January 12, 2022 – Author: Steven Itzkowitz, MD, FACP, FACG, AGAF

The beginning of a new year is typically a time for optimism, goal-setting, and fresh starts, but clearly the start of 2022 feels different. With the surge of cases brought on by the Omicron variant, and our health care system and workforce stretched to new limits, it is hard to be optimistic. However, as I reflect on 2021 and the work of our colorectal cancer fighting community, I am humbled and hopeful for the future. The relentless passion of our NCCRT members and partners has been an inspiration to me since I first attended an NCCRT meeting in 2003 and is what makes me so excited about working with you in my new role as Chair.

But first, I want to share my immense gratitude with all of you who are working on the frontlines of the pandemic. Your tireless dedication to protecting our communities against COVID-19 and caring for those infected by the virus is invaluable, immeasurable, and has not been acknowledged in ways you truly deserve. I have seen at my own hospital how stretched the doctors, nurses, trainees, and all support staff are, not only from getting COVID themselves, but having to cover other colleagues who are out sick or who have to provide child or elder care.

As I look back on our work in 2021, I am proud to reflect on our adaptability and innovation. While colorectal cancer screening rates lagged even during times that COVID-19 cases improved, you pivoted to provide options for your patients, utilizing at-home, stool-based tests. Then in May when the United States Preventive Services Task Force (USPSTF) changed its colorectal cancer screening recommendation to initiate screening for those at average risk at age 45, you rallied together to adapt your processes, promote the new guideline, and advocate for policy changes to ensure swift adoption for health insurance plans. Then, in November, at the 2021 80% in Every Community Conference & NCCRT Annual Meeting, you demonstrated your steadfast commitment to tackling persistent barriers to screening, presenting on the latest research, promising practices, and policy developments, and engaging in critical discussions to advance our work in addressing the NCCRT’s current three priority areas:

1. On-time screening (as soon as eligible whether average or increased risk)
2. Timely colonoscopy follow-up to abnormal non-colonoscopy test
3. Understanding and addressing the source of disparities

The Annual Meeting was one of the most engaging meetings we have had in recent years, with every topic having direct relevance to our work on the ground.

And 2022 is already bringing some early successes. Most importantly, On January 10^th the Department of Labor issued an FAQ regarding coverage of colonoscopies pursuant to USPSTF recommendations. The FAQ specifies that plans are required to cover without cost-sharing, a follow-up colonoscopy performed to evaluate a positive non-invasive stool-based screening test or direct visualization test. Beginning on or after May 31, 2022, plans must provide coverage without cost sharing for plan or policy years. This is a tremendous success, thanks in no small part to the work of numerous NCCRT members.

I’m also excited to share with you that we have several exciting new resources and opportunities in the pipeline for the coming year:

• We will soon release our new Steps Guide for Increasing Colorectal Cancer Screening in Primary Care Practices, which is being updated to reflect the new guidelines, recent research and best practices, and will now be expanded beyond community health centers to all primary care settings;
• We are working on new market research to better understand how to reach Black and African American adults and adults that are newly or soon-to-be eligible for colorectal cancer screening; and
• We are planning a new webcast series, which we’re calling Blue Star Conversations, in which our Strategic Priority Teams will host virtual meetings featuring an expert speaker on a timely topic, followed by member conversation. Watch for registration for these “meet the expert” sessions coming soon!

I also want to share a reminder that the NCCRT’s 2020 resource, Reigniting Colorectal Cancer Screening As Communities Face And Respond To The COVID-19 Pandemic: A Playbook, remains a vital resource to align NCCRT members and partners in working to reignite screening during the pandemic. We will look for opportunities to update and add to this work this year.

Since our mission is to reach “every community”, we need to redouble our efforts to identify and overcome the CRC screening rates based on disparities related to race, ethnicity, gender-identity, and insurance, in our local communities. Collectively, we have huge talents and expertise to overcome these barriers, and we know, by example, that it can be done.

While the challenges in our day-to-day lives and in our work remain unprecedented, I am confident that we will continue to find new ways to adapt and innovate to reach more individuals for colorectal cancer screening, and in turn save more lives from this often-preventable disease. I’m in awe of your dedication and proud to work alongside you as we strive to reach 80% in Every Community.

Thank you for all that you do. Stay safe and well.

Steven Itzkowitz, MD, FACP, FACG, AGAF
Professor of Medicine, Oncological Sciences and Medical Education
Icahn School of Medicine at Mount Sinai
Chair, NCCRT