Community Health: Colorectal Cancer Awareness

Host Janet Michael sits down with Dr. Michael Avery, board-certified general surgeon, Colorectal surgery specialist with Valley Health Surgical Oncology at Winchester Medical Center  to discuss colorectal cancer — why awareness matters, who's at risk, how to screen, and how far treatment has come. Dr. Avery brings both personal backstory and clinical expertise to a conversation that could save your life.

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About Dr. Avery

• Originally from Charlotte, NC; discovered medicine through a hospital internship
• Completed undergrad at East Carolina University, medical school at Campbell University
• General surgery residency at Carolinas Medical Center; colorectal fellowship at UT Southwestern in Dallas
• Now practicing at Valley Health Surgical Oncology, Winchester Medical Center

Colorectal Cancer by the Numbers

• 3rd most commonly diagnosed cancer in men and women
• 2nd leading cause of cancer death
• 150,000+ diagnoses in 2023; approximately 50,000 deaths
• Nearly half of cases are linked to modifiable risk factors

Screening: What You Need to Know

• Screening should begin at age 45 for average-risk individuals (lowered from 50)
• If a first-degree relative was diagnosed, begin screening 10 years before their diagnosis age
• Gold standard: Colonoscopy — both diagnostic and therapeutic in one procedure
• Alternative options: Cologuard (DNA stool test, ~94–95% sensitivity), CT colonography
• A positive Cologuard result requires follow-up colonoscopy
• Colonoscopy prep and sedation have improved significantly — most patients feel comfortable and remember nothing

Warning Signs & Symptoms

• Rectal bleeding (hematochezia)
• Abdominal pain
• Changes in bowel habits (constipation or diarrhea)
• Iron deficiency anemia
• Unintentional weight loss
• Blood mixed in stool
• Note: Do not dismiss these symptoms at any age — young-onset colorectal cancer is rising

Risk Factors

• Non-modifiable: Family history, inflammatory bowel disease, genetics
• Modifiable: Sedentary lifestyle, obesity, diet high in processed meats/red meats/refined grains/sugar-sweetened beverages, smoking, excess alcohol
• Consuming 2+ sugar-sweetened beverages per day associated with nearly 2x increased risk

Who's Most at Risk

• Men are more prone than women and have higher mortality rates
• African American men face a disproportionately higher risk and younger onset
• Young-onset colorectal cancer is increasingly left-sided and rectal, which can be more life-altering

Advances in Treatment

• Minimally invasive surgery: hospital stays now typically 1–3 days
• Total neoadjuvant therapy for rectal cancer — organ preservation approach ("watch and wait") to potentially avoid surgery
• Targeted therapies and immunotherapies showing remarkable response rates for certain genetic profiles (e.g., work from Memorial Sloan Kettering)
• Early-stage colon cancer has an 85–90% five-year survival rate

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Key Takeaways

1. Colorectal cancer is largely preventable and highly treatable when caught early.
2. Get screened at 45 — or earlier if you have a family history.
3. Don't ignore symptoms — rectal bleeding and bowel changes deserve prompt evaluation.
4. A colonoscopy is the gold standard: one test, one time, can both find and fix the problem.
5. Treatment today looks nothing like it did for your grandparents' generation.

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Resources & Next Steps

• Talk to your primary care physician about scheduling a colonoscopy or Cologuard test
• Contact Valley Health Surgical Oncology at Winchester Medical Center to learn more about colorectal cancer screening and treatment
• Learn more at valleyhealthlink.com