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March 19, 2021

By School of Nursing

MSN Student’s Advocacy Helps Remove Barriers to Colorectal Screenings

For more than 20 years, March has been designated as National Colorectal Cancer Awareness Month. During this month patients, survivors, their families, and healthcare providers raise colorectal cancer awareness by wearing blue, engaging in fundraising and educational events, and advocating for policies that facilitate colorectal cancer treatment, screening, and prevention.

One of these advocates is Jessica Miller, RN, BSN, CGRN, NE-BC, a nurse and current student in Capital’s Master of Science in Nursing program. This past year, a major legislative battle was won in the fight against colon cancer, thanks in part to the efforts of Miller. For the past five years, she has been advocating for the passage of the “Removing Barriers to Colorectal Cancer Screening Act,” which addresses a colonoscopy loophole in government and private health insurance programs.

By law, colonoscopy screening is supposed to be provided without co-pay or out-of-pocket costs to patients aged 50 and older. Unfortunately, the loophole resulted in patients having to pay if polyps were discovered and removed by a physician during the colonoscopy. This polyp removal is necessary, as it is the very action that can prevent colorectal cancer. The threat of having to pay out-of-pocket costs is identified as a significant barrier to getting eligible patients appropriately screened. 

Colorectal cancer can be treated, and even prevented if it is caught early, said Miller. Colonoscopy, a colorectal cancer screening tool, is an effective method to prevent colon cancer. 

Among cancers that affect both men and women, colorectal cancer is the second leading cause of death. In fact, the American Cancer Society projected 147,950 new diagnoses of colon and rectal cancers in the United States in 2020 and 53,200 deaths. While a national concern, colorectal cancer prevalence is also a significant concern at a local level. The American Cancer Society ranked Ohio seventh for projected colorectal cancer diagnoses for 2020. 

The MSN program at Capital University has multiple core competencies, and one is that the graduate nurse will “Integrate health policy processes to promote safety and quality of health delivery systems and advocate for social issues of health disparity and equality.” Miller credits the program as a catalyst for her advocacy work. 

“As students we are encouraged to initiate, manage, and advocate for change. Every course within the program gave me the opportunity to do that, the encouragement to use my voice, and the tools to support me in doing so.”  

In multiple courses, Miller targeted her advocacy assignments on efforts to support the “Removing Barriers to Colorectal Cancer Screening Act.”  

“I wrote multiple letters to local and national legislators, initiated and executed a petition of local hospital workers, and raised awareness during the Ohio Nurses Association’s Nurses Day at the Statehouse.” 

In December 2020, Jessica shared with her nursing professors that those advocacy efforts had finally paid off. 

As part of an end-of-year spending bill, Congress passed H.R. 1570/S. 668, the “Removing Barriers to Colorectal Cancer Screening Act.” The goal of those letters and petition was achieved, and with a phase-in period, it is now law that patients will not face out-of-pocket costs when polyps are detected and removed during a screening colonoscopy. The passage of this act will increase access to life-saving cancer screenings and benefit many within Ohio and around the nation. 

Miller said she will use the tools she gained as an MSN-prepared nurse to continue to lead advocacy efforts in the fight against colon cancer. Her next efforts are focused on assuring colorectal cancer screening will be available at no cost beginning at age 45, rather than 50. 

“The incidence of colorectal cancer at age 45 is now equivalent to that of those who are 50,” Miller said. “This would be another huge win in our efforts to reduce the incidence of colorectal cancer and continue saving lives. I anticipate it will be another long road of advocacy, but with the skills and knowledge I have gained as a Capital graduate, I know I have the tools to endure.”