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“Using all the tools in our toolbox will help us get out of the screening backlog.”

Drs. Durado Brooks and Paul Limburg of Exact Sciences talk colorectal cancer screening in a pandemic.

As told to Lisa Berry Edwards. This piece has been edited for clarity. | June 1, 2021

Exact SciencesPrevent Cancer Foundation invited Exact Sciences to share this piece as part of their sponsorship of the 2021 Prevent Cancer Dialogue, where they presented on colorectal cancer screening challenges.

Successful colorectal cancer screening requires more than just an accurate test. Performance is, of course, a key component of successful screening, but we also have to have tests that people will use and tests that people can access. There is no time like now with the pandemic-related screening backlog, with pandemic-aggravated health disparities, and with the need to address the increase in colorectal cancer in young adults, to emphasize some of these issues. We are in a new landscape in which we need to rethink how we go about screening, put all solutions on table and work in new collaborative ways. In short, we have a lot to do.

Using all the tools in our toolbox will help us get out of the screening backlog and reduce the negative impact of colorectal cancer  on our patients, families and communities.  The good news is that multiple screening options are available and widely recommended for average-risk colorectal cancer  screening. The reality is that no single approach works for everybody. Barriers to screening include anxiety, lack of easy access and even just being too busy.  Screening is not one-size-fits-all.

Multi-target stool DNA testing represents an evolution in the opportunity for earlier detection of colorectal cancer and precancers by using a molecularly-based, multi-targeted screening approach. These noninvasive tests can effectively identify lesions of interest and accelerate more successful treatment of colorectal cancer. Notably, patients are supported by a navigation system with reminders and language and insurance support to help them through the screening process.

As patients, families, and communities emerge from the acute changes to daily life imposed by the pandemic, it’s hard for them to focus on longer term issues like cancer screening. But we need to. Early in the pandemic, people didn’t have access to face-to-face medical care. A recent study estimated that 3.8 million colorectal cancer screenings were missed between February and July 20201.

Further, the U.S. Preventive Services Task Force (USPSTF) has just released their new colorectal cancer screening recommendation that has lowered the recommended screening age to start screening to 45. Now an additional 19 million people are eligible to be screened. 

Additionally, we know that in colorectal cancer, and many other types of cancer and chronic conditions, barriers to screening disproportionally affect the most vulnerable populations. Working with organizations like the Prevent Cancer Foundation really allows Exact Sciences to extend and complement all the resources we are positing for our shared common goal of reducing the cancer burden in more effective and efficient ways.

We have to address these issues as a community. This includes raising awareness, providing information to patients and providers on available options, and navigating under-resourced patients through the whole screening process, so all groups can realize the same benefits from colorectal cancer screening. We look forward to working with all committed stakeholders to make sure patients understand their screening options and complete the test that works best for them, so we can realize the great potential of screening that so many of us believe in.

Note

1. Chen RC, et al. Association of cancer screening deficit in the United States with the COVID-19 pandemic. JAMA Oncol. [Published online April 29, 2021]. doi:10.1001/jamaoncol.2021.0884

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