Jose was 34 the first time he came into my office. For three months, he’d been dealing with stomach pain, something many people his age might brush off. He assumed it was stress from planning his wedding and caring for a newborn at home. It wasn’t. It was colon cancer.
Colon Cancer: The Basics
The colon is a part of your digestive system and is the longest part of the large intestine, connecting your small intestine to your rectum. It spans about 5 feet and is responsible for absorbing water, forming stool, and storing it until your body is ready to get rid of it. Colon cancer is the third most common cancer in the United States, with more than 150,000 new cases diagnosed each year. Due to better screening options and improvements in lifestyle and awareness, the overall rate of colon cancer is on the decline.
However, a troubling trend has emerged in recent years: people are being diagnosed at younger ages. In 2019, about one in five new cases occurred in individuals younger than 55. While this is concerning, there is encouraging news: when colon cancer is detected early, outcomes are very good, with survival
rates greater than 90%.
Take Control with Screening
Screening remains the most powerful tool we have to prevent colon cancer or detect it early. Everyone is a candidate for colon cancer screening, even those without symptoms. While most individuals should start screening at age 45, some high-risk individuals should begin earlier. These include individuals with a family history of colon cancer, those with inflammatory bowel disease (such as Crohn’s disease or ulcerative colitis), and those with certain inherited genetic conditions. Speak to your physician if you believe that you fall into one of these categories.
There are several options for screening:
• Colonoscopy is the most widely recognized screening test and allows physicians to identify and even remove precancerous polyps, tiny growths, before they develop into cancer. This is the most comprehensive option.
• CT colonography uses specialized X-ray technology to create detailed pictures of your colon and rectum. Colonoscopy preparation is still required.
• Fecal immunochemical test is a noninvasive annual stool test looking for trace amounts of blood that may indicate underlying cancer.
• Stool DNA test is another noninvasive test that looks for both blood and abnormal DNA from cancer or polyps in your stool and should be done every three years.
Whichever screening method you choose, the most important message is simple: the best screening test is the one that gets done.
Dismantling the Fear
I have had countless conversations with my patients over the years about their hesitancy with colon cancer screening. This conversation is not unique to my clinic. In 2023, a study showed that 38% of eligible adults were not up to date with their screening. The truth is, I understand the hesitation. Very few people would describe colonoscopy preparation as pleasant. It involves fasting, drinking a cleansing solution, and spending a fair amount of time in the bathroom before the procedure.
Furthermore, some individuals fear undergoing the procedure itself. Please take comfort in knowing that significant complications occur in less than 1 in 500 procedures and most often arise in those with underlying issues. I personally have completed a colonoscopy, and while I can’t say I look forward to the next one, I can say I am grateful for the clarity and reassurance it provided me.
Diet: The Problem or the Cure
Beyond screening, diet and lifestyle play a meaningful role in lowering the risk of developing colon cancer. Studies consistently show that diets high in processed meats, large amounts of red meat, alcohol, sugar-sweetened beverages, and highly processed foods are associated with increased colorectal cancer risk. Instead, experts recommend diets that emphasize whole foods: fruits, vegetables, whole grains, legumes such as beans and lentils, fish, and healthy fats. And if
you want to go for extra credit, there may be some benefit to incorporating specific foods such as Japanese sweet potatoes, turmeric, garlic, citrus fruits, pomegranate, and green tea into your diet.
A Preventable Cancer – If You Act
Ultimately, colon cancer is one of the most preventable cancers we know. Early detection through screening can stop cancer before it begins or identify it at a stage when it is highly treatable. Everyday choices, such as maintaining a balanced diet, staying physically active, limiting alcohol, avoiding tobacco, and prioritizing whole foods can further reduce risk. While no one enjoys the idea of screening, the peace of mind and potential life-saving benefit make it
well worth the effort.
I encourage each of you to take advantage of the tools we have. Get screened when recommended and make choices that support long-term health. Your future self will thank you. I know that Jose is grateful, because instead of waking up to face his mortality, he wakes up to his
wife and son.