Steve Livingston op-ed: Alabama has momentum — now let’s access colorectal cancer screenings

(Screenshot/APTV)

After a successful legislative session this year focused on ensuring access to cancer screenings, I was reminded of something fundamental: every Alabamian should be able to have access to the health and care they need.

That is why I am proud that we passed SB 19 earlier this session – legislation that eliminates cost-sharing for prostate cancer screenings for men over 40 who are at high risk.

With this bill, Alabama became the tenth state in the nation to remove financial barriers to lifesaving screenings. It’s a victory worth celebrating and the mark of a successful session for access to preventive health. While many are reflecting on the past session, I want to already look ahead. I’m asking myself: Why stop here?

The truth is, Alabama faces a cancer screening crisis that extends well beyond prostate cancer.

According to the American Cancer Society, Alabama ranks in the top 10 nationally for colorectal cancer incidence rates. In 2026 alone, 2,690 Alabamians will be diagnosed with colorectal cancer, a majority of whom would not have been up to date with their recommended colorectal cancer screening.

Like the men we’re helping with SB 19, Alabamians deserve a fighting chance to catch cancer early, when treatment is most effective, and outcomes are best. That means we need to expand access to all available screening methods, not just one.

This is where innovation comes into play. Guardant Health’s Shield blood test, the first and only FDA-approved blood test for primary colorectal cancer screening for those 45 and older at average risk, represents a major breakthrough by allowing Alabamians to now screen for colorectal cancer with just a blood draw.

For many Alabamians, Shield offers a quick, easy way to screen that eliminates barriers to detection, with no invasive, complicated procedure, time needed off work for special prep and recovery, and the ability to be completed during a routine doctor’s office visit instead of a far drive to a specialist, particularly in our rural areas.

The encouraging part is that Shield is already covered through many of Alabama’s major insurance pathways. Veterans can access Shield through the Veterans Affairs Community Care Network. Medicare beneficiaries also have access.

But there is still work to be done. If we’re serious about closing the screening gap, we must move from talking about innovation to implementing it, and that begins with updated screening guidelines to include blood-based testing as a first-line screening option for millions of Americans, including many right here in our state.

Alabama has an opportunity to lead on this issue. We’ve already made progress with SB 19. Now we need to ensure that progress extends across all screening methods and all Alabamians, regardless of their insurance status or zip code.

Early detection saves lives, and I’m proud to see our legislature is taking steps in the right direction this year.

But there is still more work to be done for every Alabamian to have a fighting chance to catch cancer early and be there for their families in years to come. That means continuing to push for expanded access to all available screening methods to help ensure all eligible patients have access to a potentially life-saving test.

State Senator Steve Livingston has represented the people of District 8 since 2014. He was elected Majority Leader of the Alabama Senate Republican Caucus in 2023. 

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