Every week, I have conversations that break my heart. I sit across from patients who have just been diagnosed with colon cancer—cancer that could have been prevented if they had come in for screening earlier. They often tell me they were too busy, felt fine, or were simply too scared to schedule the appointment. Now, they’re facing a battle they never had to fight.
This is why I’m writing to you today. Not to scare you, but to save you. Because colorectal cancer is one of the most preventable cancers, yet it remains the third leading cause of cancer-related deaths in both men and women. The tragedy is that most of these deaths are entirely avoidable.
Why Colon Cancer Screening Matters More Than You Think
Colon cancer doesn’t develop overnight. It typically starts as small, benign growths called polyps that form on the inner lining of your colon or rectum. These polyps can take 10 to 15 years to transform into cancer. This slow progression is actually good news—it gives us a massive window of opportunity to find and remove these polyps before they become dangerous.
Think about that for a moment. We have a 10-15 year window to prevent cancer. Very few cancers offer us this luxury. With breast cancer, lung cancer, or pancreatic cancer, we’re often detecting the disease after it’s already developed. But with colon cancer, screening isn’t just about early detection—it’s about prevention.
When we perform a colonoscopy and find polyps, we remove them on the spot. No surgery, no chemotherapy, no radiation. Just a simple removal during the screening procedure itself. Those polyps never get the chance to become cancer. This is why screening is so powerful.
The Alarming Truth About Who’s at Risk
If you think colon cancer is just an “old person’s disease,” you need to hear this: colorectal cancer rates are rising dramatically in younger adults. People in their 30s, 40s, and 50s are being diagnosed at increasing rates. In fact, if current trends continue, by 2030, colon cancer is projected to be the leading cause of cancer death in people aged 20-49.
This shift has prompted medical guidelines to change. The recommended age to begin screening has been lowered from 50 to 45 for average-risk individuals. But here’s what many people don’t realize: if you have certain risk factors, you may need to start screening even earlier.
You should consider screening before age 45 if you have:
- A family history of colorectal cancer or polyps
- A personal history of inflammatory bowel disease (Crohn’s disease or ulcerative colitis)
- A genetic syndrome such as Lynch syndrome or familial adenomatous polyposis
- A personal history of radiation to the abdomen or pelvic area
I’ve diagnosed patients in their early 30s with advanced colon cancer who had dismissible symptoms they ignored for years. They thought they were too young. They thought the bleeding was just hemorrhoids. They thought the stomach pain was stress. By the time they came to see me, their cancer had spread.
Breaking Down the Barriers: Why People Avoid Screening
I understand why people put off colonoscopy. I’ve heard every excuse, and many of them are valid concerns. Let me address the most common ones:
“I’m too scared of what they might find.”
This is the fear paradox. You’re so afraid of finding something that you guarantee the worst possible outcome by avoiding screening altogether. Finding polyps or early-stage cancer is good news—it means we caught it in time. Not looking doesn’t make cancer go away; it just allows it to grow undisturbed.
“The prep sounds terrible.”
I won’t lie—the bowel preparation isn’t pleasant. You’ll need to drink a cleansing solution and spend time in the bathroom. But prep solutions have improved dramatically in recent years. They’re smaller in volume, better tasting, and more tolerable. And honestly? It’s one day of inconvenience versus potentially saving your life. Most patients tell me the prep wasn’t as bad as they feared.
“I don’t have time.”
You’ll need to take a day off work for the procedure and recovery. But consider this: if you develop colon cancer, you’ll lose far more than a day. You’ll lose months to surgery, chemotherapy, and recovery. You’ll lose time with your family. Some people lose their lives. One day now can save you years of suffering later.
“I feel fine. I don’t have any symptoms.”
This is perhaps the most dangerous misconception. Colon cancer typically doesn’t cause symptoms in its early stages. By the time you have symptoms like bleeding, pain, unexplained weight loss, or changes in bowel habits, the cancer may have already advanced. Screening is designed to find disease before you feel sick.
“It’s too expensive.”
Most insurance plans, including Medicare, cover colorectal cancer screening with no out-of-pocket costs. The Affordable Care Act requires that preventive screenings like colonoscopies be covered without copays or deductibles for average-risk individuals. If cost is a concern, talk to your doctor’s office about payment options and assistance programs.
Understanding Your Screening Options
While colonoscopy is considered the gold standard for colon cancer screening, it’s not your only option. Several effective screening methods exist, and the best one is the one you’ll actually do.
Colonoscopy remains the most comprehensive option. It allows your doctor to view your entire colon, remove polyps during the procedure, and provide 10 years of protection if results are normal and you’re at average risk. You’ll be sedated during the procedure, so you won’t feel discomfort.
Stool-based tests like FIT (fecal immunochemical test) or FIT-DNA tests check for hidden blood or abnormal DNA in your stool. These are done at home and are non-invasive. However, they need to be repeated annually or every three years, and any abnormal result requires a follow-up colonoscopy.
CT colonography (virtual colonoscopy) uses X-rays and computers to create images of your colon. It’s less invasive than traditional colonoscopy but still requires bowel prep and doesn’t allow for polyp removal during the test.
A gastroenterologist can help you understand which screening method is most appropriate for your individual risk factors, preferences, and medical history.
The Stories That Keep Me Up at Night
I want to share a story that represents too many others. A 52-year-old woman came to see me after finally scheduling her first colonoscopy—seven years after she was supposed to. She had been putting it off, always finding reasons to delay. She felt healthy, was active, and had no symptoms.
During her colonoscopy, I found a large mass in her colon. The biopsy confirmed advanced colon cancer that had already spread to her lymph nodes. She needed major surgery, months of chemotherapy, and years of monitoring. She survived, but her life was forever changed.
The heartbreaking part? Three years earlier, she had experienced some minor rectal bleeding but convinced herself it was hemorrhoids. That was likely her early warning sign. If she had come in then—or better yet, at age 45 when screening is recommended—I would have found and removed polyps before they became cancer.
I have another patient who did everything right. He came in at age 45 for his first screening colonoscopy, even though he felt perfectly healthy. We found and removed several large polyps. The pathology showed they were pre-cancerous and would have definitely become cancer within a few years. He sends me a thank-you card every year.
These are the two paths. Which one will you choose?
What to Expect: Demystifying the Colonoscopy Process
Knowledge reduces fear. Let me walk you through what actually happens during a colonoscopy so you know exactly what to expect.
Before the procedure: You’ll receive detailed instructions for bowel preparation, typically starting the day before your colonoscopy. You’ll switch to a clear liquid diet and drink a prescribed cleansing solution. Stay near a bathroom and keep yourself hydrated.
Day of the procedure: You’ll check in at the endoscopy center or hospital. A nurse will start an IV and review your medical history. You’ll meet with your doctor and the anesthesia team.
During the procedure: You’ll receive sedation medication that makes you sleepy and comfortable. Most patients don’t remember the procedure at all. The doctor will insert a thin, flexible tube with a camera (colonoscope) through your rectum to examine your colon. If polyps are found, they’re removed immediately. The entire procedure typically takes 20-45 minutes.
After the procedure: You’ll rest in a recovery area until the sedation wears off. You’ll need someone to drive you home. Most people feel completely normal by the next day and can return to regular activities.
Take Action Today
I know this has been a long read, but if you’ve made it this far, you clearly care about your health. Now it’s time to act on that care.
If you’re 45 or older and haven’t had a colonoscopy, call your doctor today—not next month, not after the holidays, not when things slow down at work. Today. If you’re younger but have risk factors, don’t wait. Your life is worth a phone call.
Stop letting fear, embarrassment, or procrastination make healthcare decisions for you. Stop gambling with your life when the odds are entirely in your favor if you just take action.
I’ve seen too many people whose cancers could have been prevented. I’ve held hands with patients who wished they had listened to warnings like this one. I’ve also celebrated with countless patients whose lives were saved by a screening they almost didn’t schedule.
Which patient do you want to be?
Schedule Your Screening Today
Dr. Preetha is committed to helping patients achieve optimal digestive health through personalized care and evidence-based treatment. If you’re due for colorectal cancer screening, experiencing any digestive symptoms, or have questions about your colon health, contact our office to schedule your consultation. Don’t wait until symptoms appear—prevention is always easier than treatment. Your future self will thank you for taking this important step today.