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While colorectal cancer remains the third most common type of cancer in men and women in the U.S., there are several myths or misconceptions that need to be addressed so people can identify their level of risk for developing the disease.

According to the American Cancer Society, an estimated 104,270 cases of colon cancer and 45,230 cases of rectal cancer will be diagnosed in the U.S. this year. The term “colorectal cancer” is used to describe cancer of the colon and rectum, which are often grouped together given their close anatomic proximity and treatment.

Myth: Preventing colorectal cancer is not possible.

The American Society of Clinical Oncology (ASCO) recently released its fourth annual National Cancer Opinion Survey, in which two-thirds of Americans reported their scheduled cancer screenings, such as colonoscopies and mammograms, have been delayed or skipped amid the COVID-19 pandemic. Due to delayed or missed screenings, some cancer cases could be diagnosed at a later stage with a poorer prognosis or go undetected altogether with ominous repercussions.

When detected early and treated appropriately, colorectal cancer has an approximately 90 percent five-year survival rate. Though there are several factors that can contribute to the development of colorectal cancer, some are beyond our control and others we can change; including, but not limited to:

• Family history of the disease
• Poor eating habits
• Lack of exercise or obesity
• History of, or current, tobacco use
• Excess alcohol consumption

Empowering yourself with this kind of information can help you and your doctor develop a plan to reduce your risk of getting colorectal cancer; delaying necessary screenings, on the other hand, can drastically affect one’s prognosis.

Myth: Screening is only necessary when you have symptoms

While colorectal cancer symptoms are strong indicators a checkup is needed, screening can find precancerous polyps that can be removed before becoming cancerous or causing symptoms.

Talk to your physician if you are experiencing any of the below symptoms:

• Rectal bleeding, either bright or dark red in color
• Narrow stools or change in stool size
• Tenesmus, or the feeling that you have to empty your bowel but nothing passes
• Anemia caused by iron deficiency
• Persistent abdominal pain
• Unexplained weight loss

Myth: Various screening methods exist that prevent colorectal cancer.

A colonoscopy can sometimes intimidate patients, but the American Society for Gastrointestinal Endoscopy (ASGE) considers it the gold standard of colorectal cancer screening methods for its ability to view the entire colon and both detect and remove polyps during the same procedure. Its ability to remove polyps before they turn into cancer differentiates colonoscopies from other screening methods as the only test that can prevent colorectal cancer. Other less-invasive methods for identifying abnormalities include stool DNA tests and visual exams that use x-ray imaging. While these procedures are adequate screening options for many people, they must be performed more frequently and can miss polyps that would otherwise be identified during a colonoscopy. For this reason, my colleagues and I strongly encourage patients speak with their physicians about screening options and prioritize colonoscopies, particularly if they have risk factors such as family history of colorectal cancer.

Myth: Colorectal cancer affects men, women, and all races equally.

Compared to people who are normal weight, obese men have about a 50% higher risk of colon cancer and a 25% higher risk of rectal cancer, while obese women have about a 10% increased risk of colon cancer and no increased risk of rectal cancer. However, a recent study published by JAMA Oncology found that the higher a woman’s body mass index (BMI), the greater her risk of developing colorectal cancer before age 50.

Additionally, according to surveillance research published by the American Cancer Society, African Americans are medically underserved considering they are about 20% more likely to get colorectal cancer and about 40% more likely to die from it than most other demographic groups. While efforts are being made to address these inequities, the COVID-19 pandemic has exacerbated cancer disparities, including screenings, threatening progress.

Myth: I am too young to consider colorectal risks and screening.

 The likelihood of colorectal diagnosis before the age of 39 is slim but increases after the age of 40 and rises sharply after 50. However, increasing incidence of colorectal cancer in young adults has created cause for concern in the medical community. The American Cancer Society and the U.S. Preventive Services Task Force recommend individuals at average or high risk for colorectal cancer begin screening at age 45 and continue through age 75. Individuals with low to normal risk should begin screenings at age 50.

Education regarding a healthy lifestyle and access to screening can significantly reduce risk of developing colorectal cancer, an often preventable yet potentially deadly disease. Staying on top of your health and knowing the risk factors can help you and your primary care provider understand the dangers and devise a proactive plan to promote good colorectal health.

Kevin E. Woods, MD, MPH is chief of Interventional Endoscopy, Gastroenterology & Nutrition, at Cancer Treatment Centers of America (CTCA) Atlanta. President of the Atlanta Medical Association, Dr. Woods earned a Bachelor of Science in Biology at Morehouse College and a Doctor of Medicine at Meharry Medical College. He completed the Osler Internal Medicine Residency at The Johns Hopkins Hospital and Master of Public Health at The Harvard T.H. Chan School of Public Health.