March Is Colorectal Cancer Awareness Month — And I'm a Surgeon Who Hopes You Never Need Me
- Aden Davis
- Mar 4
- 4 min read
AT A GLANCE ✓ Screening starts at 45 — earlier if you have a family history or IBD ✓ Caught early: 90%+ survival rate. Caught late: the math changes fast. ✓ Colorectal cancer is now the #1 cancer killer in Americans under 50 — seven years ahead of projections
Ready to act now? Start at the American Cancer Society or Fight Colorectal Cancer
Something I don't say lightly: I hope you never need me.
Not for this.
I've been a surgeon long enough to know that the operating room isn't where this disease gets beaten. It gets beaten — when it gets beaten — in a clinic, years before anyone calls me.
March is Colorectal Cancer Awareness Month. That means I get to say out loud what I think about the rest of the year: colorectal cancer is one of the only cancers we can actually prevent. Not detect early. Prevent. There's a difference, and it matters.
Most people don't know that. Which is the whole problem.
What Prevention Actually Looks Like
Here's what happens on a good day in the endoscopy suite.
I'm doing a colonoscopy. I find a polyp — precancerous, hasn't turned into anything yet. I take it out. Same scope, same session, ten extra minutes. The patient goes to recovery, we talk while the anesthesia wears off, they ask when they can eat, and they go home.
That's it. No cancer. Not an early-stage cancer we caught in time. There's no cancer. It never had the chance to develop.
That's what screening does when it works.
What I've seen too often is the other version. The patient who put off the colonoscopy for three years because life got busy. The one who thought rectal bleeding was hemorrhoids — and wasn't wrong, until they were.
Those conversations are different.
The Numbers Are Moving in the Wrong Direction
The American Cancer Society estimates 158,850 new colorectal cancer diagnoses in 2026 and around 55,230 deaths. That's the overall picture.
The part that doesn't leave me alone is the under-50 data.
Colorectal cancer is now the number one cause of cancer death in Americans under 50. Not second. First. A decade ago it ranked fifth in that age group. It didn't drift upward — it climbed, and it arrived at the top of that list seven years earlier than researchers projected.
It's the only major cancer where death rates in people under 50 are still rising. Overall cancer mortality in that age group has fallen 44% since 1990. Colorectal cancer went the other direction.
One in five people diagnosed with colorectal cancer today is under 55. In 1995 that was one in ten.
I have operated on people in their thirties with metastatic rectal cancer. I'm not going to dress that up.
Why 45 — And Why It's Not a Suggestion
The U.S. Preventive Services Task Force moved the recommended screening age from 50 to 45. That change came from data. From patients who showed up at 48 with a cancer that had been growing for years undetected.
Colorectal cancer stopped being a disease of older age a while ago. Clinicians know this. The guidelines caught up.
And screening isn't only about finding cancer that's already there. A colonoscopy finds polyps — tissue that hasn't turned malignant yet — and removes them on the spot. Fecal blood tests, stool DNA tests, sigmoidoscopy are also options. None of them perfect, all of them far better than a waiting room conversation I'd rather not have.
When colorectal cancer is found while it's still localized, the five-year survival rate exceeds 90%. Once it's moved beyond the colon or rectum, that number drops hard and fast.
What I do in the OR is downstream of the real decision, which is whether someone got screened.
We Know Awareness Works
This isn't theoretical.
Breast cancer mortality has declined 44% since 1989. Treatment improved, yes. But a significant piece of that is cultural: mammograms became something women just did. Something they reminded each other to do. Something that stopped feeling optional.
Colorectal cancer screening isn't there yet. And that gap is showing up in the data.
What I'm Asking
If you're 45 or older and you haven't been screened: schedule it. Not soon. This month.
If you're younger with a family history of colorectal cancer or polyps, inflammatory bowel disease, or symptoms you've been quietly explaining away — stop explaining and call your doctor. Earlier screening may be appropriate for you.
Then tell one person. That's it. Just one.
I went into surgery because I wanted to fix things. But fixing things after the fact isn't the win. The win is the patient who never needed the operating room, who went home the same day after a scope, who doesn't think much about colorectal cancer because there's nothing to think about.
That's the outcome I'm working toward. And I can't get there without you doing your part first.
Resources
colorectal cancer awareness, colon cancer screening, colonoscopy, early onset colorectal cancer, colorectal cancer awareness month, black surgeons, black physicians
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