After an Arlington man in his 80s died of colon cancer, undiagnosed until his intestines were blocked completely, his widow got his genetic testing done and he tested positive for two variants on the chromosome that can increase susceptibility to colon cancer. 

An email went out to his six adult children: get a colonoscopy. They did, except for one. Two (in their thirties) had polyps; three had nothing, and the last of the six children did not get a colonoscopy. He said he was okay because he used a test that measures blood in the stool. And he had no symptoms.  

There was always some reason for not doing it — Covid, or insurance issues, or his belief that he was okay because of the non-invasive test results. 

Finally, 9 years after his father died of the disease, he got a colonoscopy. Result? Stage 3 colon cancer. He now tells people: “Don’t wait.” 

March is Colorectal Cancer Awareness Month. MedStar Health recently conducted a national survey to learn what people know about colon health: 

* 77% do not know the correct age for when to get your first colonoscopy (45 is the recommended age for colonoscopies for people with average risk) 

* 75% do not know how often to get a colonoscopy (every 10 years for people with average risk)

* 47% believe you need a colonoscopy every 5 years

* Just 13% can identify all symptoms of colorectal cancer

* 36% of adults who are 45+ have not had a colonoscopy

* The most common reason for delaying a colonoscopy is because they have no family history (40%).

Nikiya Asamoah, MD, a board-certified gastroenterologist affiliated with MedStar Washington Hospital Center responded to questions about colonoscopies and colorectal health: 

Q. Arlington Connection (AC): Isn't it correct that you should have a colonoscopy every five years?
A. Dr. Asamoah: Not necessarily. The frequency of colonoscopy is based on your own risk factors, such as family history of cancers or personal history of inflammatory bowel conditions as well as how many polyps were found on your colonoscopy. Some people require colonoscopy every 1-3 years, while others can go 10 years if they have no risk factors or polyps.
Q.: What is the updated guidance on colonoscopy prep?
A. Dr. Asimoah: The new guidelines for bowel prep recommend that patients can eat a light meal for breakfast 1 day prior to colonoscopy, which eliminates the long fasting period. Additionally, they suggest that patients should be offered low volume (2L) bowel prep instead of the standard 4L prep.

Q.: Is it the processed food that people eat, the microplastics in our environment, or our more sedentary lifestyle that is causing all this colon cancer?

A. Dr. Asimoah: Likely all of the above. Many environmental factors and genetics contribute to the risk of colon cancer. It is recommended that people eat a well balanced diet with regular fruits/vegetables, lean proteins and a healthy lifestyle with regular aerobic exercise.

Q.: Is the Cologuard test good enough to detect colon cancer?
A. Dr. Asimoah: The Cologuard test is a great screening test for colon cancer with a >90% sensitivity for picking up cancer if it is there. 

Q.: Is a family history of polyps enough to schedule more frequent colonoscopies?

A. Dr. Asimoah: No. Your family history often dictates when you should start getting colonoscopies. Future colonoscopies are based on the findings of your own colonoscopy or if you have family history of colon cancer or cancer syndrome.

Q.: People say age 40 is the new age for a first colonoscopy. Is that wrong?
A. Dr. Asimoah: Yes, it is wrong. 45 is the recommended age for first colonoscopy for individuals that are NOT high risk for colon cancer.

Q.: What is the single most frequent reason people say they delayed getting a colonoscopy?
A. Dr. Asimoah: Concerns about the bowel prep or concerns about having anesthesia.

Q.: Is colon cancer more frequently diagnosed among African Americans and why is that?
A. Dr. Asimoah: Yes, it is true that African Americans have a higher incidence of colorectal cancer than most other racial and ethnic groups. There are multiple factors that contribute including health and socioeconomic disparities.

Q.: Any other ethnic group where it is more frequent or less frequent?

A. Dr. Asimoah: American Indian and Alaskan Native people have the highest incidence while Asian/Pacific Islanders have the lowest incidence according to American Cancer Society 2025 estimates.

Q.: Is it true that just taking fiber gummies won't really give you the right kind of fiber to provide colon health?

A. Dr. Asimoah: That is true. Fiber gummies often have excess sugar or sweeteners and not a significant amount of fiber. Fruits and green leafy vegetables are the best sources of soluble and insoluble fiber.

March became Colorectal Cancer Awareness Month in the year 2000. In addition to the above guidance, spreading the word about preventing colorectal cancer by asking friends and relatives if they have had their colonoscopy, and following this guidance about alcohol, smoking and symptom awareness will also go a long way to bringing down the alarming rise in colorectal cancer diagnoses.

* Healthy Habits: Reduce risks by eating a high-fiber diet with fruits/vegetables, limiting red/processed meats, limiting alcohol, and avoiding smoking.

* Watch for Symptoms: Consult a doctor if you experience persistent changes in bowel habits, blood in stool, unexplained weight loss, or abdominal pain.

* Wear Blue: Support the Colorectal Cancer Alliance and wear blue to raise awareness.

For more information about colorectal health, see: Colorectal Cancer Alliance https://colorectalcancer.org/