Colon Cancer Awareness Month: Why Screening Saves Lives

March is National Colorectal Cancer Awareness Month, a time to shed light on one of the most preventable yet deadly forms of cancer affecting Americans today.

The silent threat

According to the American Cancer Society, the incidence of colorectal cancer in adults under 55 has nearly doubled, increasing from 11 percent in 1995 to 20 percent in 2019.

Colon cancer is the third most common cause of cancer deaths in women and the second most common in men. What makes this disease particularly dangerous is its silent nature.

"Colon cancer is actually very silent until it is too late, so we like to emphasize screening," says Dr. Janine Harewood, medical oncologist with the Lee Health Cancer Institute.

The symptoms, when they do appear, are often vague and easily dismissed: abdominal pain, changes in bowel habits (constipation or diarrhea), blood in the stool, unexplained weight loss, or changes in appetite. By the time these symptoms become noticeable, the cancer may have already advanced.

A troubling trend

While the overall incidence of colon cancer has been declining since the 2000s in most populations, there's a troubling exception. 

"The incidence is going down, and the amount of people dying from colon cancer is going down in most populations—except for patients under the age of 50," Dr. Harewood notes.

Many experts believe this rise in younger patients may be linked to dietary choices.

"We think that rise may be linked to diet. It's well-known that diets high in red meat and processed meat have an increased risk of colon cancer," she says.

WATCH HEALTH MATTERS: Colon cancer is increasing in younger adults. Why? An expert weighs in

The power of prevention

The good news is that colon cancer is one of the most preventable forms of cancer, thanks to effective screening methods. The gold standard for screening is the colonoscopy, which Dr. Harewood strongly advocates for those 45 and older.

What makes colonoscopies so effective is their dual purpose.

"The good thing about a colonoscopy is that not only are you able to visualize, but you can actually do something about what you see. If you see a polyp, you can take it out," Dr. Harewood explains.

This ability to remove precancerous growths is why colonoscopies don't just detect cancer—they prevent it. 

"Colon cancer starts out as a polyp, and over the course of 10 years or so, that polyp divides and eventually becomes cancer," Dr. Harewood says. "That's the reason why the incidence of colon cancer is going down because now when you have a colonoscopy and you're taking out those polyps earlier, persons are not developing cancer because the pre-cancerous lesions are being removed."

Screening options

While colonoscopy remains the preferred method, Dr. Harewood acknowledges that other screening options exist:

• Colonoscopy: The gold standard is recommended every 10 years for average-risk individuals 45 and older.
• Imaging: Similar preparation to colonoscopy but using imaging technology instead of an endoscope. It should be done every 5 years, but if anything concerning is found, a follow-up colonoscopy is still necessary.
• Stool-based testing: Two types are available—one that looks for invisible blood (performed annually) and DNA testing that detects genetic changes associated with colon cancer (performed every 3 years).

Early detection saves lives

Understanding your risk factors is also crucial. The most significant risk factor for developing colorectal cancer is age. More than 90 percent of all diagnosed cases are in patients aged 50 or older, according to the Centers for Disease Control and Prevention (CDC).

The stage at which colon cancer is detected dramatically affects survival rates. Start getting your screening earlier rather than later.

"Usually starting off at stage one disease, your chances of survival are almost more than 80 percent. However, when you drop down to stage four, the chances of survival reach somewhere around 30 percent," Dr. Harewood observes.

Early-stage colon cancer (stages 0-1) is typically confined to the bowel wall and often requires only surgery. By stages 2-3, the cancer may have spread to nearby lymph nodes, requiring both surgery and chemotherapy. Stage 4 indicates the cancer has spread beyond the bowel and lymph nodes to other organs, significantly reducing survival rates and treatment options.

Personalized screening plans

Dr. Harewood emphasizes that screening plans should be individualized based on personal risk factors. 

"Based on what is found in your colonoscopy, you develop a plan with your gastroenterologist about what your follow-up scans or follow-up colonoscopies are," she explains.

For example, if high-grade lesions are found, the recommended interval between colonoscopies might be shortened from 10 years to 3 years.

Family history plays a crucial role in determining when to begin screening and how frequently to be screened. 

"The screening plan is definitely personalized, but you won't know when to screen for you unless you have a conversation with your doctor," Dr. Harewood advises.

WATCH: Meet Dr. Harewood

Know your risk factors

Understanding your risk factors, family history and receiving regular screenings can help you cut your risk of developing colorectal cancer.

Dr. Harewood notes that lifestyle factors, such as diet, play a significant role in this increase. Poor diets that are low in vegetables, fruits and fiber and high in fat, red meat and processed foods are associated with increased risk for developing colorectal cancer. 

“People with inflammatory bowel diseases, such as Crohn’s disease or ulcerative colitis, are also at higher risk. A family history of colorectal cancer increases your risk, too,” she says.

Don’t wait—take action this March

Dr. Harewood's message is clear: talk to your doctor about colon cancer screening, especially if you're 45 or older. Don't wait for symptoms to appear.

"The best-case scenario is always being diagnosed earlier rather than later," she emphasizes. With regular screening, this deadly cancer can often be prevented before it even begins.

Your life may depend on a simple conversation with your healthcare provider—make that appointment today.

Support through the Lee Health Cancer Institute

For those diagnosed with colorectal cancer, navigating treatment can feel overwhelming. The Lee Health Cancer Institute offers oncology nurse navigators—a dedicated member of the care team who helps guide patients through the treatment process at no cost. These professionals provide education, support, and assistance in overcoming barriers to care.

The Cancer Institute’s oncology nurse navigation can help with nearly every type of cancer. If you or a loved one could benefit from the support and compassion of an oncology nurse navigator, ask your doctor or healthcare provider for a referral or call 239-343-9500. 

You can also learn more here.