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  • WHO Global Initiative for Childhood Cancer: progress on all fronts

    WHO Global Initiative for Childhood Cancer: progress on all fronts

     Peru shows the way forward and the courage of Ander Martinez

    “When Ander was diagnosed, I didn´t have the possibility to cover the cost of the treatment. It was very expensive, and I had nothing,” says Rosalina Tocto, 29 years mother of Ander Martínez Tocto. Ander had just been diagnosed with acute leukemia at the young age of 6 years. From the beginning, the odds were stacked against him. He and his family lived in a rural town, six hours from the nearest city. His parents did not have a formal job, placing the family under financial strain.

    Ander and his family were not alone in this situation. “In Peru, nearly 1800 children and adolescents are diagnosed with cancer every year; however, up to 70% will have a late stage, often metastatic due to delays in diagnosis,” says Dr. Juan García, medical chief of the Pediatric Department of in the National Institute of Neoplastic Diseases (INEN) in Lima, Peru. “Most of our patients come from outside Lima and the majority of parents do not have formal employment and therefore do not have any type of insurance.”

    Fortunately, Peru has made a strong commitment to Universal Health Coverage. In 2009, a law was passed to improve access to care by introducing a mandatory health insurance system and registering everyone living in extreme poverty under Seguro Integral de Salud (SIS), regardless of age or circumstance.  

    Dr. Reina Bustamante, Executive Director of the Division of Prevention and Control of Cancer of the MINSA says “UHC is an important step in public health particularly for those who lack public or private insurance like Ander. In this context, we are trying to follow WHO guidance to achieve UHC and ensure all individuals and communities receive the health services they need without suffering financial hardship.”

    In 2019, Peru was selected as a focus country for the WHO Global Initiative for Childhood Cancer as the first focus country in the Region. The Global Initiative aims to improve survival for all children with cancer to at least 60% by 2030 while reducing suffering, altogether with the potential to save an additional one million lives.

    Four main goals were formulated for the national pediatric cancer plan: (1) improve early diagnosis of childhood cancer, (2) decrease treatment abandonment, (3) implement a national pediatric cancer registry and (4) improve the quality of services in pediatric oncology units.

    Dr. Liliana Vasquez, pediatric oncologist who works as an external consultant for the Division of Prevention and Control of Cancer of MINSA said, “Ten working groups have been established to achieve the goals.”

    Dr. Vivian Perez, advisor of the Non-Communicable Diseases Office in PAHO-Peru added “the initial focus for the Initiative will be on six cancers selected as tracers for monitoring progress across the health system, alongside engagement of at least six focus countries with a record of strong political commitment and foundational efforts supporting children with cancer.”

    For Ander, his health care team, the commitments from the government of Peru and partners and Global Initiative have made it possible to be successfully treated and will now allow him to dream of a healthy future though better access to surveillance monitoring and psycho-oncological support aimed at childhood cancer survivors.

    Peru is showing what is possible for all countries. By concerted action and promoting universal health coverage, every child in the world can have access to high-quality care with the greatest likelihood of survival, and every family should be protected from financial hardship. We can do more together. 

     

    WHO Global Initiative for Childhood Cancer: progress on all fronts
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    https://www.who.int/news-room/detail/14-02-2020-who-global-initiative-for-childhood-cancer-progress-on-all-fronts

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  • World experts and funders set priorities for COVID-19 research

    World experts and funders set priorities for COVID-19 research

    Leading health experts from around the world have been meeting at the World Health Organization’s Geneva headquarters to assess the current level of knowledge about the new COVID-19 disease, identify gaps and work together to accelerate and fund priority research needed to help stop this outbreak and prepare for any future outbreaks.

    The 2-day forum was convened in line with the WHO R&D Blueprint – a strategy for developing drugs and vaccines before epidemics, and accelerating research and development while they are occurring.

    “This outbreak is a test of solidarity — political, financial and scientific. We need to come together to fight a common enemy that does not respect borders, ensure that we have the resources necessary to bring this outbreak to an end and bring our best science to the forefront to find shared answers to shared problems. Research is an integral part of the outbreak response,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “I appreciate the positive response of the research community to join us at short notice and come up with concrete plans and commitment to work together.”

    The meeting, hosted in collaboration with GloPID-R (the Global Research Collaboration for Infectious Disease Preparedness) brought together major research funders and over 300 scientists and researchers from a large variety of disciplines. They discussed all aspects of the outbreak and ways to control it including:

    • the natural history of the virus, its transmission and diagnosis;
    • animal and environmental research on the origin of the virus, including management measures at the human-animal interface;
    • epidemiological studies;
    • clinical characterization and management of disease caused by the virus;
    • infection prevention and control, including best ways to protect health care workers;
    • research and development for candidate therapeutics and vaccines;
    • ethical considerations for research;
    • and integration of social sciences into the outbreak response.

    “This meeting allowed us to identify the urgent priorities for research. As a group of funders we will continue to mobilize, coordinate and align our funding to enable the research needed to tackle this crisis and stop the outbreak, in partnership with WHO,” said Professor Yazdan Yazdanpanah, chair of GloPID-R. “Equitable access – making sure we share data and reach those most in need,  in particular those in lower and middle-income countries, is fundamental to this work which must be guided by ethical considerations at all times.”  

    During the meeting, the more than 300 scientists and researchers participating both in person and virtually agreed on a set of global research priorities. They also outlined mechanisms for continuing scientific interactions and collaborations beyond the meeting which will be coordinated and facilitated by WHO. They worked with research funders to determine how necessary resources can be mobilized so that critical research can start immediately.

    The deliberations will form the basis of a research and innovation roadmap charting all the research needed and this will be used by researchers and funders to accelerate the research response.

    Note to editors

    GloPID-R is a global alliance of international research funding organizations investing in preparedness and response to epidemics.

    World experts and funders set priorities for COVID-19 research
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    https://www.who.int/news-room/detail/12-02-2020-world-experts-and-funders-set-priorities-for-covid-19-research

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  • Ministers to agree new global road safety agenda to 2030

    Ministers to agree new global road safety agenda to 2030

    Government ministers and senior officials from over 100 countries will meet in Stockholm, Sweden from 19-20 February to discuss new steps to halve road traffic deaths and injuries by 2030, in line with global targets agreed in the United Nations Sustainable Development Goals (SDGs).

    “The fact that an estimated 1.35 million lives are lost every year due to road traffic collisions is an outrage. It is an unacceptable price to pay for mobility,” said Dr Tedros Adhanom Ghebreyesus, Director-General at the World Health Organization (WHO).

    Road traffic injuries are now the leading cause of death for children and young adults aged 5 to 29 years, according to WHO’s most recent Global status report on road safety.

    More than half of all road traffic deaths occur among pedestrians, cyclists and motorcyclists. The risk of a road traffic death remains three times higher in low-income countries than in high-income countries. Moreover, as many as 50 million people experience non-fatal road injuries, which impose human suffering and major economic losses.

    “Most road traffic deaths and injuries can be prevented, using tried and tested strategies,” added Dr Tedros. “This conference is an opportunity for the world to embrace a new agenda to radically reduce the number of lives lost on our roads and re-think how we can provide access to safe, affordable, accessible and sustainable transport systems for all.”

    Progress in road safety

    Many countries have already made progress through effective road safety management and focusing on better legislation and enforcement around key risks such as speeding; drinking and driving, and failing to use seatbelts. They have also improved infrastructure through measures such as safer sidewalks and dedicated lanes for cyclists; implemented vehicle standards such as those that mandate advanced braking and electronic stability control; and enhanced post-crash care.

    Improvements have occurred when a number of sectors have been involved – including transport, health, urban planning and law enforcement, among others. Success has also depended mainly on strong leadership and political will at the highest level of government and in close collaboration with civil society and the private sector.

    The Stockholm Declaration

    Hosted by the Government of Sweden in collaboration with WHO, the 3rd Global Ministerial Conference on Road Safety offers delegates an opportunity to share successes and lessons learned, chart future strategic directions for global road safety, and define ways to fast-track progress around proven strategies to save lives.

    The Stockholm Declaration will be presented as the final outcome document of the Ministerial Conference calling for strong political will and international cooperation as well as partnerships across many sectors of society. The Declaration will lay out key recommendations for accelerated action to drive progress towards halving global road traffic deaths and injuries by 2030.

    Beyond preventing human suffering and major economic losses, addressing road traffic deaths and injuries has positive impact across all aspects of society and development ─ including those linked to environment, climate change, education, employment, energy, poverty, human rights and equality ─ as outlined in the SDG targets.

    Note to editors:

    Road safety is reflected in the SDGs agreed in 2015, with two dedicated targets: (a) 3.6 aimed at preventing road traffic deaths and injuries and (b) 11.2 providing access to safe, affordable, accessible and sustainable transport systems for all.

    Achieving these targets would lead to increases in walking, cycling and using public transport, in other words, those modes of transport which impact most favorably on noncommunicable diseases like heart and lung diseases, cancer and diabetes. It would also contribute to reducing environmental risks, such as air and noise pollution, and steering sustainable urbanization, with less congestion and universal access to safe, inclusive and green public spaces. 

    Ministers to agree new global road safety agenda to 2030
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    https://www.who.int/news-room/detail/07-02-2020-ministers-to-agree-new-global-road-safety-agenda-to-2030

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  • Pregnancy and breastfeeding during an Ebola virus outbreak

    Pregnancy and breastfeeding during an Ebola virus outbreak

    Women who are pregnant or breastfeeding in an Ebola outbreak face similar challenges as other population groups, but they have specific health needs which must be met.

    As the second largest Ebola outbreak in history continues in the Democratic Republic of Congo, WHO has released new clinical guidelines for healthcare providers supporting pregnant or breastfeeding women in the context of Ebola virus disease.

    Improving clinical care and reducing mortality

    92-4-000138-1Clear and coherent guidance is needed to meet the combined needs of women requiring Ebola treatment, pregnancy care and management of complications.

    Information on how to protect breastfeeding children and other members in the community from transmission of the disease is also critical.

    Limited scientific evidence on how to best manage these needs has previously been a challenge for affected countries. In addition, misconceptions that pregnant women have a higher mortality rate than other populations with Ebola may in some contexts have put pregnant women at risk of not receiving standard care.

    WHO’s Guideline on the management of pregnant and breastfeeding women in the context of Ebola virus reviews existing evidence and provides a single set of recommendations on the care continuum for women exposed to, diagnosed with, or recovered from Ebola.

    This will enable healthcare providers, emergency response teams and health policy-makers to improve prevention and treatment measures in an Ebola outbreak.

    Obstetric care at an Ebola Treatment Centre

    Optimal supportive care should be offered to all pregnant women with Ebola. Likewise, they should be offered experimental treatment and vaccination under the same conditions as non-pregnant populations.

    Ebola virus disease does increase the risk of miscarriage and early labour, requiring close clinical management at Ebola treatment centres. It is important to engage both obstetric providers and those trained in Ebola response.

    This dual expertise is also important because early Ebola and pregnancy-related symptoms can overlap. Pregnant women should be prioritised for testing to confirm an Ebola infection.

    Ebola virus can persist in pregnancy related fluids as well as breastmilk. If healthcare providers are not clear on how to manage Ebola infection risk, they may be less willing to provide care. This stigma can be life-threatening for women who experience complications during delivery.

    The new WHO guidelines advise healthcare workers on how to protect themselves while caring for pregnant women with Ebola virus disease. This includes induced labour or surgical procedures, which carry greater risk of transmission in cases of acute infection. Any invasive treatments should be carried out in full personal protective equipment.

    Breastfeeding recommendations in an Ebola outbreak

    WHO recommends that women with suspected or confirmed Ebola immediately stop breastfeeding and are prioritised for diagnostic testing. Any child exposed to Ebola through breast milk should be placed into safe care, closely monitored for symptoms over a 21-day period and fed with an appropriate breast milk substitute.  

    The guidelines strongly recommend that breastfeeding is only restarted following two consecutive negative tests of breast milk, separated by 24 hours.

    A breast milk substitute should be used even if infection is confirmed for both the mother and her child. Exceptions can be made for infants under 6 months of age who are already infected, if breast milk substitutes are not feasible, affordable, sustainable or safe and separation cannot be implemented safely.

    Women’s health and rights in a disease outbreak

    A disease outbreak does not change women’s and adolescent girls’ fundamental human right to sexual and reproductive healthcare, including evidence-based care during pregnancy and childbirth.

    Women need support to make informed reproductive health care choices for themselves and their children. Women living in an Ebola outbreak should have access to all relevant reproductive options, regardless of economic, cultural, racial or religious status, including contraception and safe abortion to the full extent of the law.

    Pregnant and breastfeeding women across affected communities need equitable and respectful care that considers the risks they face and supports the choices they make.

    Accessing the guidelines and further research

    These guidelines are now available online and may be freely downloaded. The executive summary will be available in French.

    WHO will closely monitor new data as it emerges, as there is still a pressing need to prioritise ongoing research related to Ebola virus transmission.

     

     

     

    Pregnancy and breastfeeding during an Ebola virus outbreak
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    https://www.who.int/news-room/detail/10-02-2020-pregnancy-and-breastfeeding-during-an-ebola-virus-outbreak

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  • WHO and FIND formalize strategic collaboration to drive universal access to essential diagnostics

    Geneva, Switzerland – 10 February 2020 – The World Health Organization (WHO) and the Foundation for Innovative New Diagnostics (FIND) announced today that a memorandum of understanding has been signed by the two organizations to formalize a strategic collaboration that will strengthen diagnosis in resource-poor countries by closing major diagnostic gaps at country level and bolstering disease surveillance that will inform public health initiatives and enhance outbreak preparedness and response.

    “This collaboration is an inspiring development that will take us a long way towards ensuring access to diagnostics to all who need them,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “Global health challenges such as the ongoing novel coronavirus (2019-nCoV) outbreak demonstrates that without these essential elements of health systems, we cannot hope to promote health, keep the world safe, and serve the vulnerable. I look forward to working closely with FIND to determine what countries need and to forge a path to deliver these innovations so that no one is left behind.”

    Diagnosis is a driver of patient, financial and health systems impact, and a critical enabler of universal health coverage, but it is also the weakest link in the care cascade. This is especially true in primary healthcare settings in low- and middle-income countries. A unique and unprecedented opportunity exists to expand the role and impact of diagnostics to fully realize their potential to address major health security threats and evolving disease burdens through technological and digital advances.

    FIND has been an active partner with WHO since 2008 and a WHO Collaborating Centre since 2014, acting in the areas of laboratory strengthening and diagnostic technology evaluation. This expanded collaboration will put in place the building blocks necessary to enable transformative change in a move toward a country-led diagnostics alliance. Initial workstreams will focus on demand-driven access to essential diagnostics and the development of national Essential Diagnostics Lists, alongside collection of data that assist the scale up of diagnostics to support low- and middle-income countries on their paths to universal health coverage.

    “Each and every person has the right to a quality, timely diagnosis,” said Catharina Boehme, CEO of FIND. “Comprehensive diagnostic services underpin functional and efficient health systems not only to manage day-to-day healthcare needs, but also to ensure new disease outbreaks can be spotted and contained quickly. Working closely with WHO as part of a country-led alliance, we will strive to ensure that low- and middle-income countries have what they need to develop their own comprehensive, data-driven diagnostic strategies that enable universal health coverage and empower disease surveillance. Our ambition is that all patients, providers and decision-makers have access to the diagnostic solutions needed for optimal health outcomes.”

    The strategic collaboration agreement will initially run for a period of 5 years, until 2025.

    #  #  #

    About FIND

    FIND is a global non-profit organization that drives innovation in the development and delivery of diagnostics to combat major diseases affecting the world’s poorest populations. Our work bridges R&D to access, overcoming scientific barriers to technology development; generating evidence for regulators and policy-makers; addressing market failures; and enabling accelerated uptake and access to diagnostics in low- and middle-income countries (LMICs). Since 2003, we have been instrumental in the development of 24 new diagnostic tools used in 150 LMICs. Over 50 million FIND-supported products have been provided to our target markets since the start of 2015. A WHO Collaborating Centre, we work with more than 200 academic, industry, governmental, and civil society partners worldwide, on over 70 active projects that cross six priority disease areas. FIND is committed to a future in which diagnostics underpin treatment decisions and provide the foundation for disease surveillance, control and prevention. For more information, please visit www.finddx.org

     

    About WHO

    The World Health Organization is the directing and coordinating authority for health within the United Nations system. It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends. WHO is committed to the enjoyment of the highest attainable standard of health as one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition. WHO’s current global programme of work sets out three interconnected strategic priorities: ensuring healthy lives and well-being for all at all ages; achieving universal health coverage; and addressing health emergencies and promoting healthier populations. These priorities are linked to three ambitious targets, the “triple billion”: one billion more people to benefit from universal health coverage; one billion more people better protected from health emergencies; and one billion more people enjoying better health and well-being.

     

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    https://www.who.int/news-room/detail/10-02-2020-who-and-find-formalize-strategic-collaboration-to-drive-universal-access-to-essential-diagnostics

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  • US$675 million needed for new coronavirus preparedness and response global plan

    US$675 million needed for new coronavirus preparedness and response global plan

    To fight further spread of the new coronavirus (2019-nCoV) outbreak in China and globally, and protect states with weaker health systems, the international community has launched a US$675 million preparedness and response plan covering the months of February through to April 2020.

    “My biggest worry is that there are countries today who do not have the systems in place to detect people who have contracted with the virus, even if it were to emerge,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Urgent support is needed to bolster weak health systems to detect, diagnose and care for people with the virus, to prevent further human to human transmission and protect health workers.”

    The Strategic Preparedness and Response Plan (SPRP) for the new coronavirus lays out activities and resources needed by international health organizations globally, including WHO, to implement priority public health measures in support of countries to prepare and respond to nCoV-2019 for a period February-April 2020. The objectives of the plan are to  limit human-to-human transmission of the virus, particularly in countries most vulnerable if they were to face an outbreak; identify, isolate and care for patients early; communicate critical risk and event information; minimize social and economic impact; reduce virus spread from animal sources; and address crucial unknowns.

    The plan focuses on:

    • Rapidly establishing international coordination and operational support;
    • Scaling up country readiness and response operations;
    • Accelerating priority research and innovation.

    “The effectiveness of outbreak response depends on the preparedness measures put in place before outbreaks strike,” said Dr Mike Ryan, head of WHO’s Health Emergencies Programme. “That is why we are seeking resources to safeguard the most vulnerable countries to protect people from the new coronavirus before it arrives on the doorstep.”

    As noted in the SPRP, WHO assesses that the outbreak poses a very high risk in China, and high risk regionally and globally. The risk assessment was based on factors including the likelihood of further spread, the potential impact on human health, and the varying levels of effectiveness in national preparedness and response measures. Accelerated action, as called for in the plan, can address these risks and areas requiring support.

    As of 10 a.m. Central European Time on 5 February, 25 countries have reported confirmed cases of the new coronavirus, including China, where 24,363 people had contracted the virus, or over 99% of all cases. In all other countries, 191 cases have contracted the virus.

    US$675 million needed for new coronavirus preparedness and response global plan
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    https://www.who.int/news-room/detail/05-02-2020-us-675-million-needed-for-new-coronavirus-preparedness-and-response-global-plan

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  • Female Genital Mutilation Hurts Women and Economies

    Female Genital Mutilation Hurts Women and Economies

    Female genital mutilation (FGM) exacts a crippling economic as well as human cost, according to World Health Organization (WHO).

    “FGM is not only a catastrophic abuse of human rights that significantly harms the physical and mental health of millions of girls and women; it is also a drain on a country’s vital economic resources,” said Dr Ian Askew, Director of WHO’s Department of Sexual and Reproductive Health and Research. “More investment is urgently needed to stop FGM and end the suffering it inflicts.”

    New modelling reveals that the total costs of treating the health impacts of FGM would amount to USD 1.4 billion globally per year, if all resulting medical needs were addressed. For individual countries, these costs would near 10% of their entire yearly expenditure on health on average; in some countries, this figure rises to as much as 30%.

    The interactive modelling tool that generated these data was launched on the International Day of Zero Tolerance for Female Genital Mutilation.

    Severe physical and mental health impacts for women and girls

    Women and girls living with FGM face serious risks to their health and well-being. These include immediate consequences after being cut, such as infections, bleeding or psychological trauma, as well as chronic health conditions that can occur throughout life.

    Women who have undergone the procedure are more likely to experience life-threatening complications during childbirth. They may face mental health disorders or suffer chronic infections. They may also have pain or problems when they menstruate, urinate or have sexual intercourse. 

    All of these conditions warrant much-needed medical attention and care.

    “High healthcare costs for countries mount because of the tragic personal impacts on women and girls. Governments have a moral responsibility to help end this harmful practice,” says Dr Prosper Tumusiime, Acting Director for Universal Health Coverage and the Life Course in the African Regional Office of WHO. “FGM hurts girls, imposes lifelong health risks on the women they become, and strains the healthcare systems that need to treat them.”

    Preventing FGM brings major benefits for women, girls, communities and economies

    Using data from 27 high-prevalence countries, the Cost Calculator demonstrates clear economic benefits from ending FGM. If it were abandoned now, it shows that the associated savings in health costs would be more than 60% by 2050.

    In contrast, if no action is taken, it is estimated that these costs will soar by 50% over the same time period, as populations grow and as more girls undergo the procedure.

    Since 1997, great efforts have been made to end FGM, through work within communities, research, and changes in legislation and policy. 26 countries in Africa and the Middle East now explicitly legislate against FGM, as well as 33 other countries with migrant populations from FGM-practicing countries.

    WHO is also working with countries to raise awareness of the harmful impacts of the practice among their health workers, and to engage them in prevention efforts.

    “Many countries and communities are showing that abandoning female genital mutilation is possible,” states Dr Christina Pallitto, scientist at WHO. “If countries invest to end female genital mutilation, they can prevent their girls from undergoing this harmful practice and promote the health, rights and well-being of women and girls.”

    Female genital mutilation is internationally recognized as a human rights violation. It has no medical benefits and causes only harm. WHO’s position is that FGM must never be carried out.

    Further information

    The FGM Cost Calculator will be available here, as of 00:30 CET 6 February 2020:
    www.who.int/news-room/detail/06-02-2020-economic-cost-of-female-genital-mutilation

    More on FGM

    Notes for Editors

    About FGM

    FGM includes procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons. More than 200 million girls and women alive today are estimated to have undergone the practice across 30 countries in Africa, the Middle East and Asia where FGM is concentrated.

    FGM is mostly carried out on young girls between infancy and 15 years of age.

    About the FGM Cost Calculator

    The WHO FGM Cost Calculator shows the economic cost of treating the health complications caused by FGM across 27 high-prevalence countries. These costs were calculated using the WHO One Health tool and other available scientific evidence.

    Users of the tool can calculate costs by country in a ‘business as usual’ scenario; a scenario of partial abandonment of FGM, and full abandonment of FGM over a 30-year period. In addition, the distribution of costs by different types of health complications is presented by country.

    The tool does not consider other indirect costs that hit families and communities, or the socio-economic impacts of the practice, which would be significantly higher still.

    The 27 countries modelled include Benin, Burkina Faso, Central African Republic, Còte d’Ivoire, Cameroon, Chad, Djibouti, Egypt, Eritrea, Ethiopia, Ghana, Guinea, Gambia, Guinea-Bissau, Iraq, Kenya, Mali, Mauritania, Niger, Nigeria, Soudan, Senegal, Sierra Leone, Somalia, Togo, United Republic of Tanzania, Yemen.

    Female Genital Mutilation Hurts Women and Economies
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    https://www.who.int/news-room/detail/06-02-2020-female-genital-mutilation-hurts-women-and-economies

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  • Global study shows diabetes and heart disease can be a deadly combination

    Global study shows diabetes and heart disease can be a deadly combination

    The combination of type 2 diabetes and coronary artery disease can be deadly.

    New research from a global study led by a physician from UConn Health has found that patients with Type 2 diabetes admitted into the hospital for congestive heart failure face a one in four chance of dying over the next 18 months.

    The results were presented on June 11 at the American Diabetes Association’s (ADA) annual meeting in New Orleans and published online in the ADA journal Diabetes Care. The findings paint a much grimmer picture of the outcome for diabetes patients with severe heart disease than was previously known.

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  • Changes needed to increase access to colorectal cancer screening

    Changes needed to increase access to colorectal cancer screening

    Colorectal cancer is the second highest cause of cancer death in the United States, expected to claim the lives of an estimated 49,190 people in 2016. The Affordable Care Act (ACA) aimed to increase access to CRC screening by not holding patients responsible for all costs of the procedure, yet current Medicare insurance beneficiaries lacking supplemental insurance may not be able to afford colon cancer screening and treatment. This policy disproportionally puts low-income Americans at risk and adds unnecessary strains on overall health care costs, according to a commentary in the May issue of the journal Gastroenterology.

    “Study after study shows that screening saves lives,” said Chyke A. Doubeni, MD, MPH, chair and the Presidential Associate Professor of Family Medicine and Community Health at the Perelman School of Medicine at the University of Pennsylvania, and lead author of the commentary. “Yet many of those in the group most affected by this deadly disease are unable to afford the screening they critically need. We must renew efforts to ensure equitable access to and use of disease prevention, detection, and treatment services for colorectal cancer.”

    For CRC screening, a full colonoscopy is necessary, where the doctor inspects the rectum and entire colon through a flexible lighted tube, and can remove any abnormal growth. The entire colon has to be cleansed before the colonoscopy, for which the patient is usually sedated

    There are currently an estimated 55.5 million Medicare beneficiaries in the U.S. A 2010 Kaiser Family Foundation survey found that 14 percent lacked supplemental coverage. Until recently, colon cancer screening has been viewed as a one-time activity, while in practice, screening is a series of clinical activities to identify and test patients and perform diagnostic confirmation when necessary. This series of tests and steps include a diagnostic workup, which can include a biopsy to obtain a tissue sample or polypectomy, in which polyps are removed to prevent them from becoming cancerous.

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