Colorectal cancer screening: A golden opportunity for early detection and better health

My name is Nam, and I am 48 years old. I work in an office in Ho Chi Minh City, and my life is busy with work, family, and weekend drinks with friends. I used to think I was still young and healthy. Whenever I occasionally had a stomachache or noticed unusual bowel movements, I assumed it was due to irregular eating habits. I had never seriously considered undergoing a colonoscopy.

1. My journey: From hesitation to the right decision

1.1. Initial concerns and what prompted me to act

One day, during my company’s routine health check-up, the doctor recommended colorectal cancer screening because I was over 40 and had a family history of the disease: my father had colorectal cancer. At first, I was worried. I thought a colonoscopy would be painful and inconvenient, and I was afraid of receiving bad news. I kept putting it off, telling myself, “I’ll do it next month.”

Then I came across an article from University Medical Center Ho Chi Minh City about colorectal cancer screening. That was when I suddenly realized: “If I miss the opportunity for early screening, could I end up regretting it when it’s too late?”

1.2. Overcoming fear: A life-changing turning point

I decided to schedule a colonoscopy at University Medical Center Ho Chi Minh City. It was not an easy decision, but understanding the potential risks and wanting to protect my health for myself and my family motivated me to take action.

2. Colonoscopy: Easier than I expected

2.1. The actual experience and a sense of relief

On the day of the procedure, I was very nervous, but the experience turned out to be much easier than I had imagined. The endoscopy team took excellent care of me, and the anesthesiologist was reassuring and gentle. I fell asleep and woke up to find that the procedure was already over. I felt no pain at all.

2.2. Precancerous polyps detected in time

The results showed that the doctor had found three polyps in my colon. They were removed during the same colonoscopy and sent for laboratory testing. Fortunately, the results confirmed that they were adenomas, a type of precancerous polyp.

When the doctor told me, “If left for a few more years, these polyps could develop into cancer,” I got goosebumps. But immediately afterward, I felt an overwhelming sense of relief. I was relieved that I had acted at the right time. I was relieved that I would not have to face surgery, chemotherapy, radiation therapy, or even greater suffering. Most of all, I was relieved that I still had the opportunity to live a healthy life with my wife and children.

3. Why is early colorectal cancer screening important?

3.1. The growing risk of colorectal cancer

Colorectal cancer is the third most common cancer and the second leading cause of cancer-related death worldwide [5]. In the United States, colorectal cancer is the leading cause of cancer-related death among men under 50 and the second leading cause among women under 50 [9]. Risk factors include age, family history, a personal history of polyps or inflammatory bowel disease, and lifestyle factors [3,8].

3.2. Screening helps detect and remove precancerous polyps

Colorectal cancer often develops from small, benign growths called polyps that protrude from the lining of the colon or rectum. Over time, some of these polyps can become cancerous. This process usually occurs silently over 5–10 years, or even longer [4]. This creates a “window of opportunity” to detect and remove polyps before they become cancerous [4]. Regular screening helps identify these polyps and prevent the development of cancer.

3.3. The benefits of early detection

Colorectal cancer screening plays a key role in reducing both the incidence of the disease and mortality [1,2]. When cancer is detected at a localized stage, the five-year survival rate can reach 91.1%, compared with approximately 15.7% for distant metastatic disease [2].

The greatest benefit of screening is the ability to detect and remove precancerous polyps before they have a chance to develop into cancer. During a colonoscopy, doctors can remove polyps immediately, helping prevent cancer at an early stage [1].

4. Who should be screened, and at what age should screening begin?

4.1. General recommendations and circumstances requiring earlier screening

People at average risk (those without a family history or relevant underlying medical conditions) should begin colorectal cancer screening at age 45 [1,2].

You may be at higher risk and need to begin screening earlier if you have any of the following factors [1,2]:

• Family history: A first-degree relative (parent, sibling, or child) has had colorectal cancer or an advanced adenomatous polyp. Screening should begin at age 40 or 10 years before the age at which the youngest affected relative was diagnosed, whichever comes first [1].
• Inflammatory bowel disease: Ulcerative colitis or Crohn’s disease increases the risk.
• Hereditary syndromes: Conditions such as Lynch syndrome or familial adenomatous polyposis (FAP).

The appropriate age to begin screening should be discussed carefully with your doctor, who will assess your individual risk factors.

5. Colorectal cancer screening methods

Several screening methods are available, each with its own advantages and disadvantages. The most appropriate method depends on your health status, risk factors, and discussion with your doctor [2].

5.1. Colonoscopy: The “gold standard” for screening and intervention

Colonoscopy is considered the “gold standard” for colorectal cancer screening [1,3]. It is the most direct and comprehensive screening method.

• Procedure: A flexible tube equipped with a camera is used to examine the entire lining of the colon. Thorough bowel preparation with laxatives is required. Sedation or anesthesia is commonly provided to help ensure comfort [3].
• Advantages: Colonoscopy allows direct visualization of the entire colon, immediate removal of polyps, and collection of tissue samples for biopsy [1,3]. For people at average risk whose results are normal, repeat screening is generally recommended every 10 years [1].

5.2. Other screening methods

• Fecal occult blood testing (FOBT) / fecal immunochemical testing (FIT): These tests detect blood in the stool, which may be a sign of polyps or cancer [2,6].
• Stool DNA testing: This method detects genetic markers associated with cancer or polyps in stool samples [2].
• Virtual colonoscopy (CT colonography): Computed tomography (CT) is used to create images of the colon. Bowel preparation is still required. If an abnormality is detected, a conventional colonoscopy is needed for further examination and treatment [2].
• Capsule colonoscopy: The patient swallows a capsule containing a camera. This method is less invasive, but it cannot obtain biopsy samples or remove polyps [2].

6. Advice from someone who has been through it

6.1. Don’t let fear hold you back

Looking back, I am grateful that I decided to undergo screening that year. I am grateful to the doctors who detected and treated the polyps in time. Most of all, I am grateful to myself for overcoming my initial fear and taking steps to protect my health.

If you are reading this and hesitating just as I once did, take it from me: colonoscopy is not as frightening as you might think, and taking action early is one of the greatest gifts you can give yourself and your family.

6.2. Screening is a gift to your health

Do not wait until your body starts sending warning signs before seeking medical attention, because by then it may be too late. I took that step, and now I am living a healthy life with greater peace of mind than ever before. Get screened early!

— Nam, 48, Ho Chi Minh City

7. Frequently asked questions (FAQ)

1. Who should undergo colorectal cancer screening? Most health organizations recommend that average-risk individuals begin colorectal cancer screening at age 45 and continue at regular intervals [1,2]. People with a family history or other risk factors may need to begin screening earlier [1,2].
2. Is colorectal cancer screening painful? During colonoscopy, patients are often given sedation or anesthesia to help make the procedure comfortable and pain-free [3,4].
3. Which colorectal cancer screening method should I choose? Colonoscopy is considered one of the most effective methods because it allows direct visualization of the entire colon and immediate removal of polyps [4]. However, stool-based tests are also suitable options for people who cannot or prefer not to undergo colonoscopy [1,2]. Discuss the available options with your doctor to determine the most appropriate method.
4. How often should I undergo colorectal cancer screening? The recommended screening interval depends on the method used and the results of the previous screening. If a colonoscopy is normal and there are no additional risk factors, it can generally be repeated after 10 years [1,4]. Stool-based tests need to be performed more frequently [1,6]. Your doctor will provide specific recommendations based on your individual health status.
5. Where and how can I schedule a colonoscopy? You can schedule an appointment at University Medical Center Ho Chi Minh City to consult with the endoscopy team, undergo an assessment, and receive a recommendation for the most appropriate examination. Your doctor will answer your questions and provide detailed instructions about the procedure and bowel preparation, helping you feel reassured throughout the process.

8. References

1. U.S. Preventive Services Task Force. Recommendation: Colorectal cancer screening [Internet]. Rockville (MD): USPSTF; c2021 [cited 2025 Dec 13]. Available from: https://uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening
2. National Cancer Institute. Colorectal cancer screening fact sheet [Internet]. Bethesda (MD): National Institutes of Health; c2024 [cited 2025 Dec 11]. Available from: https://www.cancer.gov/types/colorectal/screening-fact-sheet
3. Centers for Disease Control and Prevention. Screening for colorectal cancer [Internet]. Atlanta (GA): CDC; c2024 [cited 2025 Dec 13]. Available from: https://www.cdc.gov/colorectal-cancer/screening/index.html
4. Wolf AMD, Fontham ETH, Church TR, Flowers CR, Guerra CE, LaMonte SJ, et al. Colorectal cancer screening for average-risk adults: 2018 guideline update from the American Cancer Society. CA Cancer J Clin. 2018;68(4):250–81. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9167799/
5. World Health Organization. Global cancer observatory: colorectal cancer [Internet]. Lyon (FR): International Agency for Research on Cancer; c2024 [cited 2025 Dec 13]. Available from: https://gco.iarc.fr
6. MedlinePlus. Colorectal cancer screening tests [Internet]. Bethesda (MD): U.S. National Library of Medicine; c2024 [cited 2025 Dec 13]. Available from: https://medlineplus.gov/lab-tests/colorectal-cancer-screening-tests/
7. U.S. Pharmacist. The importance of colorectal cancer screening [Internet]. Cranbury (NJ): U.S. Pharmacist; 2024 [cited 2025 Dec 11]. Available from: https://www.uspharmacist.com/article/the-importance-of-colorectal-cancer-screening
8. Mayo Clinic. Colon cancer: symptoms and causes [Internet]. Rochester (MN): Mayo Foundation for Medical Education and Research; c2024 [cited 2025 Dec 11]. Available from: https://www.mayoclinic.org/diseases-conditions/colon-cancer/symptoms-causes/syc-20353669
9. National Cancer Institute. Possible signs of colorectal cancer in younger adults [Internet]. Bethesda (MD): National Institutes of Health; 2023 [cited 2025 Dec 11]. Available from: https://www.cancer.gov/news-events/cancer-currents-blog/2023/colorectal-cancer-young-people-warning-signs
10. National Center for Biotechnology Information. Lynch syndrome (hereditary nonpolyposis colorectal cancer) [Internet]. Bethesda (MD): National Institutes of Health; c2023 [cited 2025 Dec 11]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK431096/

The information above is for reference purposes only and is not intended as medical advice. Please contact your doctor for detailed medical consultation.