What Colorectal Cancer Awareness Month Means When You've Lost Someone

For most people, March is the month the world turns blue. Ribbons and graphics and awareness campaigns, here and then gone by April. For me, March is about my brother, Jimmy, who died from colorectal cancer at the age of 36.

I carry his absence into every colonoscopy waiting room I have ever sat in. A stool test flagged blood in 1994, opening a door to a diagnosis that came too late. Today, with all we know about Lynch syndrome — a genetic condition that significantly raises a person's risk of colorectal and other cancers — his story might have unfolded differently. Might. I have learned to live inside that word.

Colorectal Cancer Awareness Month isn't abstract for me. It is deeply personal, lingering even as many years pass and as I advocate for him.

So this March, I want more than awareness because awareness is just the start.

I urge you to act. Talk to your doctor about scheduling a colonoscopy. If you have a family history of colorectal cancer, ask about genetic counseling. Your primary care doctor can refer you to a certified genetic counselor. Have you received an abnormal stool test and ignored it? Stop waiting, follow up now, and make March a turning point. Let it mean action, not just awareness.

Colorectal cancer is no longer just a disease of older adults. Cases in adults under 55 have nearly doubled, from 11% of diagnoses in 1995 to 20% by 2019. Early-onset colorectal cancer is now the top cause of cancer death in people ages 20 to 49. Read that again. The number one cause. This is not something people in their twenties, thirties, and forties expect to face. And yet here we are.

Nobody has found a single reason why. Researchers point to obesity, heavy alcohol use, environmental factors like microplastics, and disruptions in the gut microbiome. A study published in Nature found a strong connection between childhood exposure to colibactin — a bacterial toxin that damages DNA — and colorectal cancer in patients under 40. This suggests the harm may begin before age ten, putting people on a collision course with the disease decades earlier than expected.

Science is still catching up to the trend. What we do know is that younger people are often diagnosed later because no one thought to look. Delays of up to 6 months from the onset of symptoms are common. As a result, younger adults have more advanced disease by the time anyone finds it.

If you have blood in your stool, persistent changes in bowel habits, unexplained weight loss, abdominal pain, or a feeling that your bowel never fully empties, do not talk yourself out of it. Do not wait. Those symptoms are reasons to call your doctor today.

For most people at average risk, screening guidelines recommend a colonoscopy starting at age 45. Repeat screening every 10 years if results are normal. For those with a family history or a genetic syndrome like Lynch, that timeline shifts. Sometimes screening is every one to two years, starting much earlier. Talk to your doctor about what your personal risk actually requires.

Consider this: People with Lynch syndrome who follow that every one to two year surveillance schedule have a lower risk of developing colorectal cancer than the general population. Not despite Lynch, but because consistent screening works. Polyps are found and removed before they become something worse. The scope that feels like an inconvenience is doing its job.

Jimmy didn't stand a chance. The surveillance, the genetic counseling, the hereditary cancer conversations — none of it existed for him the way it does now. He had a stool test, blood was found, and the diagnosis that followed came too late for any of it to matter.

That is why I have never once considered skipping a scope. Every time I sit in that waiting room, I am doing what Jimmy never could. I am using knowledge he never had.

Jimmy never saw his daughter take her first steps. He never saw her amazing achievements. He never got to see who she became. He was gone before any of it, taken by a syndrome written into his DNA that nobody knew to look for. He never knew he had Lynch syndrome.

He was 36. His life was full, but taken too soon. If his story moves even one person to act, someone who finally picks up the phone, then something of Jimmy goes forward in the world. My brother's death can become someone else's second chance. For every person who acts, he is not just remembered; his death is not in vain.

This piece reflects the author’s personal experience and perspective. For medical advice, please consult your health care provider.

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