Cancer PreventionWorks July 2021

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Issue: July 2021





Awesome Games Done Quick





Eliminating cervical cancer around the globe


What if you are living with cancer? Katie’s story.


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Colonoscopies starting at 45 Multi-Cancer Early Detection Testing – A new way to detect cancer early

Up in smoke: Smoking’s increase during COVID-19


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Fitting in fitness from home Clean your eating routine



Milestone event fundraisers

CEO’S CORNER Dear Friends, With COVID-19 vaccination rates climbing and positivity rates going down, we hope there is a light at the end of the tunnel. In the meantime, while many of us continue to be “safer at home,” we are here to help you build healthy habits any way you can. If you’ve started or increased a smoking habit during the pandemic, you are not alone. Our feature article, “Up in smoke: Smoking’s increase during COVID-19,” details the pandemic-related rise in tobacco usage in the U.S.—and provides resources to help you quit. (Silver lining: E-cigarette use in kids and teens is down!) We will also keep you informed of the most important cancer prevention and early detection issues. Read on for information on the World Health Organization’s cervical cancer elimination strategy, new colorectal cancer screening guidelines, breakthrough technology for multi-cancer early detection tests, and a stark reminder from breast cancer survivor Katie Scola on the importance of rescheduling your routine cancer screenings and health appointments.

AWESOME GAMES DONE QUICK In January, hundreds of thousands of gamers from around the world gathered online to raise money for the Prevent Cancer Foundation® at Awesome Games Done Quick (AGDQ) 2021. The weeklong, 24-hour-a-day annual event is a speedrunning marathon, featuring gamers who compete to complete video games as fast as possible. Fans show their support during the livestream by making donations and sharing how cancer has impacted their lives. Despite being completely virtual this year, the event raised more than $2.76 million from about 42,000 individual donations. These funds will support national and global grants for cancer prevention and screening. Throughout the event, several Prevent Cancer Foundation grant recipients spoke with gamers about their global work made possible by past AGDQ marathons. Games Done Quick has grown from a $10,000 fundraiser—held in a basement in 2010—to a twice a year event that typically draws thousands of in-person participants and hundreds of thousands more online to raise millions for selected charities. (The current record, set in 2020, was $3.13 million for the Prevent Cancer Foundation!)

As we navigate the challenging days ahead, remember that you can’t afford for your health to take a back seat. We are here to help you reduce your cancer risk so you can Stop Cancer Before It Starts!®

During the marathon, the Prevent Cancer Foundation invited participants to share #WhyIAGDQ on social media. Twitter user @GamingBricaBrac shared: Cancer took my grandparents but couldn’t take my mom. Seeing others who love games as much as I do harness that passion to improve the world is an amazing sight and gives me hope that we’ll be able to save so many more from cancer.

Carolyn Aldigé Founder and CEO

With support from passionate gamers, we are well on our way.

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ELIMINATING CERVICAL CANCER AROUND THE GLOBE No one should die of cervical cancer. At the Prevent Cancer Foundation, we know this is true—most cases of cervical cancer could be prevented with the human papillomavirus (HPV) vaccine, and routine screening can also detect cervical pre-cancers and cancers early, when successful treatment is more likely. And yet, around the world, people continue to die of cervical cancer. That’s why in 2018, the World Health Organization (WHO) called for the elimination of cervical cancer. WHO defines cervical cancer elimination as reducing the number of cervical cancer cases in each country to 4 per 100,000 women or lower. When this is achieved, cervical cancer will be “eliminated” as a public health problem. No country has achieved elimination yet, although Australia has come close. The WHO’s Global Strategy for the Elimination of Cervical Cancer as a Public Health Problem provides a roadmap, through the following 90-70-90 targets for 2030:

90% of girls fully vaccinated with the HPV vaccine by age 15

70% of women screened with a high-performance test by 35 and 45 years of age

90% of women identified with cervical disease receive treatment (90% of women with pre-cancer treated; 90% of women with invasive cancer managed)

The Prevent Cancer Foundation stands with the WHO in working to eliminate cervical cancer. We have supported this goal by focusing our global grants process on funding projects around the world that focus on cervical cancer education, screening and treatment. We also continue to spread the word across the U.S. with Think About the Link®, an education campaign on the link between certain viruses, like HPV, and cancer. Learn more at 3


WHAT IF YOU ARE LIVING WITH CANCER? KATIE’S STORY. By Katie Scola OK so here comes a heavy hypothetical… What if you were told right now you are living with cancer? You will need to go through chemotherapy. You will lose your hair. You will need to undergo major surgeries and go on medication for a long time. Would you call the doctor? Of course you would. But if you are anything like I was, this hypothetical has never seriously crossed your mind. It was a pretty normal Sunday at the end of January 2016 when we noticed something a little abnormal on my left side. I will admit I was past due on scheduling my yearly OBGYN appointment. I called the doctor on my way to work Monday morning and was scheduled to go in on Tuesday. I was a little nervous but also knew I was the healthiest I had ever been—I worked out 5-6 days a week, ate healthy and felt great. Besides, I was only 27 and no one gets breast cancer at 27, right? I left the doctor on Tuesday feeling relieved. Apparently, it felt cyst-like, meaning the lump was full of water so it couldn’t be a tumor. Normal protocol is to have a mammogram and ultrasound, so I was scheduled to come back on Thursday to be safe. I had been fortunate to live a healthy life up to this point, so why would I be worried? Come Thursday, I was lying on the table with my left arm over my head trying to guess what the radiation oncologist was looking at on the screen. At first, she said 4 Cancer PreventionWorks: July 2021

I endured one year of intense treatment for my breast cancer, and continue to be treated with hormone therapy.

it looked like a common fibroadenoma (nothing to be worried about), but I swear she was looking at it for an additional 5-6 minutes and said nothing. She told me she wanted to do a needle biopsy. I don’t do well with needles, getting blood drawn or anything in that category. No thank you. I’m pretty sure I asked her if there was any other way to see what type of tissue this was made of.

Suddenly I found myself with a needle in my left side, and everything got real. Nope. Suddenly I found myself with a needle in my left side, and everything got real. As I was sitting there with an ice pack in my bra, feeling lightheaded, she told me she would call after 12 p.m. the following day with the results. As I drove out of the garage my heart sank into my stomach and I lost it. What in the world is going on? I told myself 90% of these

IN THE WORLD OF CANCER are benign and people have this done all the time so I’m sure I have nothing to worry about, but it was starting to hit me just how serious this could be. I tried to have a normal Friday and around 2:00 p.m. I received a call from the doctor telling me I had ‘a cancer’ (yes, she actually phrased it like that). She said she was just as surprised as me. In that instant, life as I knew it completely changed. After multiple tests over the next 2 weeks, at age 27, I was diagnosed with Stage 2b Invasive Lobular Carcinoma. I had about one year of intense treatment and am currently undergoing 5-10 years of hormone therapy.

Never expected that I would be in the FIGHT against cancer at just 27.

I share this story not in an effort to scare you, but to say that cancer can happen to anyone. Fortunately, there are some simple steps to try and find it early if, heaven forbid, you are diagnosed. One of those is to stay on top of your normal health screenings. In the early days of my diagnosis, I remember thinking, what if I had gone to the doctor sooner than I did? Would they have found this in an earlier stage before

In the early days of my diagnosis, I remember thinking, what if I had gone to the doctor sooner than I did? it had spread? Would my treatment look different? Unfortunately, there is no way to know. Since the start of the pandemic, I have continued receiving hormone therapy and have made many trips into the Massachusetts General Hospital Cancer Center in Boston. Each time I go, I feel safe and know these appointments are important to keeping me healthy. It can be easy in such hard and uncertain times to de-prioritize proactive screenings, but it’s critical that we don’t put these off. If you can take one thing away from this, I hope you will get your

We recently celebrated 4 years since my original diagnosis. My husband, Jeff and I are living happy and healthy in downtown Boston.

next annual appointment or screening back on the books. Early detection really does save lives. Call your doctor ahead of time to learn about the COVID-19 protocols they are following to ensure you feel prepared and safe. Again, if you were told that you are living with cancer… would you act differently? I know I would have! 5


COLONOSCOPIES STARTING AT 45 The U.S. Preventive Services Task Force (USPSTF) has lowered the recommended screening age for colorectal cancer from 50 to 45. Colorectal cancer is one of the most preventable cancers. With routine colonoscopies, your doctor can discover and remove polyps before they have the chance to become cancerous, making this screening truly lifesaving. There are also other options for visual or stool-based screening (if you receive a positive result, you need to follow up with a timely colonoscopy). Now, in accordance with the Affordable Care Act and new guidance from the USPSTF, private insurers are required to fully cover colorectal cancer screening for all adults ages 45-75. These recommendations apply to adults who are of average risk, meaning they do not have symptoms of the disease and do not have a personal history or family health history of colorectal cancer or colorectal polyps, a personal history of inflammatory bowel disease or a genetic disorder that increases the risk of colorectal cancer. Colorectal cancer is a devastating disease and is the second-leading cause of cancer deaths in males and females combined in the United States. Despite strong evidence that screening for colorectal cancer is effective, about a quarter of people ages 50 to 75 have never been screened. Why the change in guidelines? For years, we’ve seen an alarming trend of increased colorectal cancer cases in people younger than 50, known as “young-onset” colorectal cancer. Incidence rates of young-onset colorectal cancer cases have increased by 2% each year since 1990, and the median age of diagnosis dropped from 72 to 66. Because screening had been previously unavailable for most adults under 50, young-onset colorectal cancer cases are often diagnosed late, when treatment is less likely to be successful. In response to this trend, the American Cancer Society changed its guidelines in 2018 to recommend colorectal cancer screening for those at average risk begin at age 45 (down from 50). Now the USPSTF’s “B” recommendation for colorectal cancer screening for adults ages 45-49 ensures insurance companies will cover the cost of screening, making prevention and early detection an accessible reality for millions of people. (The USPSTF maintained their “A” recommendation for adults ages 50-75, so insurance companies must continue to cover their screenings, too.) This is a big win for cancer prevention and early detection. The Prevent Cancer Foundation advocates for colorectal cancer screening for all average-risk adults beginning at age 45, but those with certain risk factors may need to start even sooner or get screened more often. To learn more about risk factors and the rise of colorectal cancer among young adults, visit

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GUT CHECK: YOUNG-ONSET COLORECTAL CANCER IN YOUR STATE The Gut Check report from the Prevent Cancer Foundation details the current rates of colorectal cancer in the United States as well as factors and trends associated with the higher incidence of disease among younger adults. Members of Congress who support the draft USPSTF recommendations have referenced Gut Check to emphasize the problem of young-onset colorectal cancer cases and support lowering the age for initial colorectal cancer screening. You can download the report for free at


MULTI-CANCER EARLY DETECTION TESTING – A NEW WAY TO DETECT CANCER EARLY When it comes to cancer, we need time on our side. Finding cancer early leads to more effective, efficient treatment and a better quality of life for patients and their loved ones. Today, routine screening is available for only five types of cancer, which leaves the vast majority of cancers without available screening tests. But when cancer is detected early, nine of every 10 cancer patients will live five years or longer.

“One test-one cancer” approach

“One test-many cancers” approach

Low-dose CT (lung cancer)

• •

Breast cancer Lung cancer

• • •

Colon cancer Prostate cancer Cervical cancer

Lymphoic neoplasm

• • •

Plasma cell neoplasm Ovarian cancer Bladder cancer

• • • • • • • • • •

Gastrointestinal cancer Liver cancer Pancreatic cancer Head and neck cancer Anorectal cancer Uterine cancer Kidney cancer Melanoma Thyroid Myeloid neoplasm

Screened cancers

Multi-cancer early detection • Sarcoma (MCED) tests are blood-based • Multiple other cancers screening tests (also called liquid biopsies) that are designed to identify the presence of cancer for more than one cancer at a time at the earliest possible stages, before noticeable symptoms occur. These tests are designed to detect many types of cancers by looking for cancer signals in the blood. They are intended to complement existing screenings and extend the benefits of early detection to detect more cancers in early, more treatable stages. Currently, MCED tests are not covered by insurance. The Prevent Cancer Foundation and more than 300 advocacy organizations and cancer centers are calling on Congress to ensure seniors with Medicare have access to multi-cancer screening tests once they are approved by the Food and Drug Administration (FDA). Under current law, Medicare coverage of preventive services is limited to tests for which Congress has explicitly authorized coverage. Private insurers cover screening tests that receive an “A” or “B” recommendation from the U.S. Preventive Services Task Force (USPSTF). In the absence of congressional action, it could take several years after FDA approval before Medicare beneficiaries can receive coverage for MCED tests.

WHAT IS THE MEDICARE MULTI-CANCER EARLY DETECTION SCREENING COVERAGE ACT OF 2021? On March 16, Representative Terri Sewell (D-Ala.) introduced the Medicare Multi-Cancer Early Detection Screening Coverage Act of 2021 (H.R. 1946), and on June 3, Senator Mike Crapo (R-Idaho) introduced the Senate companion bill (S. 1873). Both Rep. Sewell and Sen. Crapo were joined by a bipartisan group of colleagues. If passed, this bill will remove barriers to innovative multi-cancer screening technologies for America’s seniors. This bipartisan legislation recognizes emerging advances in our nation’s fight against cancer by ensuring Medicare can make a coverage decision for new, innovative tests that can detect multiple types of cancer before symptoms develop. Learn more about multi-cancer early detection at 7


Tobacco sales in the United States have continued to drop for decades. In 2020, however, that steady decline slowed down, as the COVID-19 pandemic made its impression. In Annals of Internal Medicine, researchers reported a 13% increase in tobacco sales during the early months of the pandemic—in addition to a 34% increase in alcohol sales— when compared to the same time period in 2019. "These are significant jumps, and show that the stress, boredom and loneliness caused by the pandemic may have led to increased alcohol and tobacco use," said lead study author Brian P. Lee, M.D., MAS. Based on Nielsen data, Reuters reports that U.S. tobacco sales by volume fell 2% in the seven months between March 2020 (around the time of the first lockdown orders) and October 2020, which is lower than an average drop of just over 3% in the previous two years. News outlets have reported a variety of reasons for this uptick in cigarette smoking: Those working from home have more opportunities to smoke than they did in office environments. Less money spent on travel and commuting expenses made the higher pack prices (approximately 44% of which goes toward state and federal cigarette taxes) of cigarettes easier to swallow, and many have turned to smoking as a form of self-soothing during this stressful time. Those who were already regular or heavy smokers began hoarding cartons of cigarettes as states began to issue lockdown orders.

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CURRENT TOBACCO USERS The Centers for Disease Control and Prevention (CDC) estimates that 34.1 million adults in the United States currently smoke cigarettes. The percentage of current smokers declined from 20.9% in 2005 to 14% in 2019. Of current smokers, the CDC reports the following key trends: • More men (15.3%) are smokers than women (12.7%). • Cigarette smoking is highest among people aged 25–44 (16.7%) years and 45–64 years (17%). • Non-Hispanic American Indians/Alaska Natives and people of non-Hispanic Other races are most likely to be current smokers. • Current smoking is highest among those with Medicaid (24.9%) and those who are uninsured (22.5%). Another CDC finding that seems particularly important to consider during the pandemic: Adults who experience severe anxiety (34.5%) are more likely to smoke than those who report minimal anxiety (12%).

VAPE USE TAPERS—AS DOES TEEN TOBACCO USE While cigarette smoking has increased, use of vaping products—which have become the tobacco products of choice for young adults—has gone down. Several factors have contributed to the drop in vape use, including the number of teens and young adults under increased adult supervision during the pandemic. High schoolers and college students who might normally use vaping products have been forced to stay home and are unable to vape as often as they had before.

A study published in Morbidity and Mortality Weekly Report indicates that 2020 saw an overall drop in teen tobacco use: • Nearly 1 in 4 high school students (3.65 million) were current users of any tobacco product in 2020, down almost 25% from about 1 in 3 (4.7 million) in 2019. • About 1 in 15 middle school students (800,000) were current users of any tobacco product in 2020, down nearly 50% from about 1 in 8 (1.5 million) in 2019. • For the 7th year in a row, e-cigarettes were the most commonly used tobacco product among both middle and high school students. Other reasons for the decrease in vaping during the pandemic include increased health concerns, higher taxes and the ban of some flavored vaping products.

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THE TIME TO QUIT IS NOW The CDC’s Tips From Former Smokers, the nation’s first federal tobacco education campaign, celebrates its 10th year in 2021. It’s estimated that this campaign has helped more than 1 million U.S. adults quit smoking and inspired millions more to try to quit. The Tips From Former Smokers website features a variety of resources in multiple languages for those who want to quit smoking, including text messaging programs, tobacco quit lines, strategies to crush cravings, a free smartphone app and more. The Prevent Cancer Foundation encourages those who currently smoke to consider quitting for good. Here are some tips for kicking the cigarette habit: • Write a list of reasons why you want to stop and reference it when you’re tempted. • Set a date for stopping—making a plan will help you be more successful. • Tell your friends and family you’re quitting for support and accountability. • Take one day at a time and mark each smoke-free day off on a calendar. • Reward yourself with the money you’ve saved on cigarettes by buying something that makes you feel happy.

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According to the World Health Organization, tobacco causes 8 million deaths every year as a result of cardiovascular diseases, lung disorders, cancers, diabetes and hypertension. And while smoking is linked to 90% of lung cancers, that’s not the only danger. Cigarette smoking can cause cancer almost anywhere in the body: the mouth and throat, esophagus, stomach, colon, rectum, liver, pancreas, voice box (larynx), trachea, bronchus, kidney and renal pelvis, urinary bladder and cervix. It can also cause acute myeloid leukemia. Are those who smoke at a higher risk for complications from COVID-19? In a WHO study, researchers found a statistically significant association between smoking and severity of COVID-19 outcomes (including death) among patients. However, it should be noted that population-based studies are needed to quantify the risk to smokers of hospitalization with COVID-19 or of infection by SARSCoV-2. Experts at Cedars-Sinai say that while there is no definitive proof that a person who smokes is more likely to contract COVID-19, they could have increased risk for being hospitalized or being placed on a ventilator if they get the virus.



In the age of the COVID pandemic, our homes have become our hubs. They are where we eat, sleep, work and play. And for many, they’ve also become the new 24hour gym. Working out from home isn’t a new concept, but current conditions mean more and more people are trying to stay active from home. The Centers for Disease Control and Prevention (CDC) recommends 150 minutes of moderate-intensity activity per week for optimal health. What’s more, maintaining a healthy weight and being physically active can reduce your risk of colorectal, breast and endometrial cancers. Beyond expensive Peloton bikes and ancient Jane Fonda VHS tapes, there are now more options than ever for staying fit while staying home.

GET UP AND GET OUT Summer is here—and more sunny days are on the way. Head to the great outdoors to get your blood pumping and take advantage of the vitamin D—but don’t forget to protect your skin from the sun to reduce your risk of skin cancer! Get the whole family involved: Go for a nice post-dinner walk, pull the bikes out of the garage for a spin around the block or head to a local park for playtime.

BODYWEIGHT WORKOUTS Hands down, this is the easiest option for exercising at home. There’s virtually no equipment required! Pushups, situps, mountain climbers, squats—there are many options for strength training using just your own body weight as resistance. Search “10 minute workout” for a great place to start, and don’t be afraid to modify movements to fit what works for you.

Research indicates there is a connection between both physical inactivity and obesity and the incidence of certain cancers. One of the best ways to reduce your risk for cancer and cardiovascular disease is to stay active— you’ll keep your ticker in tip-top shape and have a greater chance of reaching and/or maintaining a healthy weight. STREAM TEAM Whether you’re yearning for yoga or wanting to lift weights, there are myriad video workouts available at your fingertips—all you need is an internet connection (and in some cases, a subscription). YouTube is home to tons of free fitness-focused videos and channels, from highintensity interval training (HIIT) and weightlifting to energetic dance workouts and restorative yoga. 11



It’s that time of year to toss the trash—why not do some junk removal on your current diet? More than one year into the pandemic, juggling work, childcare and other responsibilities from home has become the new normal. While the last thing you may want to do at the end of a long day is cook, there are easy ways to make healthy meals without spending all evening in the kitchen.

SIMPLICITY IN THE SLOW COOKER The slow cooker is your master weapon when it comes to tasty and time-saving meals. Soups, stews, slow-roasted meats—and all you have to do is set it and forget it. Search: Crock-Pot Pineapple Chicken from Eating Well (

SHEET-PAN PERFECTION Any time you can limit the number of dishes to wash and cooking times to watch, that’s a win. Sheet-pan meals require very little cleanup and guarantee everything is hot and ready at the same time. You can mix and match your proteins and veggies to satisfy any picky palates. Search: Sheet-Pan Salmon and Broccoli With Sesame and Ginger from The New York Times (

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GREEN GIANTS Simple salads don’t require much of a recipe: Start with a base of your favorite greens, add in sliced veggies, top with protein and toss with a dressing of your choice. It’s a great way to get in a serving of veggies, and the voluminous nature of salads makes them filling but not heavy. Pro tip: Olive oil with a squeeze of lemon or lime juice is a healthy and tasty dressing in a pinch. Search: Everyday Salad Recipe from Gimme Some Oven

ONE-POT WONDERS Pressure cookers are fantastic for nights when you forget to start the slow cooker but need something hearty on the table in a hurry. The only really time-consuming task is searing the meat beforehand, but you can do it right inside the pressure cooker—and the juicy, flavorful result is more than worth it. Search: Instant Pot Pot Roast from Crème de la Crumb (

TIMESAVING TIP: Utilize your pressure cooker or slow cooker by cooking batches of protein that can be used different ways throughout the week. Chicken breasts can be eaten with a whole grain and some veggies, shredded for salads or tacos or even diced and thrown into chili or pasta. 13

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MILESTONE EVENT FUNDRAISERS Do you want to support the Prevent Cancer Foundation, but you’re not exactly sure how? A great (and easy!) way for anyone to help the Foundation is to create a fundraiser around a milestone event: a birthday, wedding, retirement, Bar or Bat Mitzvah or any special occasion you want to celebrate! You can ask for charitable donations instead of gifts, or you can solicit donations in honor of the event like Maryland teen Valerie Merkowitz did. Thirteen-year-old Valerie recently celebrated her Bat Mitzvah. Young men and women who become a Bar or Bat Mitzvah often choose a “Mitzvah project,” which helps them connect with the teachings of Judaism, such as helping others. For her Mitzvah project, Valerie decided to raise money for the Prevent Cancer Foundation, because she has a personal connection to the mission. She has multiple family members who have had cancer, and she does not want other families to go through the pain and worry that hers did. You can host your own fundraiser in just two easy steps: 1. Go to to create your personal fundraising page. 2. Share that page with family and friends! When Valerie shared her fundraising page, her community’s generosity helped her to surpass her fundraising goal of $3,000.

“I think something that was helpful in reaching above my goal was that this was a cause that a lot of people can connect to and was very personal for many.” - Valerie Merkowitz, age 13

Fundraisers like Valerie’s Mitzvah project are critical to helping the Foundation continue its work to Stop Cancer Before It Starts!® 15

Find this issue and more at

TO SUBSCRIBE, CONTACT: Prevent Cancer Foundation® 1600 Duke Street, Suite 500, Alexandria, VA 22314 Toll-Free: (800) 227-2732 Main: (703) 836-4412 Email: Visit: Cancer PreventionWorks is published by the Prevent Cancer Foundation®, a 501(c)3 nonprofit organization dedicated to the prevention and early detection of cancer. All contributions are tax deductible to the fullest extent allowed by law. The Prevent Cancer Foundation® is a member of the Combined Federal Campaign (#11074).

1600 Duke Street, Suite 500 Alexandria, VA 22314

UPCOMING EVENTS September 23: Prevent Cancer Annual Gala November 4-5: Quantitative Imaging Workshop XVIII


“One test-one cancer” approach

Low-dose CT (lung cancer)

What if you are living with cancer? Katie’s Story.

“One test-many

• • • •

Multi-cancer early detection testing

• • • • • • • • • • • • •

For more information visit

• • • •

Fitting in fitness from home

Clean your eating routine

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