As Americans adjust to the unprecedented changes they have had to make as a result of the coronavirus pandemic, it can be easy to forget about pre-pandemic priorities. With so much changing in people's day-to-day lives, this disruption has sparked another health crisis – Americans skipping their necessary cancer screenings.
New data shows a 70% to 80% reduction in the number of patient visits to doctor's offices because of the coronavirus pandemic.1 Based on data from the Epic Health Research Network, the IQVIA Institute for Human Data Science, Komodo Health and the COVID and Cancer Research Network, the COVID-19 pandemic has resulted in an 85% to 90% decrease in screenings for colorectal cancer.1,2,3,4 Although colorectal cancer is the second deadliest cancer in the United States,5 with an estimated 53,000 Americans predicted to die from the disease this year alone,5 it is treatable when caught early.6 Experts predict that this screening drop-off could result in more deaths due to colorectal cancer over the next decade.7
There is good news, though. Health care providers and people who need routine colorectal cancer screening, which can help detect the disease in early stages, when it may be more treatable,6 are turning to innovative solutions like telehealth visits and screening tests that can be used at home. That could mean that people who delayed or missed a routine screening due to the pandemic's stay-at-home orders and resulting backlog may be able to be tested now. This is critically important because if colorectal cancer is caught in its earliest stages, it is more treatable in 90% of people.6+
"Even in these unprecedented times, preventive care and continuing colorectal cancer screening without interruption is so important. Regular screening can find precancerous polyps early before they can become cancer or find cancer in its early stages before it spreads and when it is more easily treatable," says Dr. Angela Nicholas, a primary care provider and Chief Medical Officer at Einstein Medical Center Montgomery in Philadelphia.
A board member of Fight Colorectal Cancer, a leading advocacy group and education resource, Dr. Nicholas lost her husband to colorectal cancer after he was diagnosed with Stage IV cancer at age 45. She is committed to making sure that screening-eligible people are aware of their options and are screened as soon as they are due. "Because early detection can save lives, it's critically important that we as primary care physicians make sure our eligible patients are screened. We're fortunate that we can offer our patients different screening options, including tests that are effective, convenient and easy to use at home," she added.
One noninvasive screening option that can be used at home is Cologuard®, a DNA-based stool test approved for use by adults age 45 and older who are at average risk for colorectal cancer.8 Cologuard is not a replacement for colonoscopy in high risk patients. False positive and false negative results may occur. By prescription only.
Robert C., a corporate sales professional, has experienced the importance of colorectal cancer screening. During a routine physical at age 50, Robert's health care provider recommended a colonoscopy. Robert, though, was uncomfortable undergoing the invasive procedure and as a result declined screening overall. Because he was at average risk and didn't have any symptoms that would suggest he had a gastrointestinal illness, his health care provider offered the noninvasive screening option of Cologuard, and Robert agreed. Because he tested positive, he underwent a follow-up diagnostic colonoscopy that confirmed he had Stage I colorectal cancer. Following surgery, Robert is now cancer-free.
"I was concerned and hesitant about having a colonoscopy, but cancer doesn't wait," says Robert. "When I was diagnosed with cancer, I couldn't believe it was happening to me. Now that I understand the benefits of regular screening, I encourage everyone – especially men who often put off health screenings or are hesitant about invasive screenings like me – to learn about their options. There are tests that are private and easy to do at home, and, especially now, people should take advantage of them."
After a health care provider prescribes Cologuard, it is delivered directly to the patient's home. After the patient collects a sample, their kit is picked up and shipped to the lab.8 People eligible for screening can also request Cologuard online through a telemedicine provider – without needing an office visit. The Cologuard Customer Care Center is available 24/7 to help people complete their kit and schedule an at-home pick-up.
Even before COVID-19 became a public health crisis this year, an estimated 44 million average-risk Americans ages 45 to 749++ – one in three people10 – remained unscreened for colorectal cancer although they were eligible.9
In this time of uncertainty because of the coronavirus, many people who are concerned about seeing their health care provider in person may be skipping routine colorectal cancer screening. Having the option of a test that can be used at home can help people age 45 and older who are at average risk stay up to date with screening. If you fall into this category, take a look at the last time you were screened and take action by talking to your health care provider.
+Based on a five-year survival rate.
++ Estimate based on the U.S. population aged 45-74 as of 2018, adjusted for the reported rates of high-risk conditions and prior screening history for colorectal cancer.
Indication and Important Risk Information
Cologuard is intended to screen adults 45 years of age and older who are at average risk for colorectal cancer by detecting certain DNA markers and blood in the stool. Do not use if you have had adenomas, have inflammatory bowel disease and certain hereditary syndromes, or a personal or family history of colorectal cancer. Cologuard is not a replacement for colonoscopy in high risk patients. Cologuard performance in adults ages 45-49 is estimated based on a large clinical study of patients 50 and older.
The Cologuard test result should be interpreted with caution. A positive test result does not confirm the presence of cancer. Patients with a positive test result should be referred for diagnostic colonoscopy. A negative test result does not confirm the absence of cancer. Patients with a negative test result should discuss with their doctor when they need to be tested again. False positives and false negative results can occur. In a clinical study, 13% of people without cancer received a positive result (false positive) and 8% of people with cancer received a negative result (false negative). Rx only.
 IQVIA Institute for Human Data Science. Shifts in healthcare demand, delivery and care during the COVID-19 era. April 2020. https://www.iqvia.com/insights/the-iqvia-institute/covid-19/shifts-in-healthcare-demand-delivery-and-care-during-the-covid-19-era. Accessed August 12, 2020
 Epic Health Research Network. Preventive cancer screenings during COVID-19 pandemic. https://www.ehrn.org/wp-content/uploads/Preventive-Cancer-Screenings-during-COVID-19-Pandemic.pdf. Updated May 1, 2020. Accessed August 6, 2020.
 London JW, Fazio-Eynullayeve E, Palchuk MB, et al. Effects of the COVID-19 pandemic on cancer-related patient encounters. JCO Clin Cancer Inform. Published online July 27 2020. doi: 10.1200.CCI.20.00068.
 Komodohealth x Fight Colorectal Cancer. Research brief: New colorectal cancer diagnoses fall by one-third as colonoscopy screenings and biopsies grind to a halt during height of COVID-19. May 2020. https://fightcolorectalcancer.org/wp-content/uploads/2020/05/COVID19-Impact-on-CRC-Patients_Research-Brief_Komodo-Health-Fight-CRC.pdf. Accessed August 6, 2020.
 Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin. 2020;70:7-30.
 National Cancer Institute. Cancer stat facts: Colorectal cancer. https://seer.cancer.gov/statfacts/html/colorect.html. Accessed August 12, 2020.
 Sharpless NE. COVID-19 and cancer. Science. 2020;368:1290.
 Cologuard Physician Brochure. Exact Sciences Corporation. Madison, WI.
 Piscitello A, Edwards DK. Estimating the screening-eligible population size, aged 45 to 74, at average risk to develop colorectal cancer in the United States. Cancer Prev Res. 2020;13:443-448.
 White A, Thompson TD, White MC, et al. Cancer screening test use - United States, 2015. MMWR Morbid Mortal Wkly Rep. 2017;66:201-206
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