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When talking about colorectal screenings with my patients, I often hear them balk, but they are fine once the screening process has been explained.    

Not counting skin cancers, colorectal cancer is the second most common cancer in men and women. You have a 1 in 20 chance of getting it.

But that’s far from the end:  if it’s detected at an early stage, you have a good chance of winning. That’s why I strongly promote prevention to my patients: get your screenings done. Now.

Here are 11 misconceptions I hear from my patients:

Myth One: I’m too young. It can’t happen to me.

Katie Couric’s husband, Jay Monahan, died at 42. Sharon Osbourne received the diagnosis at 49. Former White House press secretary Tony Snow was 53. Certain conditions can develop even in younger people, and we regularly operate on people in their 30s with colon cancer, even though it’s uncommon for those under 30 with no family history. If you’re at average risk, though, screen at age 50. African-Americans might want to be screened starting at 45 (some evidence says African-Americans are often diagnosed earlier.)

Myth Two:  If I had colon cancer, it would be picked up by the stool test. I don’t need a colonoscopy.

Sometimes there is no blood discovered in the stool test. Many cancers do not bleed ALL the time. And, the stool test isn’t as good at finding actual polyps. A sigmondoscopy or colonoscopy is the most reliable way to detect cancerous cells, and often at a stage where it is curable, or even before the cels become cancerous.  Technology has advanced with x-rays; now virtual colonoscopies can be done (it doesn’t keep you from having to do the prep however, and you still need a colonoscopy to remove any polyps found.  

Myth Three: Colon cancer is hereditary, so if no one in my family has ever had it, I don’t have to worry about it.

Some who get the disease never had any family history. Hereditary reasons are only one of the risk factors of colon cancer. The others include:  your age (9 out of 10 are older than 50) smoking, being overweight, heavy alcohol use, and type 2 diabetes. Far more people with no family history get colon cancer.  

Myth Four—the converse of myth three: I WILL get it. My father died from it, and I have many risk factors.

It does NOT mean you will definitely get colon cancer. However, it DOES mean that instead of starting your screenings at the recommended age of 50, you should start at 40, or 10 years before your family member was diagnosed. Follow-up with screenings every 5 years.

Myth Five: I would know if I had cancer—there would be plenty of blood.

Blood is not always present in the stool, though rectal bleeding or dark stools is one symptom. Many people have no symptoms until late in the disease.  It’s the change in bowel habits you want to look for: the diarrhea, constipation or narrowing of the stool, or a feeling that you need to have a bowel movement, and then it’s not relieved. Also watch for cramping, weakness, fatigue and weight loss. Talk to your doctor about any of these symptoms.

Myth Six:  I eat a diet high in fiber and take multivitamins, so I don’t need screening.

Links between fiber and cancer? Weak.  But you should eat foods that are good for you: other nutrients may help you. Multivitamins have shown little effect in outcomes in a study of those with stage III colon cancer.  CALCIUM AND ASPIRIN MAY HELP REDUCE THE RISK OF POLYPS

The best way to make use of all sorts of conflicting dietary information found in studies? Eat a diet high in fruits and vegetables (at least 5 a day) and whole grains, and low on red and processed meat, to lower your risk.

 Myth Seven: There’s nothing I can do to prevent it. Look at all the people who lead a healthy lifestyle and suddenly get it.

Yes, healthy people get cancer, but you can do many things to increase your chances of not getting cancer. Don’t smoke, watch the weight, exercise at least 30 minutes a day at least 5 days a week, don’t have more than one alcoholic drink a day, and eat very little red and processed meat like beef and bologna. And please do what mom said: eat your fruits and veggies.

Myth Eight: The prep the day before is the worst part.

This is a legitimate concern, but I think the worst part of the procedure is figuring out the insurance paperwork! The prep is time consuming; laxatives will seat you on the toilet in regular intervals the day before the test. But once you’re done cleansing your system, the procedure is usually smooth.  Also, it’s a good idea if while you are purchasing the medicines and laxatives on your doctor’s form, you buy some gentle baby wipes or anti-hemorrhoid wipes for your comfort.  

Myth Nine: The colonoscopy is painful and can puncture the wall of my intestines.

Sedated or under anesthesia, the majority of patients don't feel the test, and you’ll be ready to go back to work the next day, with only mild gas after the procedure. There IS a risk of a puncture, but it is extremely rare.

Myth Ten: If I have a polyp removed, it’s the beginning of the end.  Cancer.

Colon cancer begins with a growth…a polyp. Polyps take years to develop into full-blown cancer. And, a polyp ISN’T necessarily cancer. Polyps are benign and pre-cancerous. It could even be…hemorrhoids. Other gastrointestinal conditions like diverticulosis, infections or inflammatory bowel disease can trouble your intestines.

Myth Eleven: I’ll spend the rest of my life with a colostomy bag.

The bag that carries waste away from your body is not that common and often just a short-term solution. For those using it long-term, it’s good to consider it a change to manage, and not the end. You’ll still be able to participate in work, sports, travel, and sex…and get your life back to a new normal.

Finally, if you do need surgery to remove a polyp that we can't remove by colonoscopy or to remove a cancer, we can almost always do these procedures laparoscopically, meaning a quicker recovery with less pain for the patient.  

-about 101,700 new cases of colon cancer

-about 39,510 new cases of rectal cancer

-49,380 deaths from colorectal cancer

Dr. Conor Delaney is the chief of the Division of Colon and Rectal Surgery at University Hospitals Case Medical Center.  

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