March is Colorectal Cancer Awareness Month; bill to improve screening awaits final vote

By Melissa Patrick
Kentucky Health News

A bill to improve colorectal cancer screening coverage in Kentucky has just two days left in March to pass during this legislative session.

March is Colorectal Cancer Awareness Month, an opportunity to spread awareness about the importance of preventive screening and the prevalence of colorectal cancer in Kentucky.

House Bill 421, sponsored by Rep. Amy Neighbors, R-Edmonton, passed out of the House on March 5, 98-0, and passed out of the Senate Banking and Insurance Committee committee on March 11. The bill has had two of its three required readings and awaits a vote on the Senate floor.

March 27 and 28 are the last two days of the 2025 legislative session, where lawmakers will return to Frankfort to override the governor’s vetoes. Any legislation passed on those two days can be vetoed without fear of a legislative override.   

While presenting the bill on the House floor, Neighbors said this issue is important to her because she was diagnosed with colon cancer at age 40 and this puts her children at high risk for the disease. Because of this, she said they will need to get their colonoscopies at age 30.

“Early detection will give them and all Kentuckians the greatest opportunity for prevention and treatment of the disease,” she said.

Neighbors is one of a growing number of people under the age of 50 who have been diagnosed with colon cancer in Kentucky, which has a higher incidence of early-onset colorectal cancer compared to the national average.

According to the American Cancer Society, colorectal cancer is the third most common cancer among men and women. And while overall rates of colorectal cancer have gone down over the past 10 years, ACS says rates in people younger than age 50 have gone up by about 2% each year.

Neighbors’ bill aims to remove some of the barriers that keep Kentuckians from getting screened for a cancer that is treatable when caught early.

“Colorectal cancer is one of the most preventable and treatable cancers when it’s caught early,” Neighbors said in a news release. “The problem is, too many Kentuckians delay getting their cancer screenings because of insurance hurdles or high costs. This delay can sometimes be the difference in catching the disease early enough to beat it. House Bill 421 aims to remove these hurdles so that no one has to put off colorectal cancer screenings because they can’t afford it any longer.”

Early detection of colorectal cancer is critical because when it is diagnosed early there is a 91% chance of survival within five years, according to the ACS.

HB 421 would require health benefit plans to provide coverage for all colorectal cancer examinations and laboratory tests specified in the U.S. Multi-Society Task Force on Colorectal Cancer guidelines. This includes ensuring that high-risk individuals, such as those with a family history of the disease, or early-onset cases receive screenings much earlier as recommended by these guidelines.

The bill also would ensure coverage for all U.S. Food and Drug Administration-approved bowel preparations used for the examination and would remove prior authorization requirements for them. It also provides an exemption from the cost-sharing prohibition for health savings account-qualified high-deductible health plans under certain circumstances.

Colorectal cancer in Kentucky

In late February, Jaclyn McDowell, senior epidemiologist for the Kentucky Cancer Registry, told attendees at the Colorectal Cancer Screening Symposium in Lexington, that ACS estimates there will be more than 154,000 new cases of colorectal cancer in 2025, with 2,580 of them in Kentucky. ACS also estimates that there will be nearly 53,000 deaths from colorectal cancer in 2025, with 900 of them in Kentucky.

Colorectal cancer incidence and death rates for each county can be found on the Kentucky Cancer Registry.

McDowell lauded Kentucky’s work to increase its colorectal cancer screening rates, noting that the state increased its screening rate to 75.4% in 2020 among people aged 50 to 75, up from 34.7% in 2000.

“This is an incredible public health impact,” she said. “No other state has been able to increase screening this quickly and with this much effort.”

She said this uptick in screening resulted in a 30% decrease in the colorectal cancer incidence rate from 2000-2022 and a 34% reduction in the colorectal cancer mortality rate from 2000 to 2020.

However, she added that there is more work to do, pointing to the high rates of colorectal cancer that persist in people living in Appalachian Kentucky.

Scotty Evans, associate director of community partnerships with ACS, told the attendees of the February symposium that while anyone can get colorectal cancer, some people have a higher risk than others and it’s important to know your risk.

For example, he said people with a family history of colorectal cancer are at higher risk, as are people with inflammatory bowel disease, people with type 2 diabetes and those with inherited syndrome caused by changes in their genes like Lynch syndrome. In addition, he said Black people are at a higher risk of getting colorectal cancer.

Evans also listed some common signs and symptoms of colorectal cancer, including blood in the stool, weakness and fatigue, unintended weight loss and changes in bowel habits.

Colorectal cancer screening options

It’s often said that for most people, the best screening test for colorectal cancer is the one that they will complete. The three most common screening tests are a colonoscopy, a stool DNA test and a fecal blood test.

A colonoscopy must be done in a clinic or hospital under sedation and is considered the gold standard for colorectal cancer screening. This screening is conducted every 10 years if results are normal and is the only test recommended for anyone considered to be at a high risk of colorectal cancer.

A stool DNA test like Cologuard can be completed at home and is designed to detect abnormal cell changes in your stool that are linked to cancer. Screening is conducted every three years if results are normal.

A FIT test is a test that looks for hidden blood in stool and can also be done at home. This test is done yearly if the results are normal.

Kentuckians who are uninsured and underinsured can reach out to the Kentucky Colon Cancer Screening Program to see if they qualify for a free colorectal cancer screening.