Patient David was 55 years old. He had a wife, kids, and a successful business. In his youth, he was a competitive athlete, and although his sporting days were now behind him, he still felt well and full of energy.

I first met David after he was referred to me by his primary physician for a routine colorectal cancer screening. He had no symptoms. David has no blood in stool, no changes in bowel habits, no weight loss, and no abdominal pain.

As I continued the examination David mentioned that he felt a little winded after climbing one flight of stairs since several months before. Although there were no other cardiac symptoms, I became suspicious that he may have undiagnosed coronary artery disease.

I decided to refer him to a cardiologist before proceeding with a colonoscopy for colorectal cancer screening. He was found to have a critical blockage in a coronary artery and underwent cardiac bypass surgery shortly after.

Two months later, he returned to my office for his colonoscopy, during which I found a large tumor in the lower part of his colon. The biopsy indicated that the tumor was invasive adenocarcinoma, a type of malignant neoplasia that makes up roughly 95% of all colorectal cancer cases.

Luckily, a CT scan showed that cancer had not metastasized. I immediately referred him for colorectal surgery. The surgery was a great success. He was completely cured of colorectal cancer, and did not have to undergo chemotherapy or radiation therapy.

This case happened more than 15 years ago. Since then, David has undergone many more colonoscopies to remove pre-cancerous colon polyps. I have gotten to know David well over the years of seeing him as a patient, but his case is not unique.

Excluding skin cancers, colorectal cancer was the third most commonly diagnosed cancer in the United States for both men and women in 2019, with over 150,000 cases.

(1) If colorectal cancer is not found until the later stages, it is often fatal. The U.S Preventive Services Task Force recommends colorectal cancer screening for men and women over the age of 50 as the risk factors group.

(2) However, with rising cases of colorectal cancer occurring before the age of 50, American Cancer Society and many gastroenterologists now recommend beginning colorectal cancer screening at age 45.

The Gold Standard for colorectal cancer screening is colonoscopy. While other screening techniques such as stool tests can detect colorectal cancer, colonoscopy has the added benefit of allowing the physician to remove pre-cancerous polyps directly during the procedure. Polyps are one of the most common colorectal conditions, occurring in 15-20% of the adult population in the United States.

(3) The risk of polyps increases with age and other conditions such as obesity, or tobacco and alcohol use. Certain ethnic groups, such as Black Americans and Ashkenazi Jews, also have an increased risk of developing colorectal polyps.

If you are over the age of 45, even if you are healthy and have no family history of colon cancer, a colonoscopy can save your life.