The death of 43-year-old “Black Panther” actor Chadwick Boseman in August 2020 has brought renewed attention to colon cancer and the need for regular screenings.

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

Q. What is colon cancer, or colorectal cancer?

I joined UC Davis School of Medicine in December 2018 from the University of Chicago. Many things about UC Davis attracted me — largely the feel of the institution, the culture and the people who make it such a great place.

Q. What is your approach to care?

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 (ACS), 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.

Q. 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 it wasn’t much of a shock to me.

The incidence of colorectal cancer in people under 50 is on the rise and I’m seeing this alarming trend in my clinic. We also are seeing a shift in the past couple decades, with most patients showing sporadic cancer. This could be due to environment or lifestyle changes, but we are trying to learn the cause.

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

Symptoms include rectal bleeding, often misdiagnosed as hemorrhoids, changes in bowel movement, new constipation or diarrhea, 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.

Q. When should people start getting screened for colon cancer?

The ACS guidelines now call for screening at the age of 45, rather than 50, due to increasing rates of colorectal cancer in younger patients. Precancerous polyps can be safely removed and prevent the development of colon cancer if nothing is found and there are no symptoms, then the patient can be checked every 10 years.

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

Q. 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.

Q. What do you tell patients who are nervous about colonoscopies?

This is a cancer that can be prevented through early detection. A colonoscopy is a routine procedure that we’ve been 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.

Q. What kind of work is UC Davis 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.