Colorectal Cancer Screening Myths and Misconceptions

For many people, the word “colonoscopy” causes  unnecessary worry. In reality, common myths about colorectal cancer screenings often stand in the way of preventive care that saves lives. Whether you’re nervous about anesthesia or the thought of a colonoscopy makes you queasy, our experts can help you feel more confident and comfortable with your path toward early cancer detection. 

Let’s ditch the myths and find out the truth behind this life-saving exam.

Myth: “A colonoscopy is the only colorectal cancer screening.” 

The truth is that a colonoscopy is not the only option for colorectal cancer screening. While colonoscopies are strongly recommended and, at times, required by oncologists and gastroenterologists, there are several screening methods available that don’t involve a procedure. 

Your options for a colorectal cancer screening include: 

• Stool-based tests - Look for hidden blood or abnormal DNA in your stool, which can be an early sign of colorectal cancer or precancerous polyps. ​​These tests are noninvasive and often require regular follow-up, as set by your healthcare provider. Please keep in mind that if your stool-based test is abnormal, your gastroenterologist will usually recommend a  colonoscopy to get a closer look.
• Blood-based tests - Check for specific markers in the bloodstream that indicate an increased risk of colorectal cancer. While these tests are less invasive than a colonoscopy, they may not be recommended for people of a certain age or those with a family history of colorectal cancer. Similar to stool-based tests, abnormal results don’t always mean cancer, but they commonly prompt further evaluation, often a colonoscopy, to determine a diagnosis.
• Colonoscopies - Give trained providers the ability to examine the entire colon using a small camera while the patient is placed under general anesthesia or conscious sedation. Colonoscopies are the most comprehensive colorectal cancer screening option, as providers can remove polyps during the procedure to prevent cancer and provide a detailed view of your digestive tract.
• CT colonographies - Generate images of the rectum and colon using a CT scan. While this exam is less invasive, providers can’t remove colon polyps during it, and it may also warrant a follow-up colonoscopy.

It’s important to remember that screenings, especially colorectal cancer screenings, are not one-size-fits-all. 

“The best screening test is the one a patient will actually complete,” says Joel Kneitz, MD, a CommonSpirit Health internal medicine physician at Baylor St. Luke’s Medical Group in Sugar Land, Texas, and area medical director for South Houston. “Age, family history, and personal comfort all matter, and our role is to help patients choose an option that fits their life.”

What happens if a screening test comes back abnormal?

An abnormal colorectal cancer screening result can sound scary,  but it doesn’t automatically mean cancer. In many cases, it simply means your doctor needs more information.

If a screening test comes back abnormal, the next steps may include:

• Additional testing, often a colonoscopy, to take a closer look
  

• Removing polyps or examining areas of concern before they become more serious
  

• Monitoring over time with colon and rectal cancer care, depending on the findings

Myth: “If I feel fine, I do not need a colorectal cancer screening.”

The truth is that colorectal cancer often develops without any noticeable warning signs, especially in its early stages. Many people feel completely healthy when changes in the colon have already begun. 

When colorectal cancer or precancerous polyps are found early, before symptoms appear, treatment is often more effective and less invasive. In many cases, screenings can identify and remove polyps before they ever have the chance to turn into cancer.

“We’re seeing colorectal cancer in younger adults more often than we used to,” says Dr. Joel Kneitz. “That’s why current screening recommendations start at age 45 for people at average risk.” 

Meanwhile, those with an increased risk of developing colorectal cancer may need to start screening earlier or schedule more frequent examinations due to the following risk factors: 

• Family history of colorectal cancer, especially in a parent or sibling
• Inherited or genetic conditions that increase risk levels, like Lynch syndrome or Familial Adenomatous Polyposis (FAP)
• Inflammatory bowel diseases, such as Crohn’s disease or ulcerative colitis

By talking with your healthcare provider about your personal health history, you can receive clear guidelines on when to start and how often you should return for follow-up screenings.

Myth: “Colonoscopy prep is difficult and painful.” 

The truth is, colonoscopy prep is often more manageable than many expect. While colonoscopy prep can cause frequent bouts of diarrhea, this part of the process is designed to safely and thoroughly clean out the colon, giving providers a better view during the procedure.

“Prep is rarely anyone’s favorite part, but it shouldn’t be painful,” says Dr. Joel Kneitz. “Most patients tell us it’s not as bad as they thought it would be.” 

Colonoscopy prep usually involves a few simple steps:

• Follow a clear-liquid diet the day before the procedure
• Take a prescribed prep solution, like laxatives, to loosen stool and prompt bowel movements the day before the procedure
• Stop consumption of all liquids around three to four hours before the procedure

While colonoscopy prep can be inconvenient and may keep you home for 24 hours beforehand, it shouldn’t cause pain or prolonged symptoms. By following your provider's clear prep instructions, you reduce the need for repeat testing, as a clean colon gives providers the best chance of detecting changes that they may otherwise miss.

Myth: “A colonoscopy is a long and painful procedure.”

The truth is, a colonoscopy is a quick, often pain-free procedure. 

While colonoscopy prep begins the day before, the procedure itself lasts about 20 to 30 minutes, with an hour or so to recover at the hospital or clinic. 

During a colonoscopy, you will be given medication to help you relax and remain comfortable. Before the procedure, your care team will discuss your medication options with you: 

• General anesthesia - Causes you to be fully unconscious for the procedure, similar to a deep sleep. You won’t be aware of what’s happening and won’t feel pain, pressure, or discomfort. Most people have no memory of the colonoscopy afterward. This option is less commonly used and may be recommended based on your health history or provider preference. 
• Conscious sedation - Uses medication to help you relax deeply during the procedure. You may fall asleep or remain lightly awake, but most people feel very comfortable and remember little, if anything, afterward. You may be able to respond to simple instructions, but pain and discomfort are typically minimal or not felt at all. This is the most common option for colonoscopies.

No matter the route you take to your colonoscopy, pain is rarely reported in patient experiences, as the care team prioritizes your comfort and safety. 

How to choose the right colorectal cancer screening for you

Choosing which path you’re going to take for colorectal cancer screening doesn’t have to be overwhelming. Start by chatting with your healthcare provider about your options and preferences. 

Once you’ve been shown all your options and have considered your comfort level, your provider will consider your health factors to give you a clear answer to which colorectal cancer screening is best for you. 

Don’t let health myths get the best of you. Talk with your healthcare provider about your screening options and take the first step toward prevention and self-care today. 

Don’t let health myths get the best of you. Talk with your primary care provider about your screening options and take the first step toward prevention and self-care today.