie Crespo, 29

What is your experience with Colon Cancer? (Are you a patient, survivor, advocate, or caregiver?)

Both my parents were diagnosed with colon cancer in 2017.This was unexpected since cancer did not run in my immediate family. My dad showed signs of weight loss and anemia. He eventually was scheduled for a colonoscopy. In my gut feeling, I knew what the worst diagnosis would be and did not want to believe that it could be cancer. In mid-April, my parents and I found out that my dad had a large mass in his colon and needed surgery. This was the worst news that my family and I received. He was supposed to have surgery mid-summer but had a reaction to a cardiology test that pushed his surgery back to August. My dad had a colectomy to remove the part of the colon that had the mass. He stayed in the hospital for a few days. He had to undergo eleven rounds of chemotherapy with diagnosis of stage 3 colon cancer. With good news, he has been in remission since then.

 

While my dad was going through chemotherapy, my mom scheduled a colonoscopy that was long overdue from the beginning of the year. Unfortunately, her gastroenterologist told me he found polyps and a small mass in her colon that needed surgery to be removed. In November, she had laparoscopic colon surgery to remove the mass and was successful. She stayed in the hospital for a few days as well. Luckily, they removed everything and she did not need chemotherapy for treatment.

 

Did you have any family history of colon cancer before your parents were diagnosed?

I did have a cousin that was diagnosed before my parents.

 

Has your experience impacted your lifestyle? If yes, what are some changes you’ve made?

Exercising regularly, healthy eating habits, seeing a primary care physician yearly. 

 

Is there someone or something that you have leaned on for support during this time? How did they help you?

When my parents were both diagnosed the same year, my support group, that included my family and close friends, came to visit when my parents were in the hospital. If I needed to talk to them they were there for me. 

 

What advice would you give to others who are experiencing the same situation as you?

Definitely have a support group that you can talk to and get a colon cancer screening at age of 50 if not sooner. 

 

A recent study published by the American Journal of Cancer Research examined the impact of geographic disparities on the survival of men with early-age onse­­­­t colorectal cancer (EAO-CRC). The goal of the study was to identify gender-specific differences among those with EAO-CRC, while examining individual and county-level factors.

Data from the Centers for Disease Control and Prevention (CDC) and the Surveillance, Epidemiology, and End Results (SEER) were analyzed to study CRC patterns among men aged 15 to 49 years who were diagnosed between 1999 and 2017. EAO-CRC deaths were classified as deaths among US residents aged 15-54 from 1999-2017. Men aged 50-54 were included to account for patients diagnosed at age 49 with standardized 5-year follow-ups. In identifying hotspots, researchers at the CDC used the International Classification of Diseases, Tenth Revision (ICD-10) codes to identify county-level EAO-CRC frequencies,crude rates, and age-adjusted rates. U.S. counties were then classified as hotspots if they had high rates of EAO-CRC mortality as determined by geospatial analyses. The study population included Hispanic men and non-Hispanic white and black men. . Chi-square test helped determine variances in patient- and county-level characteristics between men in hotspot counties and in non-hotspot counties. Survival was estimated based on the date of diagnosis and the date of the last follow-up appointment or death.

The study identified 232 counties as EAO-CRC hotspots— a majority were located in the South, at a vast 92% or 214 of the 232 hotspot counties. The remaining 8%, or 18 of the 232 counties, were located in the Midwest. Although the average age of men diagnosed with EAO-CRC was 42.73 years, age was not a significant differential among men in the individual hotspot counties.

Men living in hotspot areas were more likely to be:

  • Non-Hispanic black
  • Less likely to be Hispanic
  • Less likely to be married or have a domestic partner

Men residing in these areas were also more likely to be diagnosed with metastatic CRC than men living in other areas.

Hotspot counties commonly shared the following characteristics compared to other counties:

  • Higher poverty rates
  • Higher rates of adult obesity
  • More physical inactivity along
  • Fewer exercise opportunities
  • Limited access to healthy foods
  • Lower college completion rates
  • Higher adult smoking rates
  • Higher uninsured rates
  • Fewer primary care physicians
  • Increased rurality
  • More violent crimes

Overall, men residing in these hotspot areas had a lower CRC survival rate than those in non-hotspot counties. Specifically, men diagnosed with EAO-CRC who lived in hotspots had a 24% increased risk of CRC-specific death than those in non-hotspot areas. Smoking was identified as a major cause of EAO-CRC mortality in hotspots, as EAO-CRC patients in these areas who smoked had a 12% higher rate of mortality than men who did not.

Implications

CRC hotspots in the U.S. tended to be associated with risk factors related to high levels of poverty. Potential explanations for these hotspots could be inadequate access to health care, a knowledge gap on CRC risks and symptoms, and high uninsured rates. The results of the study emphasize the need for increased education on symptoms, preventative measures, and treatments of CRC, especially in hotspot areas.

The article says: Study participants were NH-White, NH-Black, and Hispanic adults or adolescents aged 15-49 at primary CRC diagnosis. A total of 32,447 men in the SEER database were diagnosed with EOCRC from 1999-2016,

Brittney Waldrop 32, female, patient

How did you discover your diagnosis? How old were you at the time? Did you have symptoms? 

I was 31 years young when diagnosed. I went in for my first ever colonoscopy and they found one polyp that was cancerous. I had symptoms for about 5 years, but they were unfortunately overlooked by many doctors. I experienced extreme exhaustion; I could drink 8 cups of coffee a day and still go to sleep! I also occasionally had bloody stools, but they were bright red instead of the black they tell you to look for. Doctors kept saying that it was just hemorrhoids but didn’t look into it any further. If they did, maybe I wouldn’t be stage 4 at this point! It could’ve been caught sooner!

 

Did you have any prior knowledge about colon cancer before you were diagnosed? For instance, did you know about the symptoms and factors that lead to a higher risk of CRC? Did you know your family history?

I did not know anything and I do not have a family history of colon cancer.

 

Has your experience impacted your lifestyle? If so, what are some changes you’ve made?

Yes, it made me realize that life is short, and to live each day to the fullest! I’m weaker than I used to be, so I’ve been slowly trying to build my strength back up as well. 

 

It’s great that you’ve been taking the steps to regain your strength! Is there anything specific that you’ve been doing for this?

I have been walking, riding my stationary bike, reading my daily religion book, stretching and taking wheatgrass shots daily!

 

Is there someone or something that you have leaned on for support during this time?

Facebook support groups, my family & friends, and the hospital that I received care from.

 

What advice would you give to others who are experiencing the same situation as you?

Breathe, it’s going to be okay!

 

For more information related to colon cancer contact us today: www.coloncancerfoundation.org

A new law passed during the Indiana General Assembly’s 2020 session now requires insurance companies to cover colonoscopies at age 45 instead of the previously recommended 50. The law comes two years after the American Cancer Society modified their guidelines for colon cancer screenings.

In a study published in 2017 by the Journal of the National Cancer Institute, researchers found that from the mid-1980s through 2013, colorectal cancer incidence rates in adults age 55 years and older were declining while incidence rates for adults between the ages of 20 and 49 were increasing. It is speculated that the increase in colorectal cancer incidents in young adults is attributed to the fact that screenings were previously not recommended for those under 50.

Implications

It is estimated that there will be around 104,000 newly diagnosed cases of colon cancer and around 43,000 new cases of rectal cancer in the United States in 2020. Almost 18,000 of these cases are estimated to be diagnosed in adults younger than 50. The American Cancer Society estimates that among these numbers, 3,410 will be Indiana residents. Inspired by these statistics, the new Indiana law allows for cases to be diagnosed at an earlier age since screenings are now covered for those 45 years and older. Rep. Brad Barrett, who drafted the law, emphasized its benefits by explaining that insurance costs could potentially decrease if people are diagnosed at an early stage since “the cost of treatment will be less than if it had been caught at a later stage.” The five-year survival rate for colorectal cancer that has been detected early is 90%.