ROCKPORT — March is National Colorectal Cancer Awareness Month, an opportunity to emphasize the importance of early detection. In recognition, MaineHealth’s coastal region is spotlighting efforts to improve access to screening and encourage conversations between patients and care teams about available options.

Colorectal cancer is the third most commonly diagnosed cancer in both men and women in the United States, according to the American Cancer Society.

"While overall rates have declined in recent years, cases among people under 50 are increasing by about 2% annually, highlighting the need for screening and early detection," said MaineHealth, in a news release.

To help address the gaps in screening and improve access, MaineHealth launched a Colorectal Cancer Screening Workgroup in fall 2024. The group focuses on increasing awareness of screening options and supporting shared decision-making between patients and their care teams.

“The best test is the one you are willing to do,” said Patrick Tolosky, MD, a family physician and one of the current Preventive Medicine Fellows at MaineHealth. “Patients have options when it comes to screening. It’s about understanding your preferences, your risk level and what works best for you so that screening actually happens.”

For most people at average risk, screening should begin at age 45. While a colonoscopy is often the first or only option that patients are aware of for colorectal cancer screening, other effective options are available. At-home stool-based tests, such as the fecal immunochemical test (FIT) and Cologuard®, allow patients to complete screening without bowel preparation or sedation. These tests detect blood and DNA markers associated with colorectal cancer. FIT is repeated annually, while Cologuard® is repeated every 3 years. If results are abnormal, a colonoscopy is required for further evaluation.

A colonoscopy allows physicians to detect cancer and remove precancerous polyps during the same procedure, helping prevent cancer before it develops. For individuals at higher risk—including those with a personal or first-degree family history (parent or sibling) of colorectal cancer, inflammatory bowel disease such as Crohn’s disease or ulcerative colitis, certain inherited genetic conditions, or a history of significant polyps—a colonoscopy remains the recommended screening method.

Federal law requires most insurance plans to cover preventive colorectal cancer screening, including follow-up colonoscopy after a positive stool test. For patients without insurance, stool- based tests can provide an affordable and accessible option. However, costs are not always fully covered, and patients may still see a charge from a colonoscopy, such as a copay or other fee. Billing can vary by insurance plan—it is recommended to check with your insurance company about potential costs.

Barriers such as scheduling challenges, transportation, bowel preparation and concerns about anesthesia can discourage some patients from screening. MaineHealth’s Colorectal Cancer Workgroup is working to address those challenges and ensure patients understand all available options. Increasing awareness of accessible options and the conversations around them—particularly at-home stool tests—is an important step toward bridging the gap and helping more people get screened.

“One of the things we are navigating as a workgroup is how to increase screening rates across the coastal community, while also addressing barriers patients face,” said Dr. Tolosky. “That can include everything from colonoscopy scheduling backlogs to helping patients understand other screening options that may work better for them.”

Patients are encouraged to begin the conversation with their primary care provider to determine which colorectal cancer screening works for them. For more information about screening options, prevention and treatment, visit: Colon Cancer Screenings | MaineHealth.

MaineHealth is a not-for-profit, integrated health system whose vision is, “Working together so our communities are the healthiest in America,” and is committed to a mission of providing high-quality affordable care, educating tomorrow's caregivers and researching better ways to provide care. MaineHealth includes a Level 1 trauma medical center, eight additional licensed hospitals, comprehensive pediatric care services, an extensive behavioral health care network, diagnostic services as well as home health, hospice and senior care services. With more than 2,000 employed providers and approximately 23,000 care team members, MaineHealth provides preventive care, diagnosis and treatment to 1.1 million residents in Maine and New Hampshire. MaineHealth hospitals include MaineHealth Behavioral Health at Spring Harbor in Westbrook, MaineHealth Franklin Hospital in Farmington, MaineHealth Lincoln Hospital in Damariscotta, MaineHealth Maine Medical Center in Portland, Biddeford and Sanford, MaineHealth Memorial Hospital in North Conway, N.H., MaineHealth Mid Coast Hospital in Brunswick, MaineHealth Pen Bay Hospital in Rockport, MaineHealth Stephens Hospital in Norway and MaineHealth Waldo Hospital in Belfast. MaineHealth also includes the MaineHealth Barbara Bush Children’s Hospital in Portland, MaineHealth Behavioral Health in Westbrook, MaineHealth Home Health and Hospice in Saco, the MaineHealth Institute for Research in Scarborough, the MaineHealth Medical Group and MaineHealth NorDx in Scarborough. MaineHealth affiliates include MaineGeneral Health in Augusta and Waterville. It is also a significant stakeholder in the MaineHealth Accountable Care Organization in Portland and a joint venture partner in the New England Rehabilitation Hospital in Portland.