The Early Onset Emergency: A Live Panel on Colorectal Cancer's Alarming New Trend

00:00:05
Speaker 1: All of that ultra processed food that is all part of our diets. And I look around the room today, people in the room here that are in your thirties and forties, your number one risk of cancer mortality is actually colling cancer.

00:00:18
Speaker 2: Now, Hi everyone, I'm Katie Couric, and this is next question. Since March is Colorectal Cancer Awareness Month, I wanted to talk about a cause. Though important to me, I became a fierce advocate for calling cancer awareness and screening after my husband Jay died of this disease in nineteen ninety eight when he was just forty two years old. It shattered me and our girls, who were only six and two at the time. So, as many of you know, I became a screen queen of sorts, and increasing awareness and spreading the gospel of early detection has become a true mission for me. Today we're focusing on the symptoms, the diagnostic tools, the treatments, and most urgently, why the number of co directal cancer cases are going in the wrong direction, especially in people under the age of fifty. Joining the conversation is the CEO of Exact Sciences, Kevin Conroy. Kevin is a business leader here in Madison is overseeing in critical growth at his company. Kevin, of course, didn't get the memo on the second commandment here at EPIC because Exact Sciences shareholders just approved an acquisition by Abbott Laboratories. Kevin has been a tremendous partner and a true blue friend to me in the effort to get and keep people talking about co directal cancer. Judy Faulkner, of course, is the founder and CEO of Epic Systems. She's here to talk about the role AI and large data sets will be playing as we try to understand why this disease is showing up more in younger people. And finally, doctor Caitlin Murphy is a professor in the Departments of Pediatrics and Public Health Services at the University of Chicago. She holds a PhD in epidemiology from unc Chapel Hill and a master's in public health from UT Health Houston. And we'll be talking about the latest research and the rising incidents of colorectal cancer and the quest to figure out why this is happening. So please give our panel a round of applause. Thank you all so much for indulging me and for being here, and for talking about, as I said, an issue that is so important to me and I've become sort of synonymous with So you look like you're kind of tearing up, Kevin.

00:02:42
Speaker 1: I'm sitting here amazed that I am on this panel.

00:02:45
Speaker 2: All right, Well, don't be ridiculous. You should be and we'll talk to you about a lot of things, how Exact Sciences has really changed the face of this disease. So thank you for that. But first I wanted to talk with doctor Murphy. Let's talk about this alarming statistic that came out last year. Colorectal cancer is now the leading cause of cancer deaths in people under the age of fifty in this country, and we're seeing similar patterns all over the world. There are a lot of theories about why this is happening, and I wondered if we could, Caitlin just run through them, and may I call you Caitlin doctor Murphy. Yes, of course, So let's talk about the various theories.

00:03:26
Speaker 3: Well, I've been in the trenches doing work on this for a long time, and my thinking about the theories has really evolved over the last ten years or so. When I first started studying coloactual cancer and young people, I was really convinced that there was a smoking gun of a risk factor, so one thing out there that explained all of the increase in incidence in mortality rates, as you're pointing out. But really, as I've studied this disease over the last couple of years, it's been clear that there's probably thousands of possibilities, and I think what we need to do now is eliminate what some of those top suspects could be. So I think it's the environment, and how can we think about identifying maybe some of the top clues or suspects in the environment that might contribute.

00:04:12
Speaker 2: Let's talk about that, because you hear that and you think, well, I want them out of my environment. So what are they?

00:04:19
Speaker 3: We really don't know. I think maybe we can take a step back, and first, there was a lot of thought initially that things like obesity, physical inactivity, diet risk factors that we know are related to col directal cancer and older adults are also related to co directal cancer and young people, and it makes sense to think that those are the contributors because they've been increasing in our population at the same time that the incidence rates have been increasing. But we've learned in the last couple of years or so that yes, those do contribute, but they don't explain all of the increase that we're seeing, and so that's left a lot of us in the research field thinking that there's something else in the environment that may contribute. What that is I have no idea, unfortunately, but I think there's a lot of opportunity to apply some of the new technologies and tools we have to at least figure out what again might be those top suspects.

00:05:15
Speaker 2: I want to mention some of the theories because as you all can imagine, I'm obsessed with this topic and i read constantly about it, and I'm just going to throw out some of the reasons that people are looking into. For example, there was a big article in jama in November about ultraprocessed foods. As you mentioned, obesity, low fiber. People are talking and looking at microplastics and how they're interacting with something called the microbiome forever chemicals pfas, and how they might be affecting sort of our microbiome and our biology. I've also heard from doctors at Memorial Sloan kettering about the over prescription of antibiotics that somehow that's affecting our bacteria. You know that doctors were kind of handing them out like handy, even for viral infections where they weren't going to be particularly efficacious. So I even talked to a doctor, a researcher, scientist. I started Stand Up to Cancer, which is an organization that has scientists collaborate in all areas of cancer research. And to brag for a second, we've raised over eight hundred million dollars for collaborative research. Thank you. She was saying interestingly enough that scientists are even looking, Caitlin at screens and how screens might be affecting our circadian rhythms, and how that might have an impact on our biology and potentially this lack of sleep on our microbiome. So I just sort of read a laundry list of all the different theories out there, and I'm just curious what you think.

00:06:50
Speaker 3: Yeah, I think you're exactly right. There's a laundry list of possibilities. And now I think we're at a moment in science where we need to kind of narrow in on one of those things in your laundry lists.

00:07:01
Speaker 2: But it might be multifactorial, right, I mean, it might be a whole confluence of things exactly.

00:07:06
Speaker 3: I don't think it's a smoking gun, like I said, but a lot of different possibilities. The challenge I think in science has been that historically we study one thing at a time. So we've been taught as scientist to test one hypothesis and then move on to the next. But I don't think we have time in this case to test one thing at a time, and we really need to think about how can we use different tools, different methods to discover the thousands of possibilities that it might be.

00:07:33
Speaker 2: And that's where a huge data set and a company like epic Judy comes in.

00:07:38
Speaker 4: Right.

00:07:39
Speaker 2: Epidemiological studies are notoriously difficult to conduct. They take years and years. They have to get so many different people to participate, right, Caitlin, and kind of give all this personal info about what they may be eating on all kinds of things. How does a large data set that you all have accumulated here is possibility for that to help us understand why this is happening, Judy.

00:08:05
Speaker 4: Yeah, and I think that our customers who share their data with us and have people who can do the research, have a wonderful opportunity to look at that data and help make some of the decisions that need to be made.

00:08:19
Speaker 2: Because I know a lot of those doctors I queried before our conversation, they were so excited about the research aspect of EPIC and the database that you all have accumulated. You haven't even started to necessarily turn that engine on as much as it could be. Right.

00:08:38
Speaker 4: If you look at epicresearch dot org, you'll see a lot of the studies that we do and some of the studies that are various customers do as well as sometimes if you just read an article, you read, oh, this was using epic stata at the end of the article.

00:08:52
Speaker 2: Do you collaborate with researchers like Caitlin at other academic institutions.

00:08:58
Speaker 4: Yes, some of our staff do. We do have a small research group that works with some of the research folks from our customer base. Plus we've worked with the CDC a bit.

00:09:09
Speaker 2: That's awesome because I think we need all the help we can get. Right Meanwhile, Kevin, you know, in addition to the number of people under fifty really increasing, the American Cancer Society even more recently released a report that said the number of colorectal cancer cases and patients between the ages of fifty and sixty five has also increased, as has the mortality rate. And I'm curious why you think that's happening.

00:09:38
Speaker 1: The issue is a real issue that the age is lowering, and part of it is probably because we have done such a good job of screening people over time that older people are well protected because they've been screened. That's part of it. But the other part of it is there something going on in diets or the environment or the microbiome that is causing younger people, including people under sixty five, to get colon cancer. One researcher at Mail Clinic said, Kevin, people at the Mail Clinic think that sugar, a lot of sugar causes an insulin response. Insulin hits the lining of the gut of your colon, which causes cells to turn over a lot faster, which then just because the cells die, you need new cells and you have a random chance of a mutation in one of the genes that protects against colon cancer. And he said, you can look at the inside of the gut of somebody who is fifty today, it looks like the gut of an eighty year old from nineteen fifty. So all of that ultra processed food that is all part of our diets. And I look around the room today, people in the room here that are in your thirties and forties, your number one risk of cancer mortality is actually colon cancer, now you know, and lung cancer mortality in younger people has just plummeted, I think from first to third or fourth, and for leukemia that has just plummeted, I think from third to fifth. And so colon cancer just keeps increasing. And so there must be something here in the diet and the environment which means, okay, how do you protect against it? It may be twenty years before we know the answer.

00:11:34
Speaker 2: Hi everyone, it's me Katie Couric. You know, if you've been following me on social media, you know I love to cook, or at least try, especially alongside some of my favorite chefs and foodies like Benny Blanco, Jake Cohen, Lighty Hoyke, Alison Roman and Ininagarten. So I started a free newsletter called good Taste to share recipes, tips and kitchen mustaves. Just sign up at Katiecuric dot com slash good Taste. That's k A t I e c o u ric dot com slash good Taste. I promise your taste buds will be happy you did. What's interesting to me, Kevin, is you know between the ages of fifty and sixty five, and this is apparently due to an uptick and rectal cancer, the cancer that killed Catherine O'Hara. These people, this cohort is squarely in the middle of the key screening population. Do you think that people are getting screened less? What do you think is going on?

00:12:37
Speaker 1: Well, the incidence going up is probably because more people are getting screened. So when you do a jolt of screening, what do you do is you pull forward and you find a lot more cancers than you would find if you just let them occur naturally.

00:12:50
Speaker 2: And this includes early stage cancers, right, that's right when the American Cancer Society says this.

00:12:56
Speaker 1: Yes, So, for example, when you introduce a new screening test like colo Guide, And to put this in perspective, if you go back twelve years ago when coal Guard was first launched, there are about five to six million screening colonoscopies in the US every year. Today, there are five to six million screening colonosopies in the US every year, but there's also now this year will be about six million coal guard tests Ballpark. I'm not giving guidance to anybody about how many screening tests we're going to do, but what that tells you is we got this BOLDUS of people's screened twenty three million people in the last twelve years. So you're going to find more cancers, but you're going to find them earlier when they're treatable. And to put this in perspective, a stage one colon cancer ninety eight percent survival rate. Almost never do you get chemotherapy. It's surgery is curative. Stage four colon cancer when it has spread, eight percent survival. So this is a disease that can be eradicated. And the one other cancer, there's been one cancer that's been nearly eradicated, cervical can. You don't hear about it a lot. There are forty five hundred deaths a year in the US, but if you go back into the nineteen fifties, cervical cancer was the number one cause of death in women. There were forty five thousand deaths. And then came along this test called the pap smear. Doctor peploc and cow He invented the test and pretty soon everybody got screened. The disease is so slow growing it takes ten to fifteen years to go from that lesion to cancer, and you can remove the lesion, so we can do the same thing for colon cancer. And I'll just say one more thing. I know I'm going on too long.

00:14:35
Speaker 2: But oh, you're fine.

00:14:36
Speaker 1: I was at dinner with Judy and a group of people about I want to say, about seven or eight years ago, and I explained the problem that we had that we were building code to integrate with every health system in the US. And Judy looked at me and said, Kevin, that is going to break and I said, I know, but you won't let us become a customer. And he said, let me think about that. And thirty days later, Alan Hutchison called me and said, Kevin, not only do we want you to become a customer, but we want to create an electronic ordering capability so that we take the friction out of ordering. We were getting all of our orders basically by facts and results by facts. And I remember saying to Alan at the time, this decision is going to play a role in disease eradication. And so Judy thank you.

00:15:31
Speaker 2: And so I can plug col of Guard because I'm sure Kevin doesn't really want to. But the reason it's so important is there are many people who for whatever reason, can't afford a kolonoscopy, can't take time off from work, don't have people who will pick them up, They're afraid. There are all sorts of sort of cultural reasons why some people are reticent to get a colonoscopy. So you were saving a lot of lives with coll of Guard, So thank you for that. But let's talk at the screening age. Because the screening age was lowered to forty five everyone a couple of years ago. You get your baseline calling cancer screening at age forty five. Now, only one fifth of the people between the ages of forty five and fifty have been screened. So if you fall into that category, or your parents do, or your siblings, you know, please urge them to get screens starting at age forty five. Why do you think that number is so bad, Caitlin, I mean one fifth of the people. Do you think that the word hasn't gotten out? Do you think doctors aren't educated enough? What is happening?

00:16:36
Speaker 3: I think that maybe some of it. But if you think about a forty five year old sort of in the peak of their career. They may have young children at home, they may have aging parents that they're caring for. There are a lot of competing demands at that time of life where maybe taking a day off to get a colonoscopy isn't as important as maybe the other demand's right in front of you. And I don't think the awareness about alternatives to colonoscopy guys really infiltrated maybe that age group yet, so things like colon guard or other stool based tests as being sort of easier, more convenient alternatives.

00:17:10
Speaker 2: I told you I wanted justin Timberlake to do a whole ad campaign called shit in a Box. Don't you think that would be clever? But Kevin didn't really go for it. I was going to say poop, but I thought why not? Anyway, what do you think it is, Kevin that people forty five to fifty aren't getting screened?

00:17:35
Speaker 1: Let me ask how many people in the room here today? Raise your hand if you knew the screening age drop from age fifty to forty five.

00:17:43
Speaker 2: Well, this is a very smart group of people. I like that.

00:17:47
Speaker 1: I'm really happy to hear that. You know, part of it is a lot of people that in that age group go to the doctor every three or four years, and if their doc doesn't talk to them about colon cancer screening, you've missed it. And then they're the urgency just isn't there. People think it's not going to happen to me. Well, one in sixteen or one in seventeen people here will be diagnosed with calling cancer in your lifetime, and if you don't get screened, the odds of being detected late stage go up massively.

00:18:18
Speaker 2: I want to ask you about lowering the screening age. You know, if in fact this has become an epidemic. It's the number one cancer killer of people under fifty, and certainly anecdotally, almost every huge medical institution now is an early onset collorectal cancer department. You know, I've heard stories of people in their early thirties getting it. I talked to an oncology fellow from Monta Fiori who told me she had to tell a twenty one year old boy that he had stage four calling cancer. No family history, no Lynch syndrome or familio polyposis, which puts you at an increased risk, So why can't we lower the screening age.

00:18:59
Speaker 1: The essential challenge with screening is that it costs money, and so there's always just two variables that really matter is what is the impact of screening and what is the cost or the harms of screening, And so there's always a balance. And what happened was that the increase in the number of people being diagnosed the prevalence of the disease in forty five to forty nine year olds went up enough so that that balance between the impact of screening and the cost of screening tipped over to be more impactful than screening people aged seventy to seventy five, which was recommended, And so the main guideline group said, well, if it's good for seventy to seventy five year olds, it's good for forty five to forty nine year olds. And when you think about it that impact, you look at life years gained and if you're forty two and you're diagnosed with stage one cancer, you get a lot more gained there. You get forty or forty five years of gain there. So if you drop it to forty, now that that age group is at higher risk and you can do it with the lower cost test. So you take colguard is a five hundred dollars test, colonoscopy depending on where you go, is a twenty five hundred dollars test. Now colonoscopy. There just are not enough gastroinrologists in the US to screen everybody. We have a fixed capacity of five to six million tests. That's a problem when you have fifty million people not up to date with screening. We have the ability with a test like colo guard or what's called the fit test, which I think is a bad test, don't use it, but to screen a lot more people, and to start screening at maybe even thirty five and then maybe seven years later gets screened, and then once you hit forty five, get screened every three years, which is what Colguard is recommended for.

00:20:53
Speaker 2: Judy, do you ever use the epic data to change public policy? In other words, can you make a vincing argument where you have all this information about a whole slew of patients to then say this needs to be done differently? You have, haven't you? In the past.

00:21:10
Speaker 4: We did that with fentanyl very successfully.

00:21:13
Speaker 2: Tell me about that.

00:21:14
Speaker 4: Well, we found that fentanyl was being examined for tested for when people came in with drug overdose to the EDS five percent at the time, but it was responsible for forty five percent of the deaths. And so we published that and I don't know where it is now, but several states were changing their policy and what the requirements were for fentanyl testing. And if you look at the studies that are coming out now on the number of deaths from overdose, they've gone way down and the big changes with ventanyl.

00:21:48
Speaker 2: So you can envision Kevin right using data to convince well right now, I think who knows what you can convince Robert F. Kennedy Junior to do, But I mean you can can see where you could use data to make a compelling reason to change public policy.

00:22:08
Speaker 1: And this is the power of epic. So our customers are doing this. Health systems all over the country are using I think it's called healthy Planet. Healthy Planet allows you to take a look at a population within a health system and identify people within a certain age bracket that are not up to date with screening, and then they're initiating an electronic order for all of their patients who fit into that category, and it automatically then electronically triggers US shipping collection kits to hundreds thousands, tens of thousands, in one case four hundred thousand collection kits being shipped out over a two week period. So the power of EPIC is just amazing. I do believe if you fast forward twenty years, because of the power of EPIC and the power of Cologuard, you're going to have a story of calling cancer moving clearly in the direction of cervical cancer a disease of the people that aren't being screened, and that will be the rare case, not the common case.

00:23:18
Speaker 2: If you want to get smarter every morning with a breakdown of the news and fascinating takes on health and wellness and pop culture, sign up for our daily newsletter wake Up Call by going to Katiecuric dot com. Wearable Technology. I was curious about EPIC interfacing with wearable technology companies. Judy, like the fitfit founders, recently announced the launch of a new AI startup called Loofu that aims to help families proactively monitor their health. Can you see a time where you are pooling that information in individual information along with EPIC information to help come up with sort of better plans and even gleaning sort of more information about what's happening in that patient that would then help the larger patient population.

00:24:15
Speaker 4: Let me ask the group here, they may know more details about the limit. Are we already doing that with these systems? Yeah? Okay, better answer than I could give.

00:24:27
Speaker 2: They're saying, yes, come up and tell me what you're doing.

00:24:32
Speaker 5: So through my chart and even directly if a patient doesn't have my chart, organizations can enroll patients to be able to send that data back in Many like Group Health Cooperative here in town, allow patients to just link up their own personal devices so that that data can flow into the chart. They can see it in my chart, and then if it becomes relevant for their care, their providers can see it during a visit, or it can be pulled into your point for that population monitoring and seeing who are all of the patients using both the clinician entered data as well as the patient entered data from their devices to identify patients in potentially high risk populations to drive that outreach.

00:25:09
Speaker 2: What's your name, Trevor, Trevor? Thank you Trevor, because I know you're working with like Apple Watch and a bunch of other different tech companies. I can't keep you all much longer. I could talk about this all day, and I know you all have to work, But just a couple more questions, Kevin, what about liquid biopsies? Okay, so colonoscopes are too expensive, right, And I think a huge area, exciting area of medical science is these blood tests that will determine at a very cellular level. And Caitlin, I'd love to hear your thoughts on this and indicate if you have early stage cancers. Right, where are we in the technology of those things. I know that there's some on the market. Exact Sciences has one. How reliable are they and could they be used? Like every time you get a physical, you get a blood test and it checks just like it checks your cholesterol. It could see if you have any cancer cells in your blood.

00:26:07
Speaker 1: I joined Exact Sciences seventeen years ago after a four hour conversation with doctor David al Course at the Mail Clinic, who had the idea for colo guard, but he also had this far out there idea that you could do a blood draw and look for what's called DNA methylation patterns that occur in cancer and get shed into the blood. And I thought that this is so far out there it's going to take decades to do well. Here we are two decades later, and we'd launch cancer Guard and what cancer Guard would do in a population is detect probably between thirty and fifty percent of cancers. So if you ask yourself the question, if you could scream and find thirty to fifty percent of cancers in the US population today, would you well, yeah, because there's no treatment that is effective as effective as earlier detection. Every week matters, every month matters, and certainly a year matters. And so I'll tell you a story. We launched cancer Guard and Alison, who is our head of pr decided you wanted to get the test, So she went online cancer guard dot com got our test ordered by an online doctor. She was the first person at exact to get the test. She was the first person to have a positive result. She had a twenty two centimeter ovarian cancer. Now she's in her forties. It was stage one. Surgery alone treated it, no chemotherapy, and her odds going forward are really good. Earlier detection matters because almost all ovarian cancers are asymptomatic until stage three or four, and by stage three or four there are twenty thousand new cases every year in twelve to fifteen thousand deaths. Your odds are really bad. So can screening a whole population for all cancers? Yeah, it matters because you don't have to screen that many people to find one cancer. When one out of thirty three people are walking around with cancer over age fifty and don't know it.

00:28:13
Speaker 2: So when do you think it will be truly ready for prime time? That almost every cancer could be potentially detected in a liquid biopsy or blood test.

00:28:24
Speaker 1: The challenge is probably not the technology, It is the regulatory framework, the reimbursement framework. Will Medicare pay for this technology. We had to get a law passed by Congress, which we did thankfully a month ago to make this happen. That was a five year fight to make that happen. And insurance companies don't like paying for screening because you're spending money on a healthy population. So we'll have to fight that fight. But we fought that fight with Coliguard, and everybody initially said Coliguard is not good. You need a colonoscopy. Eventually people came to the conclusion, Wow, col Guard, it's pretty amazing. The same thing I believe will happen with cancer good.

00:29:06
Speaker 2: I think until the technology becomes available, the best thing we need to remind people of are the symptoms of colorectal cancer. Now, unfortunately, sometimes you're symptomatic when the cancer is pretty advanced, but at the very least, knowing the symptoms also allows you to go to a doctor right away. So, Doctor Murphy, I thought you could just review the symptoms of colorectal cancer so people will know if they have any of this happening, to make an appointment immediately to see your doctor.

00:29:39
Speaker 3: Sure, this is an area that I've become just so passionate about because I hear from many survivors and patients that they experience symptoms for months and months and months and get referred to doctor to doctor to doctor before they finally get a diagnosis. And so the key symptoms that you really want to look for are blood and stool, or we call it hematic easia, any changes in your bowel, habits, diarrhea, any sort of thing going on with your gut. And sometimes these are pretty non specific symptoms or could be related to a bunch of different things, but certainly you know your body best and if you see something that's different again, blood and stool diarrhea, change in bowel habits.

00:30:19
Speaker 2: Or bloating. Can I just add to this fun list. Yeah, symptoms like bloating, pain, unexplained weight loss, anemia right, if you have anemia and another tests right.

00:30:33
Speaker 3: And sometimes it's really easy to dismiss those symptoms, specifically in women, because there are other reasons for anemia at say mensies, you know, things like that, and so again, just making being proactive. I hear so often, so many times I saw my symptoms in my chart, for example, but my doctor didn't notice the pattern for four years.

00:30:53
Speaker 2: And sometimes you have to be pretty insistent, you know. Doctors sometimes blow you off and say, oh, it's hemorrhoids or it's nothing to be worried about. I think, particularly if you're younger. So you need to really be your own best advocate and be persistent, and if you're not feeling right, go to another doctor or really continue to search for answers because I think unfortunately some doctors aren't as well versed in what's happening with early on set colorectal cancer and in terms of preventing the disease. I promised this my last question. I'm just trying to educate everyone and help people because I care so much and I would hate to see what happened to my husband happen to any of you. It's just such a terrible loss. So things that you can do, other than being vigilant about screening and aware of symptoms are their preventative measures, Caitlin, you can do to try to stave off this disease.

00:31:49
Speaker 3: The other thing that goes with screening is knowing your family history because oftentimes if you have a family history of either color rectal cancer or the pre cancerous lesions adinoma, you can get screened at an earlier age. And there are a bunch of studies now showing that we could prevent almost all of the early onset cancer is if people had known that they had a family history in garten screened at the appropriate age.

00:32:13
Speaker 2: For example, my daughters both will be screened at thirty one because that's ten years before their father was diagnosed. He was diagnosed at forty one and died at forty two after nine months. So it really is so important to know your family history because then obviously insurance will pay for it. Also, an active lifestyle, I mean I think more and more we're hearing about the importance of exercise, getting your heart rate up thirty minutes three times a day, at least, that's what my interness just told me. Judy, don't look at me like that. But no, three times a week? Sorry? Did I say sorry? I am so sorry three times a week? Sorry? No, wonder you looked at me like that? And what about sort of limiting your consumption of red meat and fruits and vegetables. I mean, all these things to me can stave off all kinds of cancer, right, Caitlin, Exactly.

00:33:09
Speaker 3: It's not just colorectal cancer, but many other chronic health conditions that are related to these lifestyle related risk factors. Fiber fiber absolutely, taking insets or aspirin can reduce your risk. There are many things that we're in control of in terms of our diet and our lifestyle that might help a little bit.

00:33:27
Speaker 2: Well. I hope that everyone learns something today. I hope you all now know that the screening age is forty five. So anybody you know who's forty five, please tell them it could save their life. And also in terms of the symptoms, just be aware because as we know, it's affecting younger and younger people, people in their twenties and thirties. Pay attention to your body and if you have any questions, definitely see a doctor. I feel like the nagging fish wife of colorectal cancer, but I know how early detection can say lives and that's why I feel so passionately about it.

00:34:04
Speaker 1: You could order cologuard dot com and then just drop it off at our lab over there on trade.

00:34:09
Speaker 2: But you have to be forty five. Yes, you have to be forty five, but that's true. You can do that, but talk to your doctor in any event.

00:34:16
Speaker 1: Ghitting about dropping it off at the lab.

00:34:20
Speaker 2: Well Kevin Conroy and Judy Faulkner, Doctor Caitlin Murphy, thank you so much and so appreciate it. Thank you all so much for coming. I'm so grateful. Thank you, Thanks for listening. Everyone. If you have a question for me, a subject you want us to cover, or you want to share your thoughts about how you navigate this crazy world, reach out send me a DM on Instagram. I would love to hear from you. Next Question is a production of iHeartMedia and Katie Kuric Media. The executive producers are me Katie Couric and Courtney Ltz. Our supervising producer is Ryan Martz, and our producers are Adriana Fazzio and Meredith Barnes. Julian Weller composed our theme music. For more information about today's episode, or to sign up for my newsletter, wake Up Call, go to the description in the podcast app, or visit us at Katiecuric dot com. You can also find me on Instagram and all my social media channels. For more podcasts from iHeartRadio, visit the iHeartRadio app, Apple Podcasts, or wherever you listen to your favorite shows,