Insurance Coverage for Colorectal Cancer Screening

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Fecal Immunochemical Test (FIT) Outreach Shown to Increase CRC Screening Compliance

The growth of the telehealth market has highlighted a need for alternative remote outreach methods to reach individuals for preventive/wellness screens. Unlike some other screening tools, such as colonoscopy, fecal immunochemical test (FIT) can be conducted by the person at home and has become an attractive option during the COVID-19 pandemic. Previous studies regarding outreach and FIT testing focused on short-term metrics, such as a one-time intervention and limited follow-up. These studies also did not account for FIT compliance before the studies, which can be a strong predictor of one-time FIT compliance. 

In a recent multiyear, randomized study published in Clinical Gastroenterology and Hepatology, researchers looked at FIT outreach outcomes. The study included 10,771 patients from eight San Francisco Health Network clinics, aged 50-75 years, who were not up-to-date (UTD) with colorectal cancer (CRC) screening. Patients were first stratified by the clinic, gender, race/ethnicity, and FIT history and then randomly assigned to one group. The two groups were: outreach intervention and usual care. The outreach group received a mailed postcard and a phone call, followed by a FIT kit sent to the patient’s home. Patients who did not return the FIT kit after two weeks received two reminder calls. Usual care was left for the participating clinics to decide, including reminder calls, educational material, and coaching. 

Follow-ups for participants went up to 2.5 years unless the patient:

  • Was lost to follow-up 
  • Was 365 days out after an abnormal FIT result 
  • Had gotten a colonoscopy 
  • Had turned 76 
  • Had died 

At the end of the study, the cumulative proportion of patients with FIT completion in the outreach group was 73.2%, versus 55.1% in the usual care group. Patients who had previously done a FIT were more likely to complete FIT through mailed outreach. Outreach also increased FIT completion in patients who had not previously done one. However, the second cycle of mailed outreach did not increase completion in those who had not done so in the first cycle. Patients assigned to outreach were also more likely to be consistently adherent (2 of 2 FIT completed) versus intermittently (1 of 2) or non-adherent (0 of 2). The outreach group also had significantly more abnormal FIT results than the usual care group. As a result, more colonoscopies were also conducted in the outreach groups.

Overall, the study’s findings show that the outreach group had more benefits and compliance for FIT than the usual care group. Although there was no significant difference in CRC cases between the two groups, the outreach group did have more abnormal FIT results, leading to earlier detection and decreasing CRC risk over time. 

Limitations to the study included the use of safety-net populations, who are more likely to have changes in contact information, which could impact overall outreach. Stool-based option successes also require adherence to both FIT and colonoscopy follow-ups for abnormal results. However, the authors did not evaluate compliance with colonoscopy follow-ups in this study. While there was an overall increase in CRC screenings from FIT outreach, more research can be done on how other metrics impact the results. In the meantime, outreach and FIT are beneficial in the current telehealth era that we are in. 

 

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MSKCC Experts Discuss Cancer-Related Distress and How to Get Help

Blue Note Therapeutics hosted a panel discussion in May 2021 with clinical experts and patient advisors from Memorial Sloan Kettering Cancer Center (MSKCC) to discuss cancer-related distress and how to navigate it in both a patient and caregiver role. 

Jimmie Holland, MD, a psychiatrist, pioneered the field of psycho-oncology to what it is today. She was very interested in the emotional aspects of cancer and wanted to address the humanistic elements of dealing with cancer. Each of the panelists continues to work towards what Dr. Holland initially set out to do—help patients undergoing treatment at MSKCC face the stressors associated with the various stages of diagnosis, treatment, and survivorship. Both patient advisors have been through each role as a patient, caregiver, and survivor and highlighted how psycho-oncology has helped them cope with everything. 

Cancer-related distress, Haley Pessin, PhD said, “stems from having an illness and centers around that. But it can take a lot of different forms: It can be sadness and depression, it could be anxiety, worry, it could be anger, it could be feeling helpless and hopeless, feeling overwhelmed, not being able to navigate things.” He explained that while the statistics may vary depending on the study, about 35-80% of cancer patients experience distress, compared to 8-10% that may experience it in the general population. The clinicians use a distress thermometer that lists about 40 items to address concerns and problems appropriately and to understand the origin of stressors in the patients’ lives. 

When the panel was asked whether treatment for cancer-related distress could influence other areas of the disease like physical pain or the need for opioids, William S. Breitbart, MD said, “There are several areas in which psychosocial interventions can be used to ameliorate these nonsomatic components of cancer pain.” Another panelist, Wendy Lichententhal, PhD, spoke about how mental health providers can help alleviate stress and potentially improve medical outcomes. Psychological support can ease concerns and stressors and can help patients adhere to their medication and treatment regimens.

Even while receiving psycho-oncology treatment, it is very common for patients to yo-yo in their feelings of stress. For example, at the onset of diagnosis, patients might experience high stress levels, which might be lower post-treatment. This is very common not only for patients but also for caregivers. When encountering such a rollercoaster of emotions, patients might feel like a burden when wanting to ask for additional help from their medical team, but Allison J. Applebaum, PhD, says it is not a burden at all. Instead, it is as simple as saying, “I am having difficulty coping. Who, here or in the community, can provide support to me?” Not only are patients and caregivers encouraged to advocate for themselves, but also healthcare professionals should be doing the same. 

Highlighting the importance of mental health, Anne Marie, a patient advisor, said that it is of prime importance when coping with any serious health condition. Her recommendation is that when asked on a distress screener, patients should let the medical team know when they need help managing and handling issues beyond just their medical symptoms. There are many services and resources available to help patients and caregivers who may be struggling with their mental health. Learn more about them here: https://coloncancerfoundation.org/mental-health-cancer/.

 

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Research on Early-Age Onset Colorectal Cancer Presented at ASCO

At this year’s annual meeting of the American Society of Clinical Oncology, over 400 abstracts related to colorectal cancer (CRC) were presented. Here’s a glimpse into some of the early-age onset CRC research and how biological factors such as hyperlipidemia and the presence of circulating tumor cells may influence prognosis.

 

Early-Age Onset CRC:

  1. EAO-CRC, Infertility, and Sexual Dysfunction: The rates of early-age onset colorectal cancer (EAO-CRC), defined by the incidence of CRC in individuals under 50 years, have been increasing in the U.S. This pattern is even more concerning when considering the negative impact of CRC treatments on fertility and sexual function. Laura Diane Porter and team set out to explore the needs of EAO-CRC patients as they relate to fertility and sexual dysfunction by analyzing data from a questionnaire filled out by 884 EAO-CRC patients and survivors aged 20-50 years. Results from the questionnaire showed that 37% of women and 16% of men were left infertile after their treatments, but only 31% were referred to a reproductive endocrinologist. Additionally, more than 25% of respondents indicated they would have pursued alternate treatments had they known about the negative sexual effects of CRC treatment. These results indicate a need for providers to engage in transparent, supportive conversations with EAO-CRC patients about the impact of CRC treatment on fertility and sexual function

  2. Screening Guidelines for Patients with a Family History of CRC: As the rates of EAO-CRC increase, it is important to consider whether screening guidelines (SGs) accurately aim to detect and prevent it. Currently, there are established SGs on hereditary EAO-CRC, but screening for those with non-hereditary EAO-CRC who are at an increased CRC risk due to a family history of it remains poorly studied. Researcher Y. Nancy You and team aimed to define the proportion of individuals with non-hereditary EAO-CRC who also have a family history of CRC. Additionally, they set out to determine whether SGs could have helped prevent/detect EAO-CRC in this cohort. 329 EAO-CRC patients were analyzed for familial history of CRC, defined as having a first- or second-degree relative with CRC. Results showed that 27% of these individuals had a family history of CRC, and that half of the patients were screened for and diagnosed with EAO-CRC at an age earlier than the current SGs suggest for people with a family history of EAO-CRC. This indicates that refining current SGs for individuals with a family history of CRC can potentially aid in preventing/detecting EAO-CRC.

 

Biological Factors:

  1. Relationship Between CTCs and TILs in Patients with CRC: Circulating tumor cells (CTCs) are cells that have separated from a primary tumor to circulate in the bloodstream. The number of CTCs in the blood affects the risk and rate of metastasis, according to the abstract presented by Inna A. Novikova and team. The team wanted to investigate the association between CTCs and tumor infiltrating leukocytes (TILs), a type of immune cell that recognizes and kills cancer cells by moving from the blood into a tumor. The study included 299 patients with stage II-IV CRC. The number of CTCs in their blood was counted using a blood test, and their TILs were identified via histological processing of their tumor material. Results showed that in patients with moderate to strong lymphocytic infiltration, there was a notable absence of CTCs. Conversely, the presence of CTCs was most often seen in cases of weak lymphocytic infiltration. These results indicate that there is a relationship between CTC levels and the intensity of lymphocytic infiltration, which “can be used as a new prognostic approach.”

  2. Hyperlipidemia and CRC: Hyperlipidemia is a condition in which there are high levels of fat particles (lipids) in the blood. According to the abstract presented by Zahid Tarar and team, recent studies have shown that lipids play a role in tumor metastasis. Thus, the team set out to investigate the effect of hyperlipidemia in patients with a history of CRC, specifically in regard to mortality, hospital length of stay, and cost. Using the National Inpatient Sample Database for the year 2018, the team identified 34,792 patients with a history of CRC and hyperlipidemia. After conducting various analyses, the team found that patients with hyperlipidemia had lower odds of CRC-related mortality. Additionally, hyperlipidemia did not affect hospital length of stay or cost. The team postulated that statin therapy prescribed for patients with hyperlipidemia could have played a role in the lower odds of mortality seen for these patients. Thus, further research into hyperlipidemia’s effects on CRC should be conducted, and future studies should look specifically into the potential protective effects of statins in relation to CRC mortality. 

 

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ASCO: Technology, Socioeconomic Factors Can Influence Colorectal Cancer Outcomes

The American Society of Clinical Oncology held their annual meeting from June 4-8, 2021, where over 400 abstracts related to colorectal cancer (CRC) were presented. We at the Colon Cancer Foundation highlight some notable ones related to technological advancements, socioeconomic factors, and clinical care below. 

 

Technological Advancements:

  1. Using AI to Predict CRC progression: What if artificial intelligence (AI) could be used to predict disease progression and mortality in patients with metastatic CRC? That is the question Carlos Maria Galmarini presents in their abstract. By using patient datasets from two randomized phase III clinical trials, Galmarini and team created synthetic “fingerprints” (SFs) for each patient by integrating 44 various clinical features. These SFs were subsequently inputted into a deep learning framework (DLF) to categorize patients based on similarities. The SF/DLF system was able to categorize metastatic CRC into different subtypes based on clinical features that correlate with higher risk of disease progression and mortality, indicating that AI could prove beneficial to the cancer community. 

 

  1. Using miRNA and Machine Learning to Detect Cancer: Circulating microRNA (miRNA) have been associated with certain types of cancers, and their expression profiles are theorized to be cancer biomarkers. As such, Juntaro Matsuzaki and team investigated whether the combination of a novel diagnostic blood test and machine learning techniques could be used as a tool for the early detection of cancer. By processing the serum samples from individuals without cancer and comparing it to individuals with breast, colorectal, lung, stomach, and pancreatic cancer respectively, the team analyzed the entire miRNA expression profile of the samples using next generation sequencing. The expression profile was then used to train machine learning models. The diagnostic model showed an 88% accuracy for all five cancer types, indicating that circulating miRNAs can be useful biomarkers for the early detection of these cancers. 

 

Socioeconomic Factors:

  1. Intersection of Race & Rurality in CRC Surgical Treatment & Outcomes: It is widely known that racial disparities exist when it comes to CRC care, but the intersection of rurality and race on surgical treatments and outcomes among patients with nonmetastatic CRC has not been fully explored. To fill this knowledge gap, Niveditta Ramkumar and team studied 57, 710 Medicare patients who underwent surgery for non-metastatic CRC between 2016 and 2018. The patients were categorized by their race and area of residence, which was classified as metropolitan, micropolitan, and small/rural. Results showed that Hispanic patients and other minorities living in non-metropolitan areas had higher odds of facing 90-day surgical complications compared to individuals living in metropolitan areas. There was no such disparity found for white patients. Additionally, patients from minority groups had higher odds of 90-day mortality in rural areas compared to metropolitan areas, while white patients had lower odds. These results indicate the necessity to further explore the intersection of race and rurality when it comes to CRC treatment and outcomes so that specific guidelines can be enacted to protect patients belonging to vulnerable socioeconomic groups. 

 

  1. Impact of Socioeconomic Status on CRC Care: Socioeconomic factors are known to affect CRC care at all levels, but the research surrounding this topic is limited and conflicting. Therefore, Rajan Shah and team set out to explore how socioeconomic status (SES) affects CRC stage at presentation, receipt of diagnostic imaging and treatment, and overall survival. To meet this end, the team identified and analyzed data from 39,802 colon cancer and 13,164 rectal cancer patients in Canada using the Ontario Cancer Registry. In both cohorts, patients of lower SES were more likely to present at a higher stage, less likely to receive MRIs and other diagnostic tests and treatments, and had a less likely chance of overall survival. These results indicate the importance of focusing on CRC patients of lower SES to eradicate disparities in CRC care. 

 

Clinical Care:

  1. Access to Cancer Care for Medicaid Patients: According to the abstract presented by Victoria A. Marks, one in five Americans are insured with Medicaid. However, the large number of Medicaid patients does not necessarily indicate an increased access to care at Medicaid facilities. Thus, the team investigated the acceptance of Medicaid patients with new cancer diagnoses at various facilities across the U.S. They evaluated access to cancer care for a variety of cancer types (colorectal, breast, urologic, and skin) at hospitals accredited by the Commission on Cancer, and used data from the American Hospital Association and Centers for Medicare & Medicaid Services to study Medicaid access. Results showed that Medicaid acceptance was lowest in for-profit facilities and comprehensive cancer community centers. In hospitals that accepted Medicaid, only 68% of them accepted all four cancer types. These results suggest there are disparities that need to be addressed in regard to cancer care access for Medicaid patients, both between and within facilities. 

 

  1. Influence of Fellowship Training on CRC Post-Operative Outcomes: Christopher Thomas Aquina and team set out to investigate the relationship between fellowship training and surgical outcomes in CRC patients. Using two New York-based patient databases, the team identified patients who underwent stage I-III colorectal adenoma resection between 2004 and 2014. They analyzed the relationship between patient surgical outcomes and surgeon certification via the American Board of Colorectal Surgery. High volume colon surgeons (HVCS) were identified as those who performed more than 15 colon cancer resections annually, and high volume rectal surgeons (HVRS) were identified as those who performed more than 10 annual rectal resections. Results showed that patients with board-certified, HVC/HVR surgeons had better outcomes post-surgery and were associated with improved survival following resection. This suggests that individuals seeking CRC resections should go to board-certified, HVC/HVR surgeons for the best chance of recovery and survival. 

 

 

 

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FOBT Screening Compliance Reduced Colorectal Cancer Mortality, Especially in Men

Several screening options are available for colorectal cancer (CRC), such as stool-based tests like the guaiac fecal occult blood test (gFOBT), fecal immunochemical test (FIT), and the multi-targeted stool DNA test (FIT-DNA). Visual screenings are also available in the form of colonoscopy. The FOBT is done every one to two years. While annual testing is common in the U.S., European countries and Canada opt for biennial testing. In the past, using FOBT screenings has shown reductions in CRC mortality, but the trials did not have sufficient evidence to also study all-cause mortality. However, these studies did not account for compliance adjustments and the effects of screening on varied ages and sex. 

A recent study published in Clinical Gastroenterology and Hepatology evaluated the long-term reductions in all-cause and CRC mortality amongst those who comply with screenings offered when adjusted for compliance, age, and sex. Biennial screening groups in the 50-80 years age range were compared to control groups in the same age range. Funen Fecal Occult Blood Trial and the Minnesota Colon Cancer Control Study with sample sizes of 61,993 and 46,551 individuals, respectively, were used to assess the long-term effects of FOBT screenings on CRC and all-cause mortality. 

The 30-year follow-up period saw 33,478 and 33,479 total deaths, with 1,023 and 1,146 CRC-related deaths in the screening and control groups, respectively. The statistical findings showed a 16% reduction in CRC mortality and a 2% reduction in all-cause mortality among those who complied with FOBT screenings. In addition, men who complied with screenings had a higher reduction in CRC mortality compared to women. Significant reductions in CRC mortality were observed among compliant men, especially those in the 60-69 years age group, and among women 70 years and older. 

The findings from this study support that CRC screening programs should emphasize FOBT compliance to decrease CRC mortality and all-cause mortality in the long term. Individuals who comply may also engage in overall healthier behavior, such as being non-smokers and healthy eaters. These individuals are also more likely to make healthy lifestyle choices, contributing to an overall lower risk of death. Those who comply with screenings are more likely to utilize the healthcare system, leading to better health outcomes. Though the study could not directly answer why compliant groups had lower all-cause mortality than the control group, it is worth reinforcing 100% compliance among screening individuals. 

Overall, this study demonstrates a need for continued research to study the effects of screening on reducing mortality in the long term. The study did have some limitations, such as not being able to follow up on the patients’ screening behaviors once the trial ended. Compliant individuals may have stopped screenings after the trial ended, while non-compliant individuals may have initiated screening, impacting the mortality rates. The long-term effects of screening on mortality should remain an area of active research as there are newer, more accurate screenings now available, which may continue improving CRC mortality outcomes.  

 

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Could the Western Diet Be a Risk Factor for EAO-CRC?

Early-age onset colorectal cancer (EAO-CRC) rates have been steadily increasing in the U.S.. EAO-CRC, defined as colorectal cancer (CRC) found in patients under 50, has more than doubled since the 1990s. The recently concluded Early-Age Onset Colorectal Cancer Summit hosted by the Colon Cancer Foundation gave global experts a platform to discuss the underlying factors behind this concerning pattern. Diet, lifestyle, early-life exposures, and the microbiome made up a majority of the conversation during one of the summit’s sessions, as these are all factors that play a role in EAO-CRC. Diet in particular is a factor that must be explored further. According to a prospective cohort study published in the Journal of the National Cancer Institute (JNCI) in May 2021, hyperinsulinemia, chronic inflammation, and gut dysbiosis caused by a poor diet can lead to CRC. 

The JNCI study investigated the potential link between poor diet and rising incidence of EAO-CRC. The study’s researchers analyzed the documented behaviors of participants in the Nurses’ Health Study II (NHSII). NHSII is the second generation of the Nurses’ Health Study, established in 1976 to investigate risk factors for chronic diseases in women. NHSII contains a cohort of young women with well-documented endoscopic histories and assessments of diet and lifestyle factors, which “provides a unique opportunity” to address the knowledge gaps in the potential link between diet and EAO-CRC. 

The study looked at the history of 29,474 women aged 25-42 from 1991 to 2011. Every two years, participants were given questionnaires on demographics, life factors, and medical diagnoses. This allowed the study’s researchers to distinguish between participants with colorectal adenomas and those without, an important distinction as colorectal adenomas are postulated to be precursors to EAO-CRC. The adenomas were then categorized by their malignant potential based on size and histology.

To procure information about diet, the researchers looked at the food frequency questionnaires (FFQs) participants filled out every four years. The FFQs revealed two dominant dietary patterns: 1) the Western diet, characterized by refined grains, processed meats, and high-sugar foods, and 2) the prudent diet, characterized by vegetables, fruits, whole grains, and seafoods. Three indices were used to determine overall food quality: Dietary Approaches to Stop Hypertension (DASH), Alternative Mediterranean Diet (AMED), and Alternative Health Eating Index-2010 (AHEI-2010). For all three indices, higher scores indicated higher diet quality. 

Results from statistical analyses showed that participants in the highest quintile of Western dietary patterns had an increased risk of early-onset adenoma compared to those in the lowest quintile. Additionally, adherence to the Western diet was positively associated with early onset high-risk adenomas in particular. Conversely, there was an inverse association between adherence to DASH, AMED, and AHEI-2010 and risk of early-onset adenoma. 

These findings indicate that poor diet quality contributes to the increase in EAO-CRC found in the U.S.. However, it is important to note that participants following the Western diet were also more likely to engage in unhealthy behaviors, e.g. smoking and being sedentary, compared to participants following the prudent diet, DASH, AMED, and AHEI-2010. These confounding variables display the necessity for further research into the link between diet and EAO-CRC. 

 

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Fundraiser Spotlight: Billy

Billy is an artist that has created comics to get through his journey with colon cancer all the while raising funds for the Colon Cancer Foundation;

“Over the past six months, I’ve been dealing with Stage 2 Colon cancer. I decided at the time I wasn’t going to take this lying down. So I got together with some friends and started talking about my situation; and we decided that the best way to go about it was to raise money for a good cause. For research, and to put something together that we can do yearly. 

I’ve had 7 friends get colonoscopies from my experience and 2 came back with cancer. Seeing that was scary enough beyond my own diagnosis at 38, with that being said. This is the hill (beyond animal rescue) that life has given me. And I hope I can do a tremendous amount of good in that time.”

A huge thank you to Billy for sharing his inspiring story. If you are interested in starting your own fundraiser, learn more about it here: https://coloncancerfoundation.org/events/organize-your-own-fundraising-event/?fbclid=IwAR23xzwdF-K8j0t-WETp-gzIjj0j-LpXg49ywZ8g-YQjSM8vK722Mis4h-k

 

 

 

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Fundraiser Spotlight: Kelli

After losing her husband to Early-Age Onset Colon Cancer, Kelli decided to raise funds for the Colon Cancer Foundation and advocate for Colon Cancer awareness in memory of her husband until Colorectal Cancer is just as prominent in our minds as Breast Cancer: 

 

It is my pleasure to push for donations for colon cancer. In January of 2020, my husband(Frank) saw his dr for what we thought was a stomach virus. The doctor was not seeing any real big issue wrote it off as a long-lasting virus but put in an order for ultrasound in February if he wasn’t better by then. A few weeks later (and still having on and off stomach issues) he saw his headache doctor who ran some blood work. A few days later they called us concerned about his liver enzymes. They advised us to pick up a copy of the blood work and see his doctor immediately. His primary doctor was finally as concerned as we were and rushed the ultrasound. Two days later he had it done. I knew something was wrong when they asked him to stay while they called the doctor to gain permission for a CT saying the ultrasound showed “bubbles of gas”. A few hours later with no word we went home. At 10:30 that night his primary doctor called me. He explained that the ultrasound showed several masses and he wanted us to report to the ER for a CT, he hadn’t told my husband yet he called to warn me what was coming before he did. He then called and explained to Frank what the ultrasound showed. The next morning we got the kids to school and headed in for the CT. Dr. Ben (who was amazing)  at Chesapeake General got the unpleasant job of explaining he had cancer and it was not a small version but instead a very big one (stage four) and at the age of 38 with a wife and two kids. This being the spiral of colonoscopy, being moved to the top priority at the oncologist, a tumor sample surgery, and three different types of chemotherapy. The oncologist gave us lots of hope that he would beat it or at least reduce it to an operable size, he easily had about 5 years. Frank started chemo in late March that year and every two weeks he was in the chair for about 5 hours while I was stuck outside due to covid being announced and new policies. In December after no real change other than spreading to now 4 locations, he opted to take a month off. I fully supported him in that as his Birthday and Christmas were coming and he really wanted to go visit family. During December he had fewer symptoms since chemo had left him with neuropathy in his fingers and toes along with hair loss and severe reactions to cold. When we returned after New Years I immediately called the office to request a CT and restart of treatment. The CT revealed more spreading and growing tumors Frank restarted chemo immediately. A new addition to treatment was draining the fluid buildup from his abdomen every week. In the last six months, every genetic test available was run to try and find the cause of his cancer. They all came back with no issues in his genes. After four weeks of treatment and growing reactions, his oncologist called me to discuss his status. The ammonia was building up in his body as his liver was now shutting down and full of tumors. He let me know that Frank had 6-8 weeks left. We chose to call family and advise them to visit but not to tell Frank yet. The doctor ordered a permanent drain to go in. March 8th he had the procedure. On Tuesday he woke up with very diminished brain functioning. We had the hospice team come immediately- the same team that Frank refused for months. Their initial assessment was he had a week maybe two. His brain function cleared up mostly so it restored some hope of a longer time. Friday he was deteriorating again. I had taken care of him in every way in the last month but now he didn’t even have the strength to stand in the shower, or at all really. Sunday, March 14th he woke up with a bit more energy and was insistent on making homemade orange juice downstairs. So I helped him down, cut the oranges and he juiced one and a half before he was exhausted. He rested for a bit while drinking his juice then I helped him back up the stairs. The nurse came to check in and explained to me he was very rapidly slipping away so expect it in the next day or two. We spent that day watching Harry Potter as a family. He dozed on and off but was very clear when awake. Then suddenly he wasn’t. At 10:01 pm he took his last breath with the kids and I surrounded him in love. It was the worst day of our lives, telling him it was ok to let go and how much we loved him watching him slip away in mere hours after he was up and talking. 

He lived a year fighting his best fight and we spent it loving each other more than ever. 

He never had any indications before that thought to be stomach flu. Early testing has to become a routine thing and I plan to advocate and raise funds in his memory until it is just as prominent in our minds as breast cancer. No one should have to go through what we did as a family especially at such a young age.

 

A huge thank you to Kelli for sharing her inspiring story. If you are interested in starting your own fundraiser, learn more about it here: https://coloncancerfoundation.org/events/organize-your-own-fundraising-event/?fbclid=IwAR23xzwdF-K8j0t-WETp-gzIjj0j-LpXg49ywZ8g-YQjSM8vK722Mis4h-k

 

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Meet Our New Interns

The Colon Cancer Foundation is very excited to announce our new class of 2021 interns. . Scroll through to learn more about our amazing team!!

 

Laura Banazek

Hi! My name is Laura Banazek and I am an Events Intern with the Colon Cancer Foundation. I am an upcoming graduate of California Polytechnic State University, San Luis Obispo earning a B.S. in Experience Industry Management with a concentration in Event Planning. During my last four years of college, I have been very involved with my major department and sorority. I served on my sorority’s executive board as the VP of Membership Education and Programming and am currently the Event Technology and Registration Lead for the 2021 Cal Poly Experience Industry Management Auction.

As an Events Intern with CCF I am excited to gain new experience in event logistics and brand partnerships! I am passionate about creating memorable experiences and building meaningful relationships. After graduation, I dream of working as an Event Planner in either a non-profit or corporate setting. In my spare time I love getting outdoors (going on walks or to the beach!) and spending time with my friends/family. I am so grateful for the opportunity to intern with CCF and am looking forward to the many projects to come!

 

Kyla de Guzman

My name is Kyla de Guzman and I am a new Public Relations Intern for the Colon Cancer Foundation! I am a Junior at Montclair State University, majoring in Public Relations and minoring in Creative Writing. I am involved in my school’s Drama club, a member of the National Society of Leadership and Success and a part time receptionist at Dumont Animal Hospital; while maintaining a 3.7 GPA. In my spare time I love making playlists, reading, creating TikToks, thrifting and hanging out with my friends.

I am so excited and proud to be a part of CCF’s Public Relations Intern! My career goal is to work as a public relations consultant for high end fashion brands. Thanks to CCF I am able to apply my public relation course in real world experience. I am pleased to be part of a small but mighty organization that wants to spread awareness as best we can.

 

Devyn Fatzynytz

Hello! My name is Devyn Fatzynytz and I am a Junior Communications Student with a minor in Psychology at The College of New Jersey, and I am very excited to start my position as a Summer PR Intern with the Colon Cancer Foundation.

I have always had a love for writing and creating compelling messages as a means of a creative outlet. This combined with my love for people and making meaningful connections with others drew me to public relations as my field of interest. I am particularly excited about my opportunity with the Colon Cancer Foundation because I can work for a cause with the meaningful mission of finding a cure for colorectal cancer, while increasing resources and screening for disadvantaged communities.Macintosh HD:private:var:folders:r5:fg89xtm552zg8y3b5t0rj1y40000gn:T:TemporaryItems:unnamed.jpg

A little more information about myself, I am from Jefferson Township, New Jersey. I am the oldest of three, and value my family and friends tremendously. Some of my hobbies include playing soccer, running and art. Over the summer I paint wall murals for small businesses and people’s home interiors as a side gig in my free time, and have waitressed for the past four years at a local diner in Wharton, NJ.

Some of my on campus activities include TCNJ girl’s club soccer where I held a position as social chair, Delta Zeta sorority as intramural chair in 2019, and being a member of the Anti-Violence Initiates team dealing with dating abuse prevention.

This past Sprint semester I have been a research assistant, analyzing qualitative research data on the topics of gender disparities and women in leadership, while also being trained in comparing and contrasting results to identify themes in stories.

In terms of my background in Communications and Public Relations, I have taken several beneficial classes in interpersonal communications, strategies of public relations and interpersonal health communications among others. I also have prior PR internship experience with McNeil, Gray & Rice, a PR firm in Boston, MA.

 

Rachel Herrmann

My name is Rachel Herrmann, and I am excited to join the Colon Cancer Foundation’s team as its new Colorectal Cancer Prevention Intern. I am originally from Rochester, New York, and am a recent graduate of Cornell University where I majored in biology and minored in global health. Currently, I am pursuing a Master’s degree in public health through the London School of Hygiene and Tropical Medicine. During my time at Cornell, I worked as a research assistant at the Wilmot Cancer Center, so I am glad to be back working in the cancer field.

My career goal is to work for a nonprofit organization to implement public health initiatives in under-served communities, so I am thrilled to be starting my career with the CCF.

Throughout my internship at the CCF, I will be writing articles about current research in the colorectal cancer sphere in addition to working on the Early-Age Onset Colorectal Cancer Summit.

In my spare time, I love to play tennis as well as travel (I’ve been to twenty countries so far). I also love to play with my two-year-old Cavalier King Charles Spaniel, Charlie!

 

Carolene Kurien

Hello! I am Carolene, a Communications Intern at CCF. I received my Bachelor of Science degree from the University of Miami with majors in English and Neuroscience. I am passionate about CCF’s mission to lead the fight against colorectal cancer, and I strive to aid CCF’s mission by creating content that informs readers about the importance of colorectal cancer prevention, detection, and eradication. I am proud to be working towards such a worthy cause and I am excited about what lies ahead!

 

Laurel Levinsohn

My name is Laurel Levinsohn and I’m excited to be a part of the Colon Cancer Foundation! I’m a senior at Washington University in St. Louis, majoring in Cognitive Neuroscience with minors in Spanish and Children’s Studies, on the pre-med track. My career goal is to go into medicine, possibly as a pediatric specialist or as an OB/GYN. During my time with CCF, I hope to help the organization be equipped for success as it grows, and ultimately help work toward a world without colon cancer. I am excited to use my Spanish skills to help create resources that can reach a more diverse population, especially those who are often underserved in healthcare.

I love food, fitness, and working with kids. On campus, I am involved in Spoon University, a food publication, SODA: Student Organ Donation Advocates, and WashU Student Interpreters, through which I am gaining skills to serve as a medical Spanish interpreter. I hope that this position will be one way I can contribute to promoting preventive medicine and making healthcare more accessible.

 

Susan Pistone

My name is Susan Pistone; I’m one of the Colon Cancer Foundation Interns. I have a Bachelor’s Degree in Communications Studies and a minor in Public Relations. Currently, I’m pursuing a Health Promotion Management Graduate Degree from American University. In my spare time, I love the gym, kickboxing, and running. Previously, I have worked with other Public Health organizations such as Global Health Alliance to host virtual Public Health webinars. My goals would be to have a career in Public Health in roles preventing disease or corporate wellness. Public Health is my passion, and I want to spread awareness about various diseases in any future position.

Abigail Saathoff

My name is Abigail Saathoff and I am the Social Media Intern for the Colon Cancer Foundation! I am a rising junior at the University of Northern Iowa double majoring in Strategic Public Relations and Digital Journalism with minors in Business Communication and Marketing. I am actively involved in various organizations at UNI including; Alpha Delta Pi sorority, the Residence Hall Association, Panhellenic Council, and more. Outside of my student organizations and classes I love crafting, and fell in love with jewelry stamping just a few months ago! I also love reading and watching movies. 

I’m extremely excited for this opportunity to be CCF’s Social Media Intern. Right now, I’m still not 100 percent on what I want to do in my future, but know I want to help people, work for a non-profit and work in social media or public relations, so I think I’m in the perfect place! I’m excited to learn a lot all the while making graphics, writing posts and building our social media platforms that make a difference and raise awareness of Colorectal Cancer. I’m very proud to be working for such an incredible organization, and I look forward to my time here.

 

Rachel Veitch

Hello! My name is Rachel and I play an exciting role as a graphic design intern here at CCF! I spent almost 10 years working in office management before deciding what I wanted to be “when I grew up”, and now I am studying Graphic Design at Academy of Art University, where I earned my AA and am now finishing up my BFA. I love art and design and being creative and am so thankful to be able to pursue a second career in my dream job! I hope to go into either advertising or publishing, but I also do a lot of volunteering and love supporting causes I care about, like colorectal cancer awareness! I am learning a lot here at the Colon Cancer Foundation and love that I play a small part in helping to one day eliminate deaths from colorectal cancer. 

At home (which is also the office) I have two kiddos and love to spend time outdoors with them or play with legos! I also love art and illustration and hope to illustrate a children’s book someday. I have been a military spouse for 11 years now, and we have gotten to live in so many places around the country! We are originally from New Mexico, which holds a special place in my heart. We hope to settle there when my husband retires from the service. I am also creating an art/children’s book about New Mexico.

 

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