A Routine Colonoscopy Could Save Your Life

Excluding skin cancers, colorectal cancer is the third-most-common cancer diagnosed in both men and women in the United States, with the American Cancer Society estimating there were 106,180 colorectal cancer cases in the United States for 2022. This is all the more tragic as the disease is often preventable.

There is good news. As more people follow recommendations for colon cancer screening and make positive lifestyle changes, the rate of diagnosis of colorectal cancer has been on the decline for several decades. In addition, treatments have also become more advanced.

Screening colonoscopy

M. Craig Bozeman, MDA colonoscopy is the most reliable and thorough test to identify the risk for and prevent colon cancer, making it the gold standard for screening, says general surgeon M. Craig Bozeman, MD. Most people should have their first screening colonoscopy at age 45. “But if an individual has a family history of colon or rectal cancer in a first-degree relative — such as a sibling or parent —they should have their first colonoscopy 10 years prior to the age that their family member was diagnosed,” he says. “And some individuals with a history of particular inherited or genetic disorders should start at an even earlier age.”

Cause and treatment

Colon cancer begins when cells in the lining of the colon mutate into pre-cancerous cells that grow into a polyp, explains Dr. Bozeman. The polyp may take anywhere from five to 10 or more years to turn into cancer. It is common to find polyps during a colonoscopy, but they are easily removed during the procedure, he says. Compared to other colon cancer screening modalities, such as a fecal occult blood test or Cologuard test, a colonoscopy allows for the removal of these polyps at the same time as the initial discovery. Alternatively, if a stool test returns positive, a follow-up colonoscopy will still be needed for removal of suspicious polyps or cancers.

If colon cancer is found, the most common treatment is surgery. Some patients may require treatment with chemotherapy and/or radiation as well. “If the patient has stage I or stage II colorectal cancer, they usually do not need any treatment besides surgical removal. However, if the cancer has progressed to stage III or stage IV, then chemotherapy and possibly radiation will most likely be recommended,” says Dr. Bozeman. “These more advanced stages indicate that the cancer has spread beyond the colon to involve lymph nodes or other organs. Chemotherapy may be given before surgery, after surgery, or in combination with radiation, in order to shrink the tumor size or to get rid of any microscopic remaining cells,” he says.

Other treatments include immunotherapies, which work with the natural immune response of the body to recognize, attack and destroy colon cancer cells. “If colon cancer is detected early, the likelihood of achieving a complete cure is very good,” he says.

A silent disease

Colon cancer usually does not display symptoms in its early stages. By the time a person begins to experience symptoms, the cancer often has already spread. The most common signs include:

  • Blood in the stool
  • Abdominal pain and cramping
  • Unexplained weight loss
  • Anemia
  • Irregular bowel movements, which could include diarrhea or constipation
  • Change in caliber or form of bowel movements

If you have any of these symptoms, please see your doctor.