Colon cancer awareness, following the death of actor Chadwick Boseman

HOUSTON - The tragic passing of actor Chadwick Boseman to colorectal cancer this week highlights the issue that this disease is affecting many younger Americans. Almost 70% are diagnosed below the age of 50 and already late stage, making it difficult to treat. Dr. George Chang is a Surgical Oncologist, UT MD Anderson Cancer Center, and shares important advice to prevent and detect colorectal disease. He says the fact that his patients are younger than ever these days is concerning. "If we knew why we were seeing so many more cases in young people today, then that would be great if we could figure it out. Clearly, the incidence is rising particularly for cancers in the distal colon, rectal cancer and left-sided colon cancer, and the incidence is rising at alarming rates," states Dr. Chang.

       It is so alarming that when actor Chadwick Boseman died from the disease, it took the world by storm, especially since he fought his battle so privately. At the same time, it gets this conversation going, so hopefully, he can help spare others from late-stage disease, by raising awareness. "Colon or rectal cancer can present with a variety of symptoms. Early, it may be symptomless, but it can also cause blood in the stool or changes in bowel habits. Sometimes these symptoms can be rather subtle for anyone who's experiencing symptoms. We would always encourage that if these symptoms are not otherwise explained, that they should seek care. A lot of times when people are young like Chadwick Boseman was, we're more inclined to perhaps not think of the symptoms as such a big deal. We are inclined to put it off to some other cause. But if we can't identify another cause, if we don't have another explanation, then further work-up should be done," explains Dr. Chang.

       It's important to know that while screenings used to be suggested at 50 years old, it's younger than that now. "Currently the American Cancer Society recommends screening to begin at age 45, or ten years younger than the age of your nearest first-degree relative who may have been diagnosed with colorectal cancer. When colon or rectal cancers are identified early, sometimes in the stage of cancer within a polyp, or even in a precursor, such as a polyp that hasn't yet become cancer, then the development of a more serious problem can be entirely prevented.  It's very common, one in 23 Americans will be diagnosed sometime in their lifetime. Those are pretty staggering numbers if you think about it. For those individuals who are not yet 45, I think the key message is not to ignore these symptoms that if the symptoms are unexplained. If changes involve habits or abdominal complaints or blood in the stool etc is not explained, then they should seek further evaluation right now. Because of COVID-19, the rates of screening are down, and this is an important message that I'd also like to convey which is that you can be safely screened today. We shouldn't ignore this very important issue, and hopefully, as we have improvements and control over COVID, we will have less concern among the population, but I hope that people will not ignore this very important issue, and go ahead and seek their screening," says Dr. Chang.

       As far as what type of screening to undergo, Dr. Change says colonoscopy is still the gold standard. "There are other options, such as at-home tests, using a stool as an example. But if something is identified on that test, a colonoscopy will still be necessary. Also, colonoscopy can detect polyps before they ever turn into cancer and prevent cancer from ever forming. That's something that's more difficult to do with the at-home test, but I think the important message is to get screened, however, you do it, whether it's an at-home test or whether it's a colonoscopy. While the loss of Chadwick Boseman is incredibly sad, I hope this can be, in many ways, a teaching moment for everyone that this is an important issue and we have to pay attention to it," states Dr. Chang.

       Prevention tips can be found here.