Catch colorectal cancer early through screenings

Two-and-a-half years ago, Tanja Giles went in for what she expected to be a routine colonoscopy. While she didn’t have symptoms or a family history of cancer, she learned that day she had colorectal cancer.  

The Salisbury resident, 56, encourages people to get colonoscopies so they can catch any potential cancer early.  

“I think people have a false representation of what it means to have cancer,” Giles said. 

For example, that people would know something was wrong if they had it. Giles had no idea she had cancer, and now, when she doesn’t feel well, it’s usually a result of her cancer treatment, rather than the cancer itself.  

Two days after her colonoscopy, she said, she learned the cancer had metastasized to her liver and lungs. Giles’ cancer is inoperable, incurable and terminal, but she is fighting Stage 4 cancer through treatment at the TidalHealth Richard A. Henson Cancer Institute in Salisbury.  

March is Colorectal Cancer Awareness Month, and colorectal cancer is one of the most common types of cancer in the United States.  

Colorectal cancer stats 

In 2024, colorectal cancer was the fourth-most diagnosed and second-most deadly cancer in the United States, according to National Cancer Institute data. When looking at female and male data individually, colorectal cancer ranks third for both sexes (this is because breast cancer, primarily affecting women, is the most prevalent overall and prostate cancer, which can only affect men, is the second-most prevalent).  

Colorectal cancer is also a concern locally. Dorchester County has the highest age-adjusted incidence rate of colorectal cancer in Maryland per 100,000 residents, with 52.6, according to National Cancer Institute data. This compares to a national average of 36.4 per 100,000 and a state average of 35.2. 

Wicomico County ranks fifth highest among the state’s 23 counties and Baltimore City; Somerset County ranks 19th; and Worcester ranks 23rd, the data shows.  

Catching cancer early 

The earlier colorectal cancer is caught, the better the chances are for survival, said Salahuddin Siddiqui, MD, FACP, a TidalHealth physician who is also the program director for the TidalHealth Hematology & Medical Oncology Fellowship. 

If a patient is diagnosed while the cancer is still in Stage 1, and some cases in Stage 2, the cancer can be cured with just surgery, Dr. Siddiqui said. If the cancer is in Stage 3 or 4, chemotherapy is required for treatment.  

The U.S. Preventive Services Task Force recommends colorectal cancer screening for adults ages 45 to 75 and that it be selectively offered for patients ages 76 to 85. The recommended starting age was lowered from 50 to 45 in 2021. Colonoscopies are recommended every 10 years for those at average risk.  

Free screenings available 

Maryland residents who meet certain criteria are eligible to receive Cologuard, a free home test for colorectal cancer, through a program that started in February.  

Cologuard is not as precise as a colonoscopy, but it is a stool-testing option that people can easily do from home every three years. A prescription is required. 

Shane Assalone, the nurse case manager at the Wicomico County Health Department for the colorectal cancer screening program, described colon cancer as “sneaky.” By the time people have symptoms, the cancer may have progressed.  

“The idea is that you find the precancerous polyps,” Assalone said.  

Then, these can be removed.  

It can take a while to get on the schedule for a colonoscopy, so the Cancer Prevention, Education, Screening and Treatment, or CPEST, Program, helps fill the gaps. 

Clients receive case management from a registered nurse, Assalone said. To apply, talk to your primary care provider or call 410-548-5175 if in Wicomico County. 

Those who don’t qualify for this program can also talk to their provider about what test is recommended.  

If the Cologuard test comes back positive, the person will need to get a colonoscopy. It is possible to have a positive Cologuard test, but not have cancer.  

Colorectal cancer symptoms and prevention 

It’s possible to have colon cancer without symptoms, like Giles did.  

Dr. Siddiqui said other risk factors include a history of inflammatory bowel disease or cancerous or precancerous lesions. If there’s a reason to do so, people can get screened before age 45. For example, someone experiencing rectal bleeding should not wait to get screened just because they haven’t turned 45 yet.  

Moving forward 

Giles is now on the board of Unstoppable Joy, a local cancer support organization that supports people of any age who have any type of cancer. The people helped by the nonprofit, known as “cancer warriors,” can be located anywhere in the U.S. or beyond.  

Giles became involved through her business before she even knew she had cancer; now she is the nonprofit’s secretary and vice president of fundraising. Among the services the organization provides are healing bags, counseling support, activities and more. 

As a cancer warrior, Giles said communication with her doctor about how she’s feeling is important. She also recommends that people prepare for their appointments with questions, advocate for themselves, and ahead of a colonoscopy, start a liquid diet earlier in the week.