Ask the Experts


The Importance of Colorectal Screening

with Michael Remar, MD, FACS and Carol Lesage, PA-C
by Cherry Odom, BSN, RN, NPD-BC

Michael Remar, MD, FACS, a board-certified general surgeon at St. Joseph Hospital, shares his personal experience with colon cancer’s impact on his family. 

Carol Lesage, PA-C, a certified physician’s assistant with St. Joseph Hospital Gastroenterology, answers questions about the importance of colorectal cancer screenings.

For Me, It’s Personal

Dr. Remar’s older sister, Katy, developed colorectal cancer at age 45. At the time, she had two young children. Two years later, she passed away of metastatic colon cancer, leaving her husband to raise their kids as a single parent.

“Losing my sister frightened me and my wife, as we had small kids too,” shares Remar. “So, I followed the advice of my doctor, which was to begin colonoscopies 10 years before my sister’s age of diagnosis. I started in my 30s and have had a colonoscopy every five years since.”

Remar has worked at St. Joseph’s Hospital for 28 years. You might think it would be embarrassing for him to have his screenings done where he knows the staff, but he disagrees. He says, “The prep is no fun, but the colonoscopy is a completely uneventful thing. The whole team gives me such great care. The sedation you receive is just a nice sleep. You do not even realize you are having the procedure done.”

After each and every colonoscopy, Remar has a tradition of going out to enjoy a giant breakfast with his wife. He shares, “The only thing anyone should be afraid of is not having it done. It is one of the few things we do in medicine that can prevent the development of cancer.”

Learn More with Carol Lesage, PA-C

Why is 45 years old now the recommended age to begin periodic screening for colorectal cancer?

In May 2018, the American Cancer Society changed the age from 50 years old to 45 years old due to increasing incidences of colon cancer in adults younger than 50.

What is colorectal cancer?
It is a malignancy anywhere in the large intestine or rectal section of the colon. The cancer usually starts with a polyp, a small cluster of cells on the intestine’s inside lining. Some polyps do not become cancerous. Other polyps, called adenoma, are precancerous and will likely turn into cancer, if not removed.

What are some of the risk factors for this cancer?

  • Family history of colorectal cancer
  • Personal history or family history of large, multiple or precancerous polyps
  • Being overweight or obese
  • Eating a diet high in red meats and processed meats
  • Smoking
  • Physical inactivity

What are common symptoms?
Some people notice bowel changes, such as new constipation, rectal bleeding or abdominal pain. Unexplained weight loss may also be of concern. Any change in bowel habits should be reported to your health care provider. Sometimes colorectal cancer is present when there is no evidence of bleeding. Conversely, rectal bleeding may only occur after the cancer is very advanced. We do not want our patients to wait until they have symptoms to get screened.

When and how often should someone get screened?
Everyone should have a colonoscopy at age 45 years old or earlier as recommended by their doctor when there is a family history of colon cancer. If someone has precancerous or large polyps or a lot of polyps, we may ask them to repeat their screening every three to five years.

To make an appointment, call 603.578.9363. If necessary, be sure to ask your primary care provider for a referral.