What everyone should know about colorectal cancer

Colorectal cancer is one of the most common cancers in the United States but also one of the most preventable and treatable when caught early. So why does it continue to take so many lives? According to Dr. Punam Amin, assistant professor of surgery in the Division of Surgical Oncology at Baylor College of Medicine, misinformation, fear and avoidance often keep people from getting screened or seeking treatment when it could matter most.

“There’s still a lot of stigma and misunderstanding around colorectal cancer,” Amin said. “But the good news is that we have better tools than ever to detect it early and treat it effectively.”

Amin answers some of the top questions and clears up common myths about colorectal cancer.

When should I get screened for colorectal cancer?

For most people, screening should begin at age 45. If you have a family history of colorectal cancer or certain risk factors, like inflammatory bowel disease or genetic syndromes, you may need to start earlier.

Colonoscopy is considered the gold standard for screening. The procedure is performed under sedation and involves inserting a flexible tube with a camera through the anus to examine the lining of the colon and rectum. During the exam, doctors can find and remove polyps: small clumps of cells that could become cancerous if left untreated. For most people at average risk, colonoscopies are recommended every 10 years.

There are also non-invasive screening options like Cologuard, a stool-based test that checks for abnormal DNA and blood in the stool, both of which can be signs of colorectal cancer. If a Cologuard test returns an abnormal result, a follow-up colonoscopy is required. These tests are typically repeated every one to three years for those at average risk.

“Colonoscopy is still the most thorough option because it allows us to detect and remove polyps during the same procedure,” Amin said. “But for patients who may not tolerate anesthesia well or have other medical issues, stool-based testing like Cologuard can be a good alternative.”

Those at higher risk for colorectal cancer — such as individuals with Crohn’s disease, ulcerative colitis, a personal history of polyps or inherited conditions like Lynch syndrome — may require more frequent screening and earlier testing.

What are the symptoms of colorectal cancer?

Colorectal cancer often doesn’t cause symptoms in its early stages. That’s why regular screening is so important. When symptoms do appear, they may include:

• Blood in the stool.
• A change in bowel habits (constipation or diarrhea).
• Unexplained weight loss.
• Abdominal pain or cramping.
• Fatigue or weakness.

“Any persistent change in your bowel habits or unexplained symptoms should prompt a conversation with your doctor,” Amin said. “Don’t ignore them.”

Is colorectal cancer only a concern for older adults?

No. Colorectal cancer is increasingly being diagnosed in younger adults under 50. In fact, early onset colorectal cancer is one of the few cancer types rising in incidence.

“We’re seeing more young patients with advanced disease, often because they weren’t thinking about cancer when they noticed symptoms,” Amin said. “If something doesn’t feel right, advocate for yourself.”

Common myths about colorectal cancer:

Myth: If I feel fine, I don’t need screening.
Fact: Colorectal cancer can grow silently for years. Screening catches problems early — before symptoms start.

Myth: A colonoscopy is painful and dangerous.
Fact: Colonoscopies are safe, routine procedures done under sedation. Most people don’t remember the procedure, and serious complications are rare.

Myth: Only people with a family history get colorectal cancer.
Fact: Most cases occur in people with no family history. While family history increases your risk, lifestyle and age also are major factors.

What can I do to lower my risk?

According to Amin, several lifestyle changes can help reduce your risk of colorectal cancer:

• Eat a high-fiber, low-fat diet rich in fruits, vegetables and whole grains.
• Avoid processed meats and limit red meat.
• Exercise regularly.
• Maintain a healthy weight.
• Don’t smoke.
• Limit alcohol consumption.

“These are changes that benefit your overall health, not just your cancer risk,” Amin said.

Colorectal cancer is serious, but it’s also beatable. Early detection saves lives, and the first step is getting informed.

“Talk to your doctor, know your family history and don’t let fear keep you from getting screened,” Amin said. “We’re here to help you stay ahead of it.”

By Tiffany Harston, senior communications associate in the Michael E. DeBakey Department of Surgery