March 2026 | Colon Cancer Awareness Month
March is Colon Cancer Awareness Month, and this year it carries a particular weight. We lost actor James Van Der Beek on February 11, at just 48 years old — a vibrant father of six who was, by his own account, in the best shape of his life when he received a stage III colorectal cancer diagnosis. His story is a powerful reminder that colon cancer does not discriminate by age, fitness level, or lifestyle, and that screening is one of the most important things you can do for your health.
A Wake-Up Call Named James Van Der Beek
Most of us know James Van Der Beek as the teenage heartthrob who played Dawson Leery on Dawson’s Creek in the late 1990s. But in his final chapter, he became something arguably more important: a fearless, clear-eyed advocate for colorectal cancer awareness.
In the summer of 2023, Van Der Beek noticed a subtle change in his bowel habits. He initially attributed it to his coffee intake and cut coffee out of his diet. When the irregularity persisted, he called his doctor. A colonoscopy was performed — and the results changed everything. He was 46 years old, doing cold plunges, eating carefully, and maintaining excellent cardiovascular fitness. He told Healthline: “I was healthy. I was in amazing cardiovascular shape, and I had stage 3 cancer, and I had no idea.”
Van Der Beek kept his diagnosis private for over a year, focusing on treatment and family. In November 2024, he went public — not as a victim, but as a messenger. “I really wanted to raise awareness,” he told People magazine. He was startled to learn that the recommended screening age had already dropped to 45; he had assumed it was still 50. In July 2025, he appeared in interviews urging people:
“Don’t think that not having symptoms means you don’t have to get screened, especially for something that is this curable when caught early. That’s really what I want to get across.” — James Van Der Beek, 2025
He underwent surgery and adjuvant chemotherapy for his stage III disease, battling fatigue, neuropathy, and the relentless uncertainty that cancer brings. He faced it all with honesty and courage, right up until his death in February. We honor his legacy by making sure his message reaches you today.
A Disease on the Rise — Especially in the Young
For decades, colorectal cancer was considered a disease of older adults, and screening historically began at age 50. That understanding has been overturned by a troubling epidemiological shift.
Rates of colorectal cancer in adults under 55 have been rising by 1% to 2% per year since the mid-1990s, according to the American Cancer Society. In adults younger than 55, death rates from colorectal cancer have increased approximately 1% per year since the mid-2000s. A landmark 2026 study published in JAMA confirmed that colorectal cancer has now become the leading cause of cancer death among Americans under 50 — overtaking breast cancer and other malignancies in this age group.
This trend is not unique to the United States. Early-onset colorectal cancer rates are climbing globally, and researchers are actively working to understand why. Current theories include the rise of ultra-processed foods and Western dietary patterns, changes in the gut microbiome, increasing rates of obesity, sedentary lifestyles, and factors that may influence the gut environment beginning in childhood. There is no single confirmed cause — which makes the early-onset rise all the more concerning.
What is clear is this: if you are 45 or older, or if you have risk factors that push your screening start date earlier, the time to act is now. And if you are younger than 45 and experiencing any of the symptoms described below, please do not dismiss them.
Know the Warning Signs
One of the most dangerous truths about colorectal cancer is that it frequently develops with no symptoms at all — particularly in its early, most treatable stages. Many cancers begin as small polyps that cause no pain, no bleeding, and no disruption to daily life. This is precisely why screening for people without symptoms is so critical.
However, when symptoms do appear, it is essential that you contact your doctor promptly. Symptoms to be aware of include:
- A change in bowel habits lasting more than a few weeks — such as diarrhea, constipation, or a change in stool consistency (this was Van Der Beek’s initial symptom)
- Rectal bleeding or blood in the stool, which may appear bright red or very dark
- Persistent abdominal discomfort — cramping, gas, or pain that doesn’t resolve
- Narrow or pencil-thin stools on a recurring basis
- A sensation that your bowel is not emptying completely, even after a bowel movement
- Unexplained weight loss of 10 or more pounds without changes in diet or exercise
- Persistent fatigue or weakness that has no other explanation
- Iron-deficiency anemia found on lab work, especially in men or postmenopausal women
- Nausea or vomiting that is persistent and unexplained
⚠ Do not wait to be seen. Any of these symptoms — especially rectal bleeding, unexplained weight loss, or persistent bowel changes — warrant a prompt call to our office. Symptoms do not guarantee cancer is present, but they always deserve a thorough evaluation.
Screening Guidelines: Who Should Be Screened and When
The United States Preventive Services Task Force (USPSTF), the American Cancer Society, and the CDC all recommend that adults at average risk begin colorectal cancer screening at age 45. This recommendation was updated from the previous age of 50, precisely because of the rise in early-onset cases. Screening should continue through age 75 for most people. Between ages 76 and 85, the decision is individualized based on health status and life expectancy.
Higher-risk individuals may need to begin earlier. Talk to us about starting screening before age 45 if you have any of the following:
- A personal history of colorectal cancer or certain types of polyps
- A first-degree relative (parent, sibling, or child) diagnosed with colorectal cancer or advanced polyps, especially before age 60
- A personal or family history of inflammatory bowel disease (Crohn’s disease or ulcerative colitis)
- A hereditary syndrome such as Lynch syndrome or familial adenomatous polyposis (FAP)
- Prior radiation to the abdomen or pelvis
If you are in a higher-risk category, we will work with you to develop a personalized screening plan appropriate for your individual situation.
Your Screening Options: A Full Review
The good news about colorectal cancer screening is that there is no single “right” test. Multiple effective options exist, and the best test is the one you will actually complete. Below is a thorough review of every currently recommended screening modality.
Visual (Structural) Examinations
Colonoscopy — Every 10 years (if normal)
The gold standard of colorectal cancer screening, colonoscopy allows a gastroenterologist to examine the entire colon and rectum using a flexible, lighted camera. Crucially, it is both diagnostic and therapeutic: polyps found during the procedure can be removed on the spot, potentially preventing cancer from ever developing. If polyps are found, the interval for your next colonoscopy will be shortened based on their number, size, and type. Colonoscopy requires a bowel preparation (a laxative “prep” taken the evening before), dietary changes for one day, intravenous sedation, and someone to drive you home. While it carries a very small risk of bleeding or perforation, it remains the most comprehensive single test available. This is what caught James Van Der Beek’s cancer.
CT Colonography (Virtual Colonoscopy) — Every 5 years
CT colonography uses advanced X-ray imaging to create detailed pictures of the entire colon without an endoscope. It still requires a bowel prep, but no sedation is necessary and the procedure itself is quick — typically 10 to 15 minutes. Studies show it is approximately 88–90% sensitive for detecting larger polyps. Trade-offs include a small dose of radiation, potential detection of incidental findings outside the colon that can lead to additional workup, and the requirement for a follow-up colonoscopy if a polyp is found. It is an excellent option for patients who cannot tolerate sedation or have other reasons that make standard colonoscopy difficult.
Flexible Sigmoidoscopy — Every 5 years alone, or every 10 years combined with annual FIT
Flexible sigmoidoscopy examines only the lower one-third of the colon using a shorter flexible scope. It is faster than colonoscopy, requires less bowel prep, and can often be performed without sedation. Its significant limitation is that it does not visualize the upper two-thirds of the colon — where many cancers, particularly in younger patients, can arise. For this reason, colonoscopy is generally preferred when available. If sigmoidoscopy reveals any abnormality, a full colonoscopy is then required.
Stool-Based Tests
Stool-based tests are noninvasive, can be completed at home, and are excellent options for patients who face barriers to colonoscopy. Their key limitation: any positive or abnormal result must be followed up with a diagnostic colonoscopy. Consistent, on-schedule completion is essential for these tests to be effective.
FIT (Fecal Immunochemical Test) — Every year
The FIT detects microscopic blood in the stool using antibodies specific to human hemoglobin. It requires only a simple smear of stool onto a test card at home, which is then mailed to a laboratory. No dietary restriction is required beforehand. A single FIT has approximately 74% sensitivity for colorectal cancer, but when performed annually, its cumulative effectiveness over a screening lifetime rivals that of colonoscopy for cancer detection. It has roughly a 5% false-positive rate. Annual completion is key — missing a year significantly reduces the benefit. FIT is cost-effective, easy, and widely covered by insurance.
Stool DNA Test (Cologuard / Cologuard Plus) — Every 1–3 years
Stool DNA tests combine a FIT for hidden blood with analysis of DNA mutations shed by precancerous or cancerous cells into the stool. The original Cologuard test detects colorectal cancer with approximately 92% sensitivity and finds advanced precancerous adenomas at roughly twice the rate of FIT alone, though its specificity is slightly lower at 87%. The newer Cologuard Plus (2024) has improved these numbers to 95% sensitivity and 93% specificity. The test requires collecting a full bowel movement (not just a smear) and shipping it in a provided kit. It is FDA-approved and covered by most insurance plans and Medicare for average-risk patients.
High-Sensitivity Guaiac FOBT (gFOBT) — Every year
This older-generation stool blood test is still recommended in some guidelines but requires dietary restrictions for several days beforehand and is generally considered less convenient and somewhat less sensitive than the FIT. If you currently use this test, consider transitioning to FIT or a stool DNA test.
Blood-Based Tests — Emerging, not yet in standard guidelines
Blood-based colorectal cancer screening tests — often called “liquid biopsies” — are an exciting and rapidly evolving frontier. The FDA approved one such test (Shield, by Guardant Health) for average-risk adults in 2024. However, the USPSTF and American Cancer Society have not yet incorporated blood-based tests into formal screening guidelines due to still-evolving evidence, and they are generally not covered by insurance for routine screening at this time. We are following this technology closely.
The Bottom Line on Screening Choice
Every recommended test on this list has been shown to reduce colorectal cancer deaths. The most important factor is not which test you choose — it is that you choose one and complete it consistently. Colonoscopy is the most comprehensive single test and the only option that is both screening and treatment. But if you face barriers to colonoscopy, a FIT or stool DNA test done reliably is far better than no screening at all. Please call our office and let us help you decide which option fits your life.
Prevention: Reducing Your Risk Before It Starts
Screening finds cancer early — but prevention reduces the likelihood of cancer developing in the first place. While no strategy offers 100% protection, the following lifestyle measures are supported by strong evidence:
- Eat a plant-forward, high-fiber diet. Vegetables, fruits, legumes, and whole grains are consistently associated with lower colorectal cancer risk. Aim for 25–35g of fiber per day.
- Limit red and processed meats. Red and processed meats (hot dogs, bacon, deli meats) are classified as probable and definite carcinogens for colorectal cancer by the World Health Organization. Limit to occasional consumption.
- Stay physically active. Aim for at least 150 minutes of moderate activity or 75 minutes of vigorous activity per week. Even regular walking reduces risk.
- Maintain a healthy weight. Obesity is a well-established risk factor. Even modest weight loss in overweight individuals has been shown to reduce cancer risk.
- Don’t smoke. Smokers have significantly higher colorectal cancer risk. Carcinogens from tobacco enter the bloodstream and affect the entire digestive tract. Quitting reduces risk over time.
- Limit alcohol. Alcohol consumption, even at moderate levels, is associated with increased colorectal cancer risk. No more than 1 drink per day for women, 2 for men — or less.
- Ask us about aspirin. Low-dose aspirin has some evidence supporting colorectal cancer risk reduction, but it carries bleeding risks. This is an individualized conversation — not right for everyone.
- Prioritize sleep and manage chronic stress. Chronic sleep disruption and elevated cortisol are emerging as influences on gut health and inflammation, both linked to colorectal cancer risk.
It is worth noting that James Van Der Beek was doing many of these things right. He was fit, active, mindful of his diet, and health-conscious. Colorectal cancer can and does occur in people who do everything right. Prevention is important — but it is not a substitute for screening. Both matter.
If Cancer Is Found: What to Expect
Being told you have colorectal cancer is frightening. But it is essential to understand that colorectal cancer — especially when caught early through screening — is one of the most treatable cancers we know. When detected at Stage I, the five-year survival rate exceeds 90%. Even Stage II and Stage III cancers carry meaningful survival rates with modern therapies.
Treatment depends on the stage and location of the cancer and may include surgical removal of the tumor, chemotherapy, radiation therapy (more commonly for rectal cancer), targeted biological therapies, and immunotherapy — particularly for tumors with specific genetic markers. Many patients with Stage I or early Stage II colorectal cancer are cured with surgery alone. Stage III disease, like Van Der Beek’s, typically involves surgery followed by adjuvant chemotherapy to reduce the risk of recurrence.
If you receive a colorectal cancer diagnosis, our practice will help coordinate your care with gastroenterology and oncology specialists. You are not navigating this alone.
Understanding Your Family History and Genetic Risk
Approximately 30% of colorectal cancer cases have a hereditary component. If a first-degree relative (parent, sibling, or child) has been diagnosed with colorectal cancer or advanced adenomatous polyps, your lifetime risk approximately doubles compared to the general population.
Specific hereditary syndromes also require attention. Lynch syndrome (hereditary nonpolyposis colorectal cancer, or HNPCC) is the most common hereditary colorectal cancer syndrome, accounting for about 3% of all cases, and significantly elevates lifetime risk for colon, endometrial, ovarian, and other cancers. Familial adenomatous polyposis (FAP) is rarer but causes hundreds to thousands of polyps beginning in adolescence and carries a near-100% lifetime risk of colorectal cancer without intervention.
We ask about family history at every wellness visit, but please proactively share updates with us if a relative is newly diagnosed. If you are unsure whether your family history warrants earlier or more frequent screening, please ask.
Health Disparities in Colorectal Cancer
Colorectal cancer does not affect all populations equally. Black Americans have the highest incidence and mortality rates of colorectal cancer of any racial or ethnic group in the United States. The American Cancer Society and several major gastroenterology societies recommend that Black individuals begin screening at age 40 rather than 45 due to this documented elevated risk.
Hispanic and Native American populations also face elevated colorectal cancer risks, and screening rates remain lower across all underserved communities. Our practice is committed to equitable care, and we want every patient to feel encouraged and supported in completing their screening — regardless of what barriers may exist. If cost, transportation, language, or any other factor is an obstacle, please tell us. We will work with you to find a path forward.
Our Message to You This March
James Van Der Beek’s death at 48 was a tragedy — not an inevitability. His cancer was identified. His treatment was pursued. He fought with everything he had. The cruelty of cancer does not follow the rules of effort or worthiness. But his message to the world, delivered with grace right up to the end, was one of empowerment: get screened, know your symptoms, and don’t assume that being young or healthy means you are exempt.
Colorectal cancer is the second leading cause of cancer death in the United States. It is also one of the most preventable and detectable cancers we have. When caught early, it is very often curable. The tools to find it exist. The guidelines are clear. The only missing ingredient — for too many people — is action.
This March, we are asking every patient in our practice aged 45 and older — or younger with risk factors — to either confirm that their screening is current or schedule their next appointment. We are also asking you to share this article with someone you love who may be overdue. It is a conversation that can save a life.
Are you up to date? Call our office today to schedule your screening.
Medical Disclaimer: This article is intended for educational purposes and represents current general guidelines as of March 2026. It does not constitute individualized medical advice. Please consult with your healthcare provider regarding your specific risk factors, medical history, and the most appropriate screening strategy for you.
Sources: American Cancer Society · USPSTF · CDC · JAMA · Today.com · Cancer Therapy Advisor · OncoDaily