The colorectal cancer bill, HB20-1103, that the La Junta Tribune-Democrat reported was under review in the state House Health & Insurance Committee, passed with unanimous approval in that committee Wednesday afternoon

The primary sponsors of the bill in the House and Senate are Rep. Janet Buckner (D-Dist. 40), Rep. Perry Will (R.-Dist. 57), Sen. Rhonda Fields (D-Dist. 29) and Sen. Kevin Priola (R-Dist. 25).

Rep. Brianna Buentello said about the colorectal cancer screening bill: "One of the pain points of families throughout Southeastern Colorado is a lack of access to preventative and primary care medicine. HD 1103 helps to ensure that these insurance industries are covering vital preventative procedures such as screenings for colorectal cancer; this policy will undoubtedly save our Southern Colorado families money on healthcare and save lives."

Sen. Larry Crowder also commented on the bill.

"HB20-1103 will be heard today (Wednesday) in the Health Committee in the house and if successful will appear in the senate several days from now," wrote Crowder. "The difference between current testing standards of USPSTF, United States Preventive Service Task Force Guidelines which advises testing for colorectal cancer screenings to begin at 50 to 75 years of age, and the newly advised  American Cancer Society to begin testing at age 45-75. If in fact there can be direct evidence to support this change then there may very well be a benefit to people in southern Colorado and I will be supporting this bill in Senate Health and Human Services committee upon arrival."

Scott Wilson is on a mission to spread awareness about colorectal cancer and how earlier screenings can prevent financial and emotional stress and save lives.

Wilson, a stage IV colorectal cancer survivor and member of the Colorado Cancer Coalition, advocates for HB20-1103, a Colorado House bill that if enacted would require health insurance carriers to provide colorectal cancer screening coverage in accordance with the American Cancer Society's guidelines; essentially lowering the screening age from 50 to 45.

He recognizes the need for earlier screenings particular in rural areas of Colorado and the nation at large. Otero County, he said, is one of many counties in rural Colorado to have a below-average screening rate of colorectal cancer.

In fact, according to the Behavioral Risk Factor Surveillance System by the Center for Disease Control, the northwest, northeast and southeast rural-most areas of Colorado, including Otero, Bent and Crowley Counties, are rated with the lowest percentage of screenings for colorectal cancer.

The behavioral risk factor also indicates that latinos/hispanics are the group least likely to get screenings for the disease and that the most likely group to receive screenings are women and people aged 65 to 75, who the CDC notes are most likely to have medicare.

Colorectal cancer screening works in two ways currently. One is to go straight for a colonoscopy, which is covered by insurance. The other involves a FIT test, essentially a stool sample, followed by a colonoscopy should the test return positive results.

"If the FIT test is positive, you need the colonoscopy," explained Wilson. "You can't just go from FIT to surgery or treatment, you have to have the colonoscopy, and the colonoscopy is not covered under that circumstance. You suddenly face a bill that you wouldn't have if you'd gone straight for a colonoscopy."

"Colorectal cancer, particularly among young people, and late stage, are serious issues within Colorado," said Wilson. "The bill seeks to address both of those points by reducing the age of screening, which is currently 50. We think we will catch young people who are developing late stage disease, hopefully at an earlier stage where it's far more treatable and hopefully preventable.

Over half of all diagnosed cases of colorectal cancer in Colorado are late stage, said Wilson. 65 % of the diagnoses among 45 to 49-year-olds are cases of late stage cancer, and that difference is due to the lack of availability of screening, particularly in rural areas.

"You've got Kiowa, Bent, Prowers, Baca, Las Animas, Otero, Huerfano and Crowley." Wilson continued, "Together they make health region 6, and health region 6 has, unfortunately, not just the highest per capita rate of colorectal cancer, but the highest per capita rate of late stage colorectal cancer in Colorado, including the highest per capita rate of female late stage in Colorado.

"It's fairly stark in terms of those figures, 56 % of all the diagnoses in that region are late stage. ... I think this is symptomatic."

The American Cancer Society recently changed its guidelines for colorectal cancer screening ages, but only two states have adopted those guidelines legislatively; Maine and Kentucky. Wilson believes this is an opportunity for Colorado to demonstrate leadership in health care.

"States have to change the law," Wilson said. "We could change the law, and still nothing would happen. We still have to get the screening out and into underserved rural areas. That's where the lowest screening rates are. Alongside this has to be a two-way process. The system needs to be there to provide for underserved and rural areas; the people in those areas also need to be aware and willing to take advantage of those things that will save their lives."

The bill aims to make screenings more accessible, but Wilson also thinks of it as an avenue to raise general awareness about colorectal cancer through. The disease can be very lethal, but it is also a slow growing disease that, if detected early, can be dealt with efficiently. The problems with dealing with it early, aside from the primary financial barrier, have to do with fear and stigma, Wilson thinks.

"For some reason there's a myth that this is an old man's disease," said Wilson.

In truth, in five incidences of colorectal cancer there is almost a perfect statistical split between men and women, and colorectal cancer is the fastest growing cancer in young females in Colorado and the nation at large, Wilson said.

"It's also the single biggest killer of young men under 50 from cancer in the United States. Again, it's not either/or. It's a very indiscriminate disease as far as age and sex is concerned."

In addition, people tend to shy away from FIT tests and colonoscopies until it may be too late because it is a sensitive anatomical subject. But Wilson maintained that if people discussed the subject more, they would be more comfortable confronting it when it matters.

"Within 'colorectal' it is clear there is a 'rectal' element and people feel very awkward about that. But this is just, it's part of our body, it's a disease and it's affecting people, but we have to get real and normal, and just talk about these things like adults and move ahead. You can't allow fear and embarrassment kill you.

And in line with discussing the disease more often and more comfortably, Wilson hopes to bring awareness of colorectal cancer up to the levels of breast cancer for women.

"The strides that have been made in breast cancer screening, it's just automatic now," said Wilson. "Women at 40 just get screened for breast cancer now. There's no hesitation. It's just what you do. For some reason there's a hesitation among colorectal cancer and that needs to be eliminated. The hesitation of fear and of colonoscopy, for example, are nothing compared to an actual diagnosis of late stage cancer.

"I hate the idea that fear of death would actually prevent somebody from getting screened, when screening can be so effective," he said. "(One) can totally get in front of this and stop it from happening. That's the power of colorectal screening. It's a slow-growing disease. So get it early and it will not trouble you."

HB20-1103 passed unanimously in the House Health & Insurance Committee Wednesday. If it makes passes Appropriations in the House it will continue to the Senate where it will undergo further consideration.

cburney@ljtdmail.com