On Monday, October 16, ACG President Dr. Daniel Pambianco delivered a speech at Representative Debbie Wasserman-Schultz’s Cancer Survivorship Summit.
Dr. Pambianco’s remarks covered the landscape of gastrointestinal cancers, including decades of screening successes and current challenges for survivorship.
The speech outlined two key frontiers in the fight to further improve GI cancer survivorship. The first is about tackling the alarming rise in colorectal cancer in individuals younger than age 50. The second frontier is addressing inequities in diagnosis and treatment; according to the American Cancer Society, Black Americans have a 20% higher incidence rate and are 40% more likely to die from colorectal cancer compared to other racial and ethnic groups.
Dr. Pambianco also addressed the specific challenges for GI cancer survivors, due to the cancer’s effects on multiple organ systems, the risk of recurrence, and the associated effects of both chemotherapy and complex surgeries.
Of note, Dr. Pambianco highlighted ACG’s support for:
45 is the new 50: the ongoing effort to ensure average risk Americans receive their first colonoscopy at age 45
The Comprehensive Cancer Survivorship Act: Stress reduction and resilience building strategies for physicians with claims against them
Genetic testing for hereditary cancers: Patients with a new cancer diagnosis often ask, “What does this mean for my children?” Genetic predispositions are estimated to affect 2-to-4 percent of the population, and ACG continues to advocate for increased awareness and use of screenings for high-risk genes. Along with several colleagues, Dr. Pambianco piloted a risk assessment questionnaire, with results to be shared at ACG 2023.
Watch Dr. Pambianco’s speech above or read the transcript:
Good morning! Thank you to Representative Debbie Wasserman Schultz for hosting this important and impactful event.
My name is Dr. Daniel Pambianco and I’m a gastroenterologist from Charlottesville, Virginia. I also have the privilege of serving as the President of the American College of Gastroenterology.
I am honored to be here and humbled to be speaking to you today.
Many of you have had a long journey to be here. And not flight delays or travel problems, but that journey from receiving your cancer diagnosis through to treatment, remission, and recovery.
While your experiences and challenges have been unique, you all are a great inspiration.
Gastroenterologists know firsthand the strides we’ve made in preventing, diagnosing, and treating GI cancers.
When I started my career, the 5-year survival rate for colorectal cancer, regardless of stage, was around 50%. Today, that number is 67%.
This year, the American Cancer Society estimates that in Florida, we will diagnose 11,750 new cases of colorectal cancer. The tragedy is that many are preventable – it’s why I spend so much of my time speaking to patients about the importance of screenings and early detection.
We owe a great deal of progress in survivorship to incredible advances in treatment, as well as broader access to screening. They not only help us prevent cancer, but also treat early-stage cancers.
I see two crucial frontiers as we continue our fight to improve colorectal cancer survivorship.
The first is about tackling the alarming rise in colorectal cancer in individuals younger than age 50.
Compared to those born around 1950, Americans born around 1990 are estimated to have twice the risk of colon cancer and four times the risk of rectal cancer. Among younger adults, ages 20 to 49, colorectal cancer is estimated to become the leading cause of cancer-related deaths in the United States by 2030.
It’s why we continue to beat the drum: 45 is the new 50, when it comes to the age you should get your first colonoscopy.
The second frontier is addressing inequities in diagnosis and treatment.
According to the American Cancer Society, Black Americans have a 20% higher incidence rate and are 40% more likely to die from colorectal cancer compared to other racial and ethnic groups.
Further, the rate of colorectal cancer is 40% higher among those with the lowest socioeconomic status when compared to those of higher socioeconomic status.
If we increased screening rates to 80%, the impact on survivorship would be remarkable. It would reduce the number of people diagnosed with colorectal cancer by 22%, and deaths by 33%.
One critical solution to address these inequities would be to close the Medicaid coverage gap – Representative Wasserman Schultz, thank you for your continued leadership on this issue.
Even as we reflect on these advancements in early detection and prevention, we cannot lose sight of supporting those living with, through, and beyond a cancer diagnosis.
GI cancer survivors are particularly vulnerable to poor outcomes because of the cancer’s effects on multiple organ systems, the risk of recurrence, and the associated effects of both chemotherapy and complex surgeries.
From the caregiver’s lens, the financial and occupational burdens are well documented across all types of cancers.
But in many cases, families are concerned about whether GI cancers are hereditary. A common question I hear is, “What does this mean for my children?”
Hereditary genetic cancer predispositions are estimated to affect 2-to-4 percent of the population. It’s why I am a passionate supporter of improved genetic testing.
Over the last three years, I joined several of my peers in developing a risk assessment questionnaire that identifies candidates for additional genetic testing and counseling. We were able to connect more than 300 patients with testing and identify nearly 50 with higher-risk genes.
All of these challenges and opportunities underscore the importance of developing policies that support survivors and their families.
I want to applaud Representative Wasserman Schultz’s Comprehensive Cancer Survivorship Act, which would be a true lifeline for so many. It would address care planning, survivorship transitions, navigating non-clinical services and resources, and workforce assistance grants for survivors and caregivers. I know the American College of Gastroenterology supports this legislation, and I hope Congress takes action on it as well.
I want to close with a personal reflection.
Earlier this year, I joined colorectal cancer advocates to place more than twenty seven thousand flags in front of the Washington Monument. They represented the number of young adults expected to be diagnosed with colon cancer annually by 2030.
That day, I was particularly struck by advocates who felt they struggled to be heard by their doctors.
As any doctor will tell you, if we can’t prevent cancer, then our goal is to help as many diagnosed cases as possible become survivors.
But we cannot do that without truly listening to you – the patients, survivors, and families. We need to do a better job at developing personalized treatment care plans. And we need to ensure we understand not only what’s the matter with our patients, but also what matters to them.
Even though there is more work to do and progress to be made, I am honored to help us reach new peaks in our fight against cancer.
Thank you again for the opportunity to speak with you all today.
Advancing gastroenterology, improving patient care