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Call to Action: One Email, Phone Call May Just Save a Life
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It’s hard to imagine that an estimated 51,000 or more individuals will lose their lives to colorectal cancer in 2019. It’s hard to imagine because it is one of the few cancers that can be screened for, detected and prevented at an early stage so individuals do not have to suffer, and ultimately die, from this disease.
In honor of National Colorectal Cancer Awareness Month in March, I, along with other physician leaders of the American Society for Gastrointestinal Endoscopy (ASGE), American Gastroenterological Association and American College of Gastroenterology, visited Capitol Hill to provide an outline on colorectal cancer risk factors, explain the differences among colorectal cancer screening options, and highlight barriers to screening at a special briefing for congressional staff.
The briefing was exceptionally well-attended, and our visit seemed to be an effective way to connect with congressional lawmakers.
ASGE has continually focused on getting lawmakers to prioritize access to colorectal cancer screening. While we’ve made some progress, Congress has not yet acted to remove what we believe is a significant barrier to colorectal cancer screening. That is the surprise bill that Medicare patients get when they go in for a screening colonoscopy that is supposed to be without cost sharing, and they end up with a bill because the gastroenterologist found a polyp and removed it before it has a chance to become cancerous.
Being on Capitol Hill allows us to approach lawmakers and their staff to help them understand that colorectal cancer research and screening are important issues, and that very concrete benefits have been demonstrated when we screen for colon and rectal cancer and when we fund research through the National Institutes of Health.
Wrong Impressions
Many gastroenterologists, and physicians broadly, have an inaccurate impression when it comes to how the legislative process works. The health policy staffers with whom I’ve been fortunate enough to meet have been receptive to my views and ideas. My experiences tell me that members of Congress and their staff want the perspective of the physicians and patients who live and work in the states and districts they represent.
Advocacy doesn’t require gastroenterologists to travel to Washington, D.C., to make a difference. So much can be done at home from a grassroots level. It is the ASGE’s job to keep its members aware of important regulatory and legislative issues and how they can lend their voice. Although it may seem insignificant to send an email or open a dialogue with legislative representatives, those communications can make a real difference in how policy is shaped, or funding is appropriated.
How GIs can Help
Colorectal cancer screening received a significant boost when the Affordable Care Act (ACA) mandated that preventive screenings with a high approval rating from the U.S. Preventive Services Task Force would be available to commercially insured patients, as well as Medicare and Medicaid beneficiaries without cost sharing. Thanks to the ACA and improved screening techniques, there has been a significant drop in the mortality rate for colon cancer in this country, as well as the ability to detect cancer at an early stage when it can be cured.
Still, there is much work to be done. Increasing the number of people who are up-to-date with recommended screening means removing barriers to screening. This is why the ASGE has long been a leading voice in support of the Removing Barriers to Colorectal Cancer Screening Act. The bill would correct a glitch in current policy that leaves Medicare patients on the hook for coinsurance when a polyp is removed during the screening encounter. This hiccup in the law can be fixed with the passage of the Removing Barriers bill and would help to ensure everyone is screened at the appropriate age and lives are saved.
Physician members of the GI societies who want to contact their members of Congress should work with the GI professional societies — ASGE, ACG and/or AGA. All three societies have created, through online advocacy tools and resources, the ability of gastroenterologists to have their voices heard and influence matters important to all of us, including our patients.
Taking an active role in advocacy need not be time-consuming or overwhelming for physicians if they avail themselves of the tools and networks offered by their professional societies. I encourage anyone with an interest in helping to make a difference for patients to take advantage of these opportunities.
Steven Edmundowicz
President
ASGE
Interim Division Director, Gastroenterology and Hepatology
University of Colorado School of Medicine
Disclosure: Edmundowicz reports no relevant financial disclosures.