NEWS | September 1, 2020

Death of Chadwick Boseman highlights colon cancer among younger patients, need for regular screening


The recent death of 43-year-old “Black Panther” actor Chadwick Boseman is bringing renewed attention to colon cancer and the need for regular screenings.

Medical oncologist May Cho calls colonoscopies “the gold standard” of colon cancer screening. Medical oncologist May Cho calls colonoscopies “the gold standard” of colon cancer screening.

May Cho is a medical oncologist specializing in the treatment of gastrointestinal cancer, including colorectal cancer, at the UC Davis Comprehensive Cancer Center. She is also an assistant professor at the UC Davis School of Medicine. She answered some common questions about colorectal cancer, its symptoms and diagnosis.

What is colon cancer, or colorectal cancer?

Colorectal cancer includes bowel cancer, colon cancer and rectal cancer -- any cancer that affects the colon and the rectum. According to statistics from the American Cancer Society, the overall lifetime risk of developing colorectal cancer is about 1 in 23 for men and 1 in 25 for women. Hereditary, environmental and lifestyle factors can affect your risk for developing colorectal cancer.  

What was your reaction when you heard about the death of Chadwick Boseman due to colon cancer?

He was so young and productive. It was so heartbreaking to hear but unfortunately wasn’t much of a shock to me.  

The incidence rates of colorectal cancer for people younger than age 50 are on the rise. This is an alarming and rising trend that I see in my clinic. We should learn two things from this untimely loss: colorectal cancer diagnosis is rising in younger patients, and you can still be productive and enjoy quality of life with appropriate cancer treatments.

What are the symptoms of colorectal cancer? Why are they overlooked?

Symptoms include rectal bleeding, often misdiagnosed as hemorrhoids, changes in bowel movement, constipation or diarrhea which you have not typically had before, unexplained weight loss, fatigue and bloating. All of these are symptoms. You should be alarmed if the symptoms persist. Don’t wait more than two or three months. You should see your doctor to seek procedures such as a colonoscopy if the symptoms continue.

When should people start getting screened for colon cancer?

The American Cancer Society guidelines now call for screening at the age of 45, rather than 50, due to increased incidence of colorectal cancer in younger patients. The next steps to follow depend on what the gastrointestinal physician finds through screening. If everything looks good and there are no symptoms, then the patient can return to get checked every ten years.

Precancerous polyps can be safely removed and prevent the development of colon cancer.

If a person is having symptoms, don’t wait. You can advocate for yourself to get the screening done even if your age does not fall into the obvious guidelines.

We are still trying to learn the cause. Most patients have sporadic cancer, which we suspect is due to our environment or our lifestyle changes. We are seeing changes in the past two decades creating this shift. We’re studying it as much as we can.

What’s involved in the screening?

A colonoscopy is the gold standard for screening and the preferred way to diagnose gastrointestinal cancers. It is the only way you can really look at the colon and detect polyps. There are screening tests that look at cancer DNA or blood in the stool (feces), but they are not as good a tool as a colonoscopy.  

What do you tell patients who are nervous to get a colonoscopy?

This is a cancer that can be prevented through early detection. A colonoscopy is a routine procedure that we’ve being doing for decades. The patient is asked to prepare in advance, including a special liquid diet. Then they are given anesthesia and typically have no memory of the procedure. The risks associated with the procedure are very low compared to the immense benefit of finding underlying disease that is going undetected.  

What kind of work is UC Davis Health doing to advance colorectal cancer research and care?

We work with our communities to offer prevention screening and education. We also have several active clinical trials studying colorectal cancer. The trials investigate effective treatment strategies such as immunotherapy, targeted therapy, chemotherapy and liver directed therapy, as most colon cancers tend to spread to the liver.  

If you or someone you know is interested in participating in one of these studies, please reach out to your doctor to find out more, or visit the list of cancer clinical trials at the UC Davis Comprehensive Cancer Center.